1. Understand the Different Types of Apraxia
Apraxia is a brain disorder characterized by the loss of a learned, skilled movement. People with apraxia understand how to perform the movement and have a desire to perform the movement, but they cannot execute the movement. There are several types of apraxia, and the types are often grouped in a variety of ways.
Buccofacial or oral apraxia affects movements the facial muscles, mouth and tongue such as whistling or blowing. This is the most common type of apraxia. Limb-kinetic apraxia is a type of the disease that affects fine motor movements of the arms or legs, such as using tools. Apraxia of speech affects the ability to make the sounds of speech. There are several other less common types as well. Apraxia can also be ideomotor, characterized by inability to perform movement in response to a command, or ideational, characterized by inability to string multiple movements together to perform a task. You may notice that a patient has more than one type of apraxia at the same time. This is common.
2. Seek Physical Tests to Identify Apraxia
Rehabilitation specialists use specific tests to diagnose someone with apraxia. If you are concerned about an elderly or bedridden patient, these tests can be performed bedside. To test for limb-kinetic apraxia, the patient is usually asked to pantomime common activities like brushing teeth or hammering a nail into a wall. The therapist will look for errors in the pantomime such as the patient holding the tool wrong to use as indicators of apraxia. To diagnose buccofacial apraxia, the patient is asked to perform movements with his mouth like blowing out a candle or blowing a kiss. Again, errors in these movements are used to identify apraxia.
Diagnosing apraxia of speech can be very difficult. This disorder can be developmental or acquired. For developmental apraxia, parents and speech-language pathologists have to work together to monitor a child's speech over time. They monitor for difficulty saying words correctly, particularly longer words. The ability of a patient to read, write and carry on a conversation is also used to diagnose acute apraxia of speech.
3. Differentiate Between Other Disorders
All types of apraxia can be challenging to diagnose, because the symptoms of this disorder can be caused by numerous other factors. For example, inability to perform fine motor skills could be caused by muscle weakness or paralysis rather than limb-kinetic apraxia. A stroke is a common cause of muscle weakness, paralysis and apraxia, so it can be difficult to differentiate between the causes using the underlying diagnosis alone. Likewise, dementia and traumatic brain injuries are conditions that can lead to a number of symptoms that look like apraxia. To determine if someone truly has a type of apraxia, it's necessary to rule out weakness, paralysis, cognitive impairments and sensory loss. In some cases, this can be complicated by the co-morbidity of one or more of these conditions.
