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Apraxia Lecture Notes

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Apraxia is an effect of neurological disease. It makes people unable to carry out everyday movements and gestures.

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PSY 2C 08: BRAIN, BODY AND
BEHAVIOUR
UNIT–I: BRAIN AND BEHAVIOUR
TOPIC: APRAXIA

, APRAXIA

Apraxia is an effect of neurological disease. It makes people unable to carry out everyday movements and
gestures. For example, a person with apraxia may be unable to tie their shoelaces or button up a shirt. People
with apraxia of speech find it challenging to talk and express themselves through speech. The term apraxia
was coined by steinthal in 1871. During the last century it has been used to describe a wide variety of
neurologically induced, acquired and developmental disorders including Buccofacial apraxia,
constructional apraxia, dressing apraxia, gait apraxia, gaze apraxia, limb apraxia, speech apraxia. De
ajuriaguerra and Tissot( 1969) suggested that it may be necessary to abandon the general concept of apraxia
as a class of disorders in favour of a description of various specific apraxia. Lippmann' s (1977) earliest
writings at the turn of the century suggested that the term apraxia should be used when the genesis of the
disorder was motor in nature .


Hughlings Jackson (1884) proposed that the central nervous system was hierarchically organized. At the
lowest level the behavioural repertoire is limited and the responses are stereotypic. As the level heightens
the behavioural repertoire becomes more complex and less stereotypic. Where as the behaviour mediated
at the lower levels cannot be modified and appear to be automatic or involuntary, the behaviour mediated
at the highest levels are learned, can be modified and appear to be voluntary. We use the term apraxia to
denote a loss of learned behaviour. Therefore, we define apraxia simply as a neurological disorders of
learned purposive movement skill that is not explained by deficits of elemental motor or sensory systems.


TYPES


• Apraxia of speech (AOS): Difficulty planning and coordinating the movements necessary for
speech (e.g. Potato=Totapo, Topato).AOS can independently occur without issues in areas such as
verbal comprehension, reading comprehension, writing, articulation or prosody.
• Buccofacial or orofacial apraxia: This is the most common type of apraxia and is the inability to
carry out facial movements on demand. For example, an inability to lick one's lips, wink, or whistle
when requested to do so. This suggests an inability to carry out volitional movements of the tongue,
cheeks, lips, pharynx, or larynx on command.
• Constructional apraxia: The inability to draw, construct, or copy simple configurations, such as
intersecting shapes. These patients have difficulty copying a simple diagram or drawing basic
shapes.
• Gait apraxia: The loss of ability to have normal function of the lower limbs such as walking. This
is not due to loss of motor or sensory functions

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