Complaints & connections · borters.ch
Apraxia verbalis
The word is there and correctly thought — only the mouth cannot find the route, because movement planning stalls.
Also known as: apraxia of speech · verbal apraxia · motor speech programming disorder · orofacial apraxia (related)
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
In apraxia of speech neither language is lost nor muscles paralysed — it is the planning of the speech movement that stalls. The word is fully there, clearly thought and correctly chosen, but the mouth cannot find the route to it. Lips and tongue search, start, correct, start again. This is tormenting, because people hear their own error and still cannot hit the target. Three things are typical: visible searching movements before speaking, changing errors on the very same word — one way now, another way seconds later — and the observation that automatic speech works far better than deliberate speech. Counting, weekdays, a greeting, song lyrics, prayers or a spontaneous swear word come out by themselves, while the same word on request will not. That is exactly what breeds the misunderstanding that someone could do it if they only wanted to. They cannot: these are simply two different routes in the brain. The cause is usually a stroke in the left hemisphere, less often an injury or a progressive disease; apraxia of speech very often occurs together with aphasia, which makes telling them apart hard. It belongs in the hands of speech therapy: many short sessions with high repetition, work through rhythm, melody and speaking along, plus visible and touchable cues. In Switzerland speech therapy is prescribed by a doctor and covered by basic insurance. How this is worked on in speech therapy — amount, duration, limits and the signs that are urgent — is ordered by age at logopaedie.borters.ch.
Aphasia, dysarthria and apraxia need different practice routes — the distinction decides the therapy.
Few target words, practised very often, daily in small doses — volume and regularity are what count here.
Tap a beat, sing, speak along together: carried by rhythm, words often leave the mouth more easily.
Model the mouth shape, use a mirror, point to lip position — the movement becomes more tangible.
Move from a counting series or song into the target word: the well-worn route pulls the hard word along.
Under time pressure and excitement almost nothing works. Calm, no audience, no test setting helps at once.
Relatives may simply wait. Handing over the word instantly removes exactly the practice that matters.
Writing, pointing, gestures or an app bridge daily life without giving up on speech — the two go together.
There is no drug. What works is frequent practice in small units: in children, studies show an effect from three to four sessions a week over several months — frequency counts for more here than the length of the individual session. Practice targets sequences of movement, not single sounds, because planning the sequence is the problem. Melody and rhythm as aids have been studied; speaking in time often succeeds better than free speech.
In children the frequency is about one to two in a thousand. Typically the same word succeeds one time and not the next — that variability separates it from an articulation disorder, where a sound is consistently made wrongly. Three to four short sessions a week over at least eight weeks are effective; longer, less frequent sessions work less well. After a stroke it improves mainly in the first six months.
Lips and tongue grope about before the word, starting over — as if the mouth were hunting the right position.
The same word fails twice in a row in quite different ways — unlike in dysarthria.
Counting, greetings, song lyrics or swearing come easily — the same word on request does not.
Word onsets need a run-up; syllables get evenly or wrongly stressed, speech sounds chopped up.
Immediate self-correction and another attempt — a sign that thinking and language knowledge are intact.
The combination is the rule. Only a speech-therapy assessment separates planning from word retrieval.
A lack causes exhaustion, problems concentrating, low mood and forgetfulness — and it is one of the few causes that can be found and put right with a single blood draw.
Low values are common with low mood. Whether correcting it lifts the mood is not settled; that it makes sense in winter at our latitudes is.
An empty store causes tiredness, lack of drive and problems concentrating long before any anaemia becomes visible. In women of childbearing age the most common single reason.
A building block of the cell coverings in the brain. The studies on mood are inconsistent; as part of a good diet it belongs there anyway.
Needed for making the messengers in the brain. It runs short with alcohol and under certain medicines — and it is always judged together with B12.
In apraxia of speech the planning of the movement is disturbed, not the muscle and not the nutrient. What helps is frequent, short, very regular practice — several times a day rather than once a week. No preparation intervenes here, and saying so openly is worth more than a recommendation into the blue.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
Speech therapy is responsible: repeated practice of sound sequences with feedback. The amount counts here too — frequent short sessions beat rare long ones.