how to identify apraxia in children?

Apraxia is inability to do a coordinated or skillful task that is commonly performed by a normal person. It is a neurological disorder and does not involve the muscular system. The muscles do not show any sign of weakness or paralysis, yet they are unable to use a familiar object, or imitate a particular movement, or respond to a command. The parents being close with their children, can find the problems in them very easily. Mothers have the habit of comparing their children with the children of their neighbors, friends or family members who is of the same age. Thats how they identify many things (even the things that a doctor could miss) and this is something to be appreciated in them.

Identifying different signs of apraxia in children under various classifications:
1. Ideational apraxia where parietal-occipital portion of the brain is affected. Here, the child may not be able to complete a particular task from the idea with which he started. He might have taken a comb in his hand to comb his hair but instead he will be rubbing the comb to his hand as though he has forgotten or is thinking what to do. Their actions are very slow and disorganized, but eventually they complete the task they started. Similar problems can be seen in brushing the teeth.

2. Ideo-motor apraxia where the parietal lobe of the brain is affected. The child will not be able to do something which you command him to do, in spite of his good sense of hearing and muscle strength. If you tell him to go and bolt the door, he will go to the door and just hold the knob or just do something else standing near the door but will never bolt them. He never accomplishes the task given to him. They will be able to do the same task automatically when it is not commanded.
Other examples: Commanding him to cut a paper using scissors.
Commanding him to unbutton his shirts.

3. Kinetic apraxia where the frontal lobe of the brain is affected. The child's movements are very coarse and clumsy. They cannot use a spoon or even hands to eat in a neat way while the children of his age will be able to do so.
Other examples: Poor handwriting and drawing
Poor way of coloring a picture
Inability to walk in a straight line
Inability to tap the foot or wave good-bye

4. Speech apraxia occurs when Broca of brain is affected. It comes under kinetic apraxia where the child is unable to utter words fluently or pick up a language quickly.
For example: They mispronounce or repeat or even stammer
They have improper coordination of lips, tongue and jaw.

5. Limb apraxia is connected with ideomotor apraxia where the child is unable to do fine movements using his limbs when is commanded to do so.
For example: Opening a lid of a bottle
Holding a pencil or pen
Thread a needle
Making a salute
Jump up and down in a place

6. Buccofacial or oral apraxia is also associated with ideomotor apraxia. It is also called as non speech apraxia. Here, the child will be able to talk but not use his facial muscles in an effective way when they are commanded.
For example: Blow a whistle or candle
Lick the lips
Stick out the tongue
Suck a drink using a sipper or straw
Wink an eye

7. Constructional apraxia is where the child is unable to carry out simple things which the child of his age could do.
For example: Drawing a picture of an apple

8. Oculomotor apraxia does occur but rare. Here the child is unable to respond or coordinate the movements of the eyeball.

All these signs can occur at an early age (infant) or may even start abruptly as a preschooler or schooler. They are usually accompanied with language problems. In infancy, the child does not reach the milestones at the right time. There might be delay in head control, or giving a social smile (limited facial expression). They might have their first words spoken very late and have excessive salivation when trying to speak.

When you find a delay in your child's speech or action, consult a doctor as early as you can. A team of neurologist, neurosurgeon, nurse, psychologist, speech therapist and occupational therapist can definitely help your child to get out of this problem.