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1
Presotto, Monia. "Avaliação das habilidades de praxia não verbal e verbal em pacientes com diagnóstico de Doença de Parkinson." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/114990.
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Introdução: A articulação da fala é um dos aspectos fonoaudiológicos mais comprometidos na doença de Parkinson (DP). Pacientes com DP apresentam risco de manifestar apraxia não verbal e verbal. A apraxia não verbal ocorre quando há um déficit na habilidade de sequencialização dos movimentos voluntários não verbais da língua, lábios, mandíbula e outras estruturas orofaciais associadas, e a apraxia verbal é definida como um déficit na habilidade de sequencializar os controles motores necessários para o posicionamento correto dos articuladores durante a produção voluntária da fala. A prevalência com que apraxia da fala ocorre na DP não está bem estabelecida, sendo um distúrbio pouco explorado nesses pacientes. É um estudo inédito, até onde temos conhecimento, quanto à identificação dos erros práxicos verbais na DP. Objetivo: avaliar a prevalência da praxia não verbal e verbal em pacientes com doença de Parkinson, correlacionandoas com idade, escolaridade, tempo de doença e estadiamento da DP (Hoehn e Yahr), assim como correlacionar a apraxia não verbal com a apraxia verbal e identificar os erros práxicos verbais. Método: Estudo quantitativo, observacional, descritivo e de prevalência. Foram avaliados 45 pacientes acometidos pela DP, que realizaram seguimento clínico no ambulatório de Distúrbios do Movimento do Hospital de Clínicas de Porto Alegre, Brasil, através da aplicação do Protocolo de Avaliação da Apraxia da Fala, e o estadiamento da DP foi controlado através da escala de Hoehn e Yahr (H&Y). Resultados: A prevalência de apraxia não verbal e verbal nos pacientes com DP foi de 24,4%. Não houve significância entre apraxia não verbal com idade, escolaridade, tempo de doença, estadiamento da DP (H&Y) e gênero. A correlação entre apraxia verbal e escolaridade foi significante (p≤0,05), mas não houve significância com idade, tempo de doença, estadiamento da DP (H&Y) e gênero. Os tipos de erros práxicos verbais mais frequentes foram as omissões (70,8%). Quanto ao ponto e modo articulatório os fonemas mais alterados foram os dentoalveolares (92%) e os vibrantes (57,7%), consecutivamente. Conclusão: Os pacientes com DP apresentaram apraxia não verbal e verbal com manifestação de muitos erros práxicos verbais, estando a apraxia verbal correlacionada com a escolaridade.Introduction: The speech articulation is one of the aspects most impaired in Parkinson's disease (PD). Patients PD present risk of expressing nonverbal and verbal apraxia. The nonverbal apraxia occurs when there is a deficit in the sequencing ability of nonverbal voluntary movements of the tongue, lips, jaw and other associated orofacial structures, while the verbal apraxia is defined as a deficit in the ability of sequencing the necessary motor controls in order to place the articulators correctly during the voluntary speech production. The predominance with which apraxia of speech occurs in PD is not well established and rarely explored in these patients. As far as we know, it is an unprecedented study regarding the identification of verbal praxic errors in PD. Objective: To assess the prevalence of nonverbal and verbal apraxia in patients with Parkinson's disease, correlating them with age, education, duration of disease and PD stage (Hoehn e Yahr), as well as to correlate nonverbal with verbal apraxia and identify the verbal praxic errors. Method: Quantitative, observational, descriptive and prevalence study. Forty-five patients with PD were evaluated. They were submitted to the clinical follow-up in the Movement Disorders Clinic of the Cinical Hospital of Porto Alegre, Brazil, through the application of the Speech Apraxia Assessment Protocol. Additionally, the PD stage was controlled through the Hoehn and Yahr scale (H&Y). Results: The prevalence of nonverbal and verbal apraxia in patients with PD was 24.4%. There was no significance between the nonverbal apraxia with age, education, duration of disease, PD stage (H&Y), and genre. The correlation between verbal apraxia and education was significant (p ≤ 0.05), but there was no significance with age, duration of disease, PD stage (H&Y) and genre. Omissions were the most frequent kinds of verbal praxic errors with (70.8 percent). Regarding the place and mode of articulation, the most changed phonemes were the dentoalveolar (92%)and the vibrants (57.7%), consecutively. Conclusion: Patients with PD presented nonverbal and verbal apraxia with manifestation of many verbal praxic errors and verbal apraxia correlated with education levels.
