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Wednesday, August 10, 2011

Just Say No To Apraxia

a-prax-i-a:  the inability to perform particular 
purposive actions as the result of brain damage

I remember when Bob was first diagnosed with apraxia. This particular diagnosis came from the Speech Therapist at Outpatient Rehab, but also OT and PT seemed to be on board. Every time Bob failed to follow directions, all of the therapists would shrug and shake their heads and say It's his apraxia.

I also remember having my doubts. Are you sure? I would ask. I remember the ST giving me this look that could only be interpreted as I'm the one with the degree and you're an idiot.... Then she'd demonstrate by asking Bob to do something, such as:

ST: "Point to your nose."

Bob stares at her blankly.

ST: "Bob? Can you point to your nose?"

Bob: "Yes."

ST: "OK, do it. Point to your nose."

Bob: "OK" but he does not do it.

ST: "Do you understand what I'm asking you to do?"

Bob: "Yes." But he still doesn't do it.

ST (to me): "See? He understands but he can't do it."

Me: Hmmmmm.....

And on and on, all the therapists in unison: "It's so hard, especially with his apraxia..." every time Bob had difficulty following directions. Me, I still had my doubts. I mean, was it so much that he couldn't control his movements or was it that he just didn't understand the directions?

Yesterday, during our at-home Speech Therapy, I was looking through my jumbled mass of worksheets (and really, I need to get more organized! aargh...) and I ran across a bunch of sheets on apraxia. So, I thought, what the heck and I asked him, in the following order, to point to his eyes, point to his ears, point to his nose, point to his hair and point to his chin.

And do you know what? He did them all, except the chin. No hesitation at all. When he didn't point to his chin, I showed him by pointing to my own chin and saying "This is a chin." Then he did it. He very well could do it.

So, there you have it. Apraxia, my foot. The whole problem, all along, has been the words. It's not that he can't "perform the action," it's that he doesn't always understand the directions, i.e. he doesn't understand the meaning of the words. Just as I thought. Hmmmm.


Linda said...

Dianne I went to a little workshp last week on mirror therapy. Part of it was she had people finding pics in magazines that demonstrated body parts,whole people,pets with a distinct left right demonstrated. Those were turned into flash cards.---- So. Card held up reply would be something like she is lifting her right arm, or the stroke perso can try and do the action in the card,focusing on getting right and left correct. Work on awareness of both sides, not just movement. Need to know you have that part and what it is before you can use it.
I hope I made sense here.

Nikki said...

Hah! Shows them therapists...see what a person can figure out on their own when the experts have given up?