Motor-Limb Apraxia

Overall apraxia” is often referred to as “limb apraxia,” referring to the arms and legs. Like verbal apraxia, it has a number of names. It is also referred to as “motor planning” deficits, global apraxia/dyspraxia, postural praxis, etc.

SOFT SIGNS

Typically we are seeing mild soft signs in children with apraxia. The average parent or even pediatrician can’t always spot them, why either a pediatric neurologist or developmental pediatrician evaluation is highly recommended if apraxia is diagnosed or suspected. Apraxia in itself is not a cognitive or receptive disorder, so the child knows what is expected of them. But face it -not much is expected of a 3 year old. So typically they are able to push themselves to keep up when younger. Why the neurologist is recommended early on. It’s as they get older, maybe school age, where more is expected of them and can’t keep up that they may start to break down. For example sitting upright at a desk for hours if they have hypotonia in the truncal area. So better to diagnose early so if there are any of these soft signs going on it can be addressed through early intervention as well through insurance and the IEP before they get to primary school.

MILD HYPOTONIA

A child with hypotonia will feel heavier than a child of the same weight without hypotonia (kind of like the difference between picking up your child when he’s fast asleep vs. awake) Hypotonia can be anywhere in the body. Does your child appear to tire faster than other kids his age walking in the mall etc.? Will you and your wife not dream of taking him anywhere without the stroller because you know if you don’t bring the stroller you will be stuck carrying him because if you don’t pick him up he will sit on the floor crying with his arms in the air for you to pick him up again? And since he’s nonverbal -you will get looks from people passing by, or perhaps even comments -that your child is acting spoiled. When you pick him off the floor -it’s not as easy as it looks for you -or others that try! Most will say “wow he’s solid!” when picking him up. “Solid” is the word used by almost everyone to describe your child when people pick him up come to think of it. His body may look small and light -and many times both look like a cherub, and feel a bit like a marshmallow -rounded and soft. He may sit in the “W” position. If a child has severe hypotonia -he may look a bit like a rag doll (those are the children however that are spotted early however) -gravity just pulls them down. For a school age child -look for the child who can’t sit at the desk long before leaning down on it. The child who when waiting on line will either lean or sit down. The child (or adult) with rounded shoulders who is always being told “stand up straight!” or “sit up!” etc.

Our PT’s and OT’s have specialized education and training in the treatment of children with motor-linb apraxia!