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Cera, Maysa Luchesi [UNIFESP]. "Apraxia de fala e apraxia não-verbal na doença de Alzheimer." Universidade Federal de São Paulo (UNIFESP), 2010. http://repositorio.unifesp.br/handle/11600/8965.
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Previous issue date: 2010-01-27Objetivos: avaliar as praxias verbal e não-verbal em pacientes com doença de Alzheimer (DA) e identificar os erros práxicos verbais em diferentes fases da doença, além de verificar a similaridade entre as suas ocorrências. Métodos: foram avaliados 90 indivíduos, 30 em cada fase da DA (leve, moderada e grave), submetidos às escalas: Escala clínica da demência (CDR), Mini-exame do estado mental (MEM) e avaliação das atividades instrumentais de vida diária de Lawton, além da avaliação das praxias, por meio das tarefas de agilidade oral do teste de Boston, para a comparação com os dados de normalidade, e do Protocolo de Avaliação da Apraxia Verbal e Não-verbal, para a comparação do desempenho entre os três grupos. Resultados: Em relação à população estudada, 66 pacientes eram mulheres, a média da idade foi de 80,2 ±7,2 e da escolaridade de 4,2 ±3,5 anos. As médias de agilidade oral (verbal e não-verbal) dos grupos estudados foram significativamente menores do que as da população normal. As alterações práxicas verbais e não-verbais aumentaram com a progressão da doença. Quanto aos tipos de erros, os erros de omissão e substituição apresentaram maiores médias, seguidos de ensaio, repetição, autocorreção e adição. O erro do tipo adição determinou padrões de erros diferentes entre as fases da doença. Conclusões: os pacientes com DA apresentaram apraxia verbal e não-verbal que aumentaram com a gravidade demência.
Purpose: to assess the speech and orofacial apraxia in Alzheimer’s disease (AD) and identify praxic speech errors at different stages of the disease and to verify the similarity among their occurrences. Methods: thirty subjects in each stage of AD (mild, moderate and severe) were submitted to the following assessment: Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE) and Lawton Instrumental Activities of Daily Living, and praxis tasks, using the oral agility subtest of the Boston diagnostic aphasia examination and the protocol assessment speech and orofacial apraxias. Results: there were 66 women, the mean age was 80,2±7,2 years and means educational was 4,2 ±3,5 years. The means in the oral agility task of AD patients were significantly lower than of the normal population. Difficulties in verbal and nonverbal praxis increased with the progression of the disease. Regarding the types of errors, omission and substitution were more common, followed by trial-and-error, repetition, self-correction and addition. The error type addition determined different patterns of errors between stages of the disease. Conclusions: the speech and orofacial praxias of patients with AD were impaired and deteriorated according to the stage of the disease.
TEDE
BV UNIFESP: Teses e dissertações
3
Ietswaart, Magdalena. "Visuomotor transformations in apraxia." Thesis, University of Aberdeen, 2001. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU141949.
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This thesis investigates whether the clinical neurological condition of apraxia is associated with impaired transformation of visual input into motor actions. Apraxia is generally a result of damage to the left cerebral hemisphere and is characterised by the inability to imitate gesture, to perform movements on verbal command, or to handle objects correctly. The justification for this study is that the mechanisms underlying apraxia are not well understood. Apraxia explained as a defect of visuomotor integration would provide a novel and possibly converging account of the disorder. This work used a hierarchical approach to examine different levels of visuomotor transformation in apraxic patients, looking at processes from input to output and movement classes from simple to complex. The tasks ranged from simple reaching and grasping actions, with or without on-line visual feedback, through delayed reaching and grasping actions, to complex imitative actions. The current work determined that apraxia was independent of general motor programming deficits, perceptual problems, or compromised access of the motor system to stored representations per se. No evidence was found for compromised integrated action of the perceptual and visuomotor systems in apraxia due to the disconnection of the dorsal and ventral streams according to the two visual pathways model (Milner &'38; Goodale 1995). Investigation of imitative actions did suggest that, in the process of imitation, visuomotor transformations based on egocentric body schema, especially when made in the absence of contextual cues from the environment, were essentially impaired in apraxia.
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Buchmann, Ilka [Verfasser]. "Diagnosis and Rehabilitation of Limb Apraxia and Anosognosia of Limb Apraxia / Ilka Buchmann." Konstanz : KOPS Universität Konstanz, 2018. http://d-nb.info/1221524607/34.
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Maciel, Junior Jayme Antunes 1948. "Apraxia construtiva subcortical : estudo comparativo com a apraxia construtiva cortical em lesões vasculares cerebrais." [s.n.], 1999. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313611.
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Tese (Livre-docencia) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasMade available in DSpace on 2018-07-27T03:57:19Z (GMT). No. of bitstreams: 1 MacielJunior_JaymeAntunes_LD.pdf: 22952009 bytes, checksum: 6f5332ad91c07458fda9aea3f1d8ffb2 (MD5) Previous issue date: 1999
Resumo: Embasado no pressuposto da singularidade da apraxia construtiva dentro do universo dos distúrbios executivos, e de que na prática, a apraxia é caracterizada pelos tipos de erros de natureza executiva, foram exaustivamente estudados, 27 pacientes com lesão subcorticai de natureza vascular com enfoque na semiologia neuropsicológica da apraxia construtiva. Os achados semiológicos de 17 pacientes com lesão sub cortical à direita [10 homens (idade média: 45,4 anos; escolaridade média: 4,6 anos) e 7 mulheres (idade média: 49,8 anos; escolaridade média: 6,0 anos)] e dez è esquerda [6 homens (idade média: 57,8 anos, escolaridade média: 8,5 anos) e 4 mulheres (idade média: 54,5 anos; escolaridade média: 6,7 anos)} foram comparados com grupo contraste composto por dez pacientes apresentando lesão vascular isquêmica retrorroiândica à direita e à esquerda. A primeira avaliação neuropsicológica foi realizada após seis semanas do evento vascular inicial e posteriormente aos seis meses, um e dois anos quando possível. Essa sistemática visa estabelecer as repercussões dos distúrbios práxicos construtivos e outros sintomas e sinais neuropsicoíógicos na vida diária dos pacientes. O nível mínimo de escolaridade admitido no estudo foi de fés anos. Apenas um único paciente com lesão subcortical direita apresentava lateralidade homogênea a esquerda. A bateria neuropsicológica de testes construtivos (desenhos de complexidade crescente, figura complexa de Rey, cubos de Kohs, montagem de quebra-cabeça, teste visuomotor de Bender e construção com palitos) foi acrescida pelo estudo da memória visual (reprodução da figura complexa de Rey após período de distração e fase taquistoscópica do teste visuomotor de Bender), de testes visuoespaciais (complementação de figuras, dupla cabeça de bois, cancelamento de linhas e números), de detecção de agnosia visual (figuras hachuradas, discriminação figura/fundo e ordenamento de lâminas de histórias em quadrinhos), e do estudo do cálculo. Todos os pacientes foram enquadrados segundo a avaliação sociolinguística, a lateralidade e o nível de alerta/atenção. Os pacientes com lesão hemisférica esquerda foram ainda submetidos ao exame da linguagem pela aplicação do protocolo Toulouse-Montreal (versão standard inicial) e pela descrição da prancha n°i do protocolo de afasia de Goodglass & Kaplan. Os resultados da avaliação neuropsicológica foram comparados com a extensão da lesão anatômica peia neuroimagem (TC ou RNM) e ao atlas de correlação anatômica e vascular encefálica. Este estudo conclui que: l. a apraxia construtiva por lesão subcorticai, direita ou esquerda, expressa-se de maneira semelhante à observada nas lesões corticais retrorrolàndicas. A negligência ou inatenção visuoespacial freqüentemente se associa a apraxia construtiva na presença de lesão do hemisfério cerebral direito; 2. o desempenho neuropsicológico, semelhante nas lesões subcortícais e corticais, não permite estabelecer o nível da lesão anatômica tendo como base a avaliação neuropsicológica isolada A associação freqüente de distúrbio visuoespacial nas lesões hemisféricas à direita fala a favor do papel relevante deste hemisfério no sistema da atenção: 3. a imensidade dos sintomas e smais neuropsicológicos apresentam variabilidade interindividual e se expressam de maneira heterogênea em função do teste utilizado; 4. a observação dos achados do exame neuropsicológico nas lesões subcortícais serve de argumento para à concepção de que a especialização hemisférica se manifesta na organização hierárquica do SNC abaixo do córtex, 5. a persistência dos distúrbios práxicos construtivos e visuoespaciais no período tardio pós-AVC e suas implicações na vida diária dos pacientes sugerem mecanismos de desconexão córtico-subcortical na gênese dos distúrbios, 6. a constatação de queixas de inabilidade construtiva ou visuoespacial com limitação da função do trabalho sugere que a apraxia construtiva e a negligência visuoespacial podem ser duradouras e produzir incapacidade de grau variável nos pacientes. A presente casuística de apraxia construtiva por lesão subcorticai, direita e esquerda, constitui-se em forte argumento a favor da autonomia desses distúrbios neuropsicológicos, bem como da presença de mecanismos de retrocontrole exercidos pelas estruturas tálamo-lentículo-capsulares sobre a atividade cortical e responsáveis pela modulação de comportamentos complexos
Abstract: For the clinical neurologist, constructional apraxia is one of the most frequent neuropsychological symptoms of brain damage, It is diagnostically most useful since it can be detected at the bedside with simple procedures. For the overwhelming majority of clinical, situations, constructional apraxia is defined by failure to produce a drawing a) in response to verbal command; b) copying from a model. Neuropsychological evaluation based on the constructional disorder was done in 27 patients with a single subcortical vascular lesion on CT or MR1. In 17, the lesion was in the right hemisphere [12 infarctions (9 males, 3 females); 5 intraparenchymal hemorrhages (1 male, 4 females)]; in 10, the lesion was in the left hemisphere [6 infarctions (4 males, 2 females), 4 intraparenchymal hemorrhages (2 males, 2 females)], The controls consisted of 20 patients with a single cortical infarction, 10 on the right and 10 on the left hemisphere. Neuropsychological results were correlated with the extension and topography of the lesion on CT or MRI, with special concern to cerebral anatomy and vascularization. Our study concluded that: 1) Subcortical constructional apraxia, of either left or right hemispheres, is semiologicaliy similar to cortical retrorolandic lesions of the respective hemisphere, and left sided visual spatial inattention is associated with right subcortical lesions; 2) "Neuropsychological performance is not sufficient to determine the level of the vascular lesion (i.e. cortical or subcortical) due to sémiologie similarities. Our data suggest that neglect and visuospatial deficit impair drawing in right hemisphere lesions probably due to attentionai specialization of the right sided subcortical structures; 3) Performances on both visuospatial perceptual tasks and on drawing were heterogeneous between individuals and according to the tests employed, 4) Our data of subcortical constructional apraxia suggest that hemispheric specializations are already found at the level of subcortical structures; 5) Chronic persistence of constructional and visuospatial disorders is due to intrahemispheric disconnection syndrome; 6) Chronically persisting disorders after vascular subcortical lesions interfere in all aspects of the patients' lives such as home, work and social activities. Finally, our data suggest that subcortical constructional apraxia and visuospatial disorders are important arguments favouring the hypothesis that feedback mechanisms between the cerebral cortex and the thalamo-lenticulo-capsular region are implicated in the behaviour observed in our patients
Tese (livre-docencia) - Univer
Neurologia
Livre-docente em Ciencias Medicas
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Martins, Fernanda Chapchap [UNIFESP]. "A inter-relação entre memória operacional e apraxia de fala." Universidade Federal de São Paulo (UNIFESP), 2006. http://repositorio.unifesp.br/handle/11600/8832.
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Previous issue date: 2006-12-31Objetivo: Verificar a inter-relação entre a memória operacional e a apraxia verbal e explorar quais os componentes desta memória estariam envolvidos na programação motora da fala. Métodos: Foram avaliados 22 sujeitos apráxicos e 22 controles. Foram aplicados um teste de compreensão e um protocolo para avaliar e classificar o grau da apraxia de fala. Para investigar a memória operacional dos indivíduos, foram aplicados o teste de span de dígitos na ordem direta e inversa, um teste de repetição de palavras curtas e longas, sendo que ambos investigam o funcionamento da alça fonoarticulatória e o Rey Auditory Verbal Learning Test, que investiga, além da alça fonoarticulatória, o buffer episódico. Resultados: Através da análise estatística realizada, algumas diferenças significantes foram encontradas. O desempenho dos apráxicos nos testes de memória, tanto no span de dígitos direto e inverso, quanto na repetição de palavras curtas e longas e no Rey Auditory Verbal Learning Test foi estatisticamente significante mais baixo que o desempenho dos controles. Também foi evidenciado que a performance entre os apráxicos em todos os testes de memória foi semelhante, independentemente do grau da apraxia. Conclusão: A partir dos resultados citados anteriormente, o estudo concluiu que os indivíduos com apraxia de fala apresentam um déficit na memória operacional e que este déficit está mais relacionado ao processo articulatório da alça fonoarticulatória. Além deste achado, pôde-se observar que o grau de comprometimento do déficit de memória operacional apresentado pelos apráxicos é independente do grau de apraxia de fala destes indivíduos.
To verify the interference of working memory in the apraxia of speech and explore which components of this memory would be involved in the motor planning of speech. Methods: There were assessed 22 apraxic subjects and 22 control subjects. There were administered a comprehension test and a protocol used to assess and classify the degree of apraxia of speech. To investigate working memory in the subjects, digit span forward and backward test, and a short-lenght and long-lenght word repetition test, both able to assess the phonoarticulatory loop, and the Rey Auditory Verbal Learning Test, which investigates both the phonoarticulatory loop and the episodic buffer, were administered. Results: The statistical analysis of the study showed some significant differences. The apraxic subjects performances in the memory tests, in the forward and backward digit span test, as well as in the short-lenght and long-length word repetition test, and in the Rey Auditory Verbal Learning Test was statistically significantly lower than the performance of the control group. It was also emphasized that the performance among the apraxic subjects in all of the memory tests was similar, independently on the degree of the apraxia. Conclusion: From the results mentioned earlier, the study concluded that subjects with apraxia of speech present a working memory deficit and that this deficit is more related to the articulatory process of the phonoarticulatory loop. Furthermore, a degree of compromise in the working memory deficit shown by the apraxic subjects is independent from the degree of apraxia of speech in these individuals.
TEDE
BV UNIFESP: Teses e dissertações
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Scott, Louise A. "Analysis of apraxia in Alzheimer's disease." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ53514.pdf.
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Wood, Andrew. "Theatre spectatorship and the "apraxia" problem." Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59834.
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Some recent work of Suvin (indebted to Merleau-Ponty's Phenomenologie de la perception) asserts that two fundamental aspects of the praxis of theatre spectatorship--the non-tactile, inactive physicality of the spectator, and her/his imaginative cognitive participation in the apperception of the performance text--might better be understood when examined with regard to the "apraxias," neurological disorders of purposive physical movement. This thesis follