Diagnosis & Definitions

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Apraxia:  Is a neurologic disorder characterized by the inability to perform learned movements on command, even though the command is understood and there is a willingness to perform the movement.  Both the desire and the capacity to move are present, but the person cannot execute the act.  (Info given by Web MD)

Types of Apraxia:

Limb Apraxia: Also referred to as dyspraxia.  Is outlined as the inability to make precise movements with fingers, arms or legs on command.

Non-Verbal Oral  Apraxia: Is referred as the inability to coordinate and carry out oral/facial movements on command.

Verbal Apraxia: Is referred to the inability to coordinate and sequence sounds necessary for speech on command.

(Info given by VYNE EDUCATION Suspected Apraxia and Early Intervention Seminar or www.vyne.com)

Global Apraxia:  Is when an individual experiences Limb, Non-Verbal Oral, and Verbal Apraxia all at the same time.

Sensory Processing Disorder:  is a condition in which the brain has trouble receiving and responding to information that comes in through the senses.  Formerly referred to as sensory integration dysfunction, it is not currently recognized as a distinct medical diagnosis.  (Info given by Web MD)

Complex Motor Stereotypy: 

Primary Motor Stereotypies also referred to as stereotypic movement disorder, are rhythmic, repetitive, fixed predictable, purposeful, but purposeless movements that occur in a child who is otherwise developing normally. Examples of primary motor stereotypes are flapping and waving of the arms, hand flapping, head nodding and rocking back and forth.  (Info by hopkinsmedicine.org)

Secondary Motor Stereotypies refers to the presence of an additional diagnosis with behavioral or neurological signs and symptoms, including autistic spectrum disorder, mental retardation, sensory deprivation, Rett syndrome, neurodegenerative disorders, inborn errors of metabolism, drug induced conditions, tumor, infection, or psychiatric conditions.  (Info given by Singer, H.S. (2009, 06). Motor Stereotypies.  Seminars in Pediatric Neurology, 16(2), 77-81. doi:10.1016/j.spen.2009.03.008)

Terms used to describe a processing disorder may vary based on the perspective of the professional describing the problem. Terms include, but are not limited to, "auditory processing disorder," "(central) auditory processing disorder," "language processing disorder," and "auditory information processing disorder." 

ASHA uses the term Central Auditory Processing Disorder (CAPD) to refer to deficits in the neural processing of auditory information in the CANS not due to higher order language or cognition, as demonstrated by poor performance in one or more of the skills listed above (ASHA, 2005). Although sometimes difficult, careful differential diagnosis is important to the process of treatment planning.

• CAPD may lead to or be associated with difficulties in higher order language, learning, and communication functions. 
• CAPD may coexist with other disorders (e.g., attention-deficit/hyperactivity disorder [ADHD], language impairment, and learning disability). 
• CAPD is not due to peripheral hearing loss, which includes conductive hearing loss (i.e., outer or middle ear), sensorineural hearing loss at the level of the cochlea or auditory nerve, including auditory neuropathy and synaptopathy (i.e., hidden hearing loss).

Professionals have adopted varying perspectives on the interpretation of CAPD (Cacace & McFarland, 2008; DeBonis & Moncrieff, 2008; De Wit et al., 2016; Friberg & McNamara, 2010; Jerger, 1998; McFarland & Cacace, 2006; Rees, 1973, 1981). Divergent perspectives among professionals reflect ongoing debate regarding how to define, assess, and treat auditory processing disorder.

Different viewpoints exist for a number of reasons, including the heterogeneity of symptoms, variations in the definition, the lack of a reference standard for diagnosis, the relationship between auditory perceptual deficits and language disorders, and the particular treatment approach(es) that follow from the diagnosis of CAPD (Kamhi, 2011; Moore, Rosen, Bamiou, Campbell, & Sirimanna, 2013; Vermiglio, 2014). Additional information providing an historical perspective on auditory processing disorder is available (DeBonis & Moncrieff, 2008; Richard, 2011).

Because of the heterogeneity of skills involved in auditory processing, some suggest that CAPD should be diagnosed by the specific deficit (e.g., difficulty processing signals in noise; difficulties with auditory discrimination, temporal processing, or binaural processing), rather than broadly as a CAPD (Vermiglio, 2016). Not all diagnoses of a CAPD represent a limitation for the individual (Dillon, Cameron, Glyde, Wilson, & Tomlin, 2012) or a condition that must be treated (Vermiglio, 2016). 

There is general agreement that auditory perceptual abilities influence language development—particularly the pre-literacy skills—and that it can be difficult to separate the influence of auditory and language skills with regard to academic demands (Richard, 2012, 2013; Watson & Kidd, 2008). The act of processing speech is very complex and involves the engagement of auditory, cognitive, and language mechanisms, often simultaneously (Medwetsky, 2011). 

Richard's (2013) continuum of processing includes both auditory processing and language processing. This continuum involves the following types of processing:

• Central auditory processing, which begins when the neural representation of acoustic signals are processed after they leave the cochlea and travel through the auditory nerve to the primary auditory cortices of the left and right hemispheres (Heschl's gyri). 

• Phonemic processing, during which acoustic features of the signal are discriminated utilizing phonemic skills such as sound discrimination, blending, and segmenting.

• Linguistic processing, during which meaning is attached to the signal (begins at the level of Heschl's gyrus, expands to Wernicke's area, to the angular gyrus, and finally to the prefrontal and frontal cortex, where a response is planned, organized, and mediated). 

Information provided by the American Speech-Language-Hearing Association website: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589943561&section=Causes