Who Experiences Apraxia?
- In general, one third of people with left brain damage experience apraxia (Gillen, 2009).
- Apraxia has been documented in the following populations: stroke (higher prevalence in left-sided vs. right-sided), left hemisphere acquired brain injury, Alzheimer's disease, Parkinson's disease, supranuclear palsy, and Huntington's disease (Gillen, 2009).
Remember that apraxia is not due to weakness, incoordination, sensory loss (such as a vision deficit), incomprehension or inattention to commands.
Apraxia & Aphasia
- Apraxia and aphasia can occur at the same time (Quintana, 2008). Both impairments are common in people with left hemisphere brain damage (Gillen, 2009).
- Aphasia is defined as a: "language disorder caused by brain damage that affects production and/or comprehension of written or spoken language" (Woodson, 2008, p. 1002)
- According to Gillen (2009) there is an apparent strong association between:
2) Aphasia & severe Ideational Apraxia
- Clinical application: The presence of both aphasia and apraxia can complicate functional retraining.
- For example, a typical compensatory technique for people with aphasia is to gesture. However, ideomotor apraxia results in impaired gesture ability.
- Intervention & Assessment Tip for clients with both Aphasia & Apraxia: do familiar tasks within logical environments, at the appropriate time of day (Gillen, 2009).
- When evaluating a client with aphasia, ask questions that can be answered by yes/no responses and by pointing to the correct answer (Quintana, 2008).
- For example ask, "Is this the correct way to use a pair of scissors?", wait for response, then ask "Show me how you would use this pair of scissors." If you are confident the client was able to respond correctly to the first question, yet was unable to make the appropriate movements, the client may be apraxic.
- In terms of recovery, a significant finding is that clients with apraxia who improve during their in-hospital rehabilitation on functional measures, may worsen when discharged home (Gillen, 2009). This finding may support in-home rehabilitation, allowing skills to be transferred to this environment.