Children with apraxia face harsh realities

Posted on 05/02/2022 06:00


(Credit: Kleber Sales)

The first signs of a person’s development appear in early childhood (up to five years of age), such as children’s speech and motor coordination. But parents need to be aware of this process, because what seems to be a common delay may actually be a diagnosis of apraxia – a nervous dysfunction that affects the planning and programming of the sequences of movements needed to create speech that is also poorly understood. In Brazil.

Considered a disorder, it can affect communication, motor coordination, or both at the same time, leading to depression in children. In contrast to autism – where children isolate themselves – children with apraxia struggle to hear and understand the difficulties that their brains impose on syllables, words and sentences – as if a computer were sent to print a message, but the printer would not work. Function, since there is a block in sending data.

Apart from that, there is a lack of information about this disease in the country. The range of literature available is mostly from the United States, leading to errors and late diagnoses. Also, the International Statistical Classification of Diseases and Related Health Problems (ICD) for apraxia in Brazil was the only number available in May 2021.

It is unknown at this time what he will do after leaving the post. “Previously, children would go to a speech therapist and therapist with an ICD (code) for TEA (Autistic Spectrum Disorder),” said Milena Nasimento, a child therapist, resident of Vicente Pirates, and the mother of 4-year-old Maria, who suffers from apraxia. .

Amidst the difficulty of finding adequate answers and treatment, a group of mothers formed the Brazilian Association of Speech Apraxia in Childhood (Abrapraxia). In this way, other families can now get help and information about their children’s disorder and thus avoid late diagnosis. Fabiana Kolavini, president of Abrapraxia, said her daughter Anna Beatriz was a quiet child, but her mother-in-law, who is a psychopadag, said the girl was “not in the neuro-developmental milestone” and, therefore, went after help.

Intervention

“At the age of 11 months, we started speech therapy and physiotherapy interventions, but, in the case of physical therapists, there were benefits, and in the case of speech therapists, no. He did not speak and only sound “The mother said,” he explained. “Until the age of 5, we have a window of opportunity. Speech is one of the most important points for socializing children. My daughter communicates well with words. She does not form sentences,” he added.

Mariana Chui, Gabriel’s mother, was 11 years old and involved and became the director of Abrapraxia. “Gabriel was a quiet child, he didn’t talk and he didn’t sound like a normal baby. Compared to his friends of the same age, his situation was different. The first sign we noticed was the engine, because he didn’t clap his hands on his birthday When the child starts pointing at the body parts and asking things like the face, he cannot identify the parts of the body, “she says.

“The diagnosis here was unknown and it was through speech therapy and all the material was American and the association’s job was also to translate it. We were able to translate the technical reference book”, he highlighted. He describes how to treat childhood apraxia of speech and the Speech Pathologist’s Guidelines for the Treatment of Childhood Apraxia of Speech: Effective Therapy Strategies for Toddlers, Preschoolers and School-age children.

Milena Nascimento of Brasilia said it took a while for her daughter to be diagnosed because Maria was born with laryngomalacia (a laryngeal abnormality that causes odor and shortness of breath) and the problem was first addressed. However, as the laryngomalacia became cold, the child was unable to develop speech. “I said something was wrong and I suspected apraxia. I am a pediatric therapist and I treat children with disabilities and other disabilities and that is why I became suspicious. Went, which is a reference to this, “he explained.

“My first contact with Dr. Justy was remote due to the epidemic and Maria had a pre-diagnosis. At Gusty’s direction, we took her to a speech therapist in Brasilia who works under Justy’s supervision in Sওo Paulo,” he said. Rarely do people know how to treat apraxia and our biggest problem is finding out who diagnoses it, “he lamented.

Julian Tosin, vice-president of the association, said his 11-year-old daughter, Giovanna, showed the first signs of the disorder through motor coordination. “When he was a year old, he wasn’t even close to starting walking. Then came the speech,” he said.

“We took Giovanna to a speech therapist because she had difficulty speaking. The specialist said she did not work with a child who showed things, that she could express what she wanted to say, but could not speak, but spoke.” He said

Diagnosis

According to Elizabeth Gusti, counselor at Abrapraxia, speech therapist, the diagnosis of apraxia will be made by speech therapists who have experience in the area. “Many aspects must be evaluated, such as the integrity of the vocal organs, language skills, playing and especially the motor aspects of speech, including the analysis of children’s vocabulary, the type of error it presents, the parameters of speech movement, the level of speech comprehension among others.” Diagnosis is made from observation and analysis in specific tests and functions. There is no clinical imaging test or any other type that detects apraxia “, he explained.

According to experts, the difficulties not only concern the speech, but also reach the ability to feed, suck and imitate children. “Although a final diagnosis is possible, with an average age of about 3 years, before that, we can already detect several warning signs,” he said. JUSTY further highlights that lack of access to adequate treatment can create secularization in the lives of adults, such as mental disorders. “These children realize that they can’t express themselves well and this creates a lot less self-esteem and insecurity,” he highlights. According to him, they can develop depression, anxiety and social isolation.

“An important way to help is to understand that apraxia is not a lack of stimulation, much less laziness. The child has a problem. Avoiding the stress of talking or repeating the speech is already an important way to help. Routine and organization are also important, “he concluded.

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