In the complex world of Apraxia vs. Autism: Key Differences terms like “Apraxia” and “autism” often cross paths, leading to confusion for many. To demystify the subject, let’s delve into what Apraxia is, how it differs from autism, and why it’s essential to have a clear understanding of these conditions.
1. Defining Apraxia
Childhood apraxia of speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g. Abnormal reflexes, abnormal tone). CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known and unknown origin, or as an idiopathic neurogenic speech sound disorder. The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody. (ASHA, 2007b, Definitions of CAS section, para. 1).
2. Autism Spectrum Disorder
Autism, or Autism Spectrum Disorder (ASD), is a complex neurodevelopmental disorder that affects individuals in various ways and to different degrees. The symptoms of autism can manifest differently in each person, but some common characteristics and behaviors associated with autism include:
- Social Challenges:
- Difficulty with social interactions and relationships.
- Trouble with understanding and interpreting social cues like facial expressions, tone of voice, and body language.
- Difficulty in making and maintaining eye contact.
- Limited interest in or understanding of other people’s feelings.
- Communication Difficulties:
- Delayed speech or language development.
- Repetitive or unusual speech patterns, such as echolalia (repeating words or phrases).
- Difficulty in starting or maintaining conversations.
- Challenges in understanding and using non-verbal communication, such as gestures and facial expressions.
- Repetitive Behaviors and Interests:
- Engaging in repetitive movements, like hand-flapping, rocking, or spinning objects.
- Developing intense, narrow interests in specific topics or objects.
- Following routines and rituals, and becoming distressed when routines are disrupted.
- Sensory Sensitivities:
- Heightened or diminished sensitivity to sensory stimuli like light, sound, texture, taste, or smell.
- Reacting strongly to sensory input, which can lead to sensory overload or meltdowns.
- Difficulty with Changes:
- Resistance to changes in routines or environments.
- Difficulty transitioning from one activity to another.
It’s important to note that not all individuals with autism will exhibit all of these symptoms, and the severity of these symptoms can vary widely. Autism is often referred to as a “spectrum” because it encompasses a broad range of abilities and challenges. Diagnosis and treatment are typically carried out by healthcare professionals or specialists who assess an individual’s specific symptoms and needs. Early intervention and appropriate support can significantly improve the quality of life for individuals with autism.
3. Symptoms of Apraxia
Speech Apraxia
In cases of speech apraxia, individuals may experience the following symptoms:
- Difficulty pronouncing words or sounds clearly and correctly.
- Inconsistent speech errors.
- Struggling to string together words or syllables.
- Using simpler words to avoid more complex ones.
- Difficulty coordinating motor movements due to which speech is not present at all.
4. Symptoms of Autism
Communication Difficulties
In the realm of autism, communication difficulties are prevalent. These can include:
- Limited or absent verbal communication.
- Difficulty with non-verbal communication, such as maintaining eye contact.
- Challenges in understanding and using gestures.
- Same gesture for everything.
- Social Communication
- Echolalia or gestalt language processor
5. Diagnosis and Evaluation
When it comes to diagnosing apraxia, a comprehensive assessment by a speech-language pathologist is recommended. This evaluation assesses the individual’s speech and language abilities, looking for impairments in body structure and function, including underlying strengths and weaknesses in speech sound production and verbal/nonverbal communication, and any comorbid conditions as well as any personal or environmental factors.
Autism, on the other hand, is diagnosed through a comprehensive assessment that considers a range of behaviors and developmental milestones. Autism evaluations typically involve a team of professionals, including psychologists, pediatricians, and speech therapists.
6. Causes and Risk Factors
CAS can be congenital, or it can be acquired during speech development. Both congenital and acquired CAS can occur
- as an idiopathic neurogenic speech sound disorder (i.e., in children with no observable neurological abnormalities or neurobehavioral disorders or conditions);
- as primary or secondary signs within complex neurobehavioral disorders (e.g., autism, epilepsy, and syndromes, such as fragile X, Rett syndrome, and Prader–Willi syndrome; Bashina, Simashkova, Grachev, & Gorbachevskaya, 2002; Boyar et al., 2001; Scheffer et al., 1995; Spinelli et al., 1995); or
- in association with known neurological events (e.g., intrauterine or early childhood stroke, infection, trauma, brain cancer/tumor resection; see, e.g., Brown et al., 2000).
Autism, too, has no single identified cause, but is thought to result from a complex interplay of genetic risk factors, neurobiological and environmental factors.
7. Treatment for Apraxia
When it comes to treating apraxia, speech therapy is the primary intervention. Speech therapists work with individuals to improve their motor planning and speech coordination skills. The frequency and intensity of therapy sessions may vary depending on the severity of the condition.
In Apraxia Speech Therapist work on the oral musculature – jaw, tongue, lips through Oral Placement Therapy in which a child learns (motor programing approaches) to coordinate movements of their articulators and they also learn dissociation and grading of required muscles of the abdomen. They also learn linguistic approaches where they learn how to make a speech sound. Apart from this prompting, visual prompting/ cueing, Apraxia programme are some of the techniques to treat Apraxia.
8. Treatment for Autism
Autism treatment often involves a multi-disciplinary approach. Applied Behavioral Analysis (ABA), Speech and Language Therapy, Social Communication Therapy, Occupational Therapy, and developmental interventions are commonly used to address specific needs and challenges of the individual. Basically, early intervention and all required therapies on a regular basis helps in the improvement in all areas.
9. Success stories about Autism and Apraxia
In my career, I have worked with many children who got admissions to the best colleges are now working with the best companies of the world. However, when the intervention started years back it was difficult to see the picture of their bright future.
Many children moved into mainstream classes from special education, after developing their communication skills while using these skills in their academics. Children have shown improvement up to 99% in their language and communication skills after few years of regular Speech and Language Therapy.
10. Conclusion
In conclusion, understanding the differences between Apraxia and autism is crucial for providing appropriate care and support to individuals affected by these conditions. While both are neurodevelopmental disorders, they manifest in distinct ways, with speech Apraxia primarily affecting speech and autism impacting a broader range of social and communication skills. If you suspect that you or someone you know may be dealing with either of these conditions, seeking professional evaluation and support is the first step towards improving their quality of life. Remember, early intervention and tailored therapy can make a world of difference in the journey towards improved communication and overall well-being
Bibliography and learn more about Apraxia and Autism-
https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/
https://www.asha.org/practice-portal/clinical-topics/autism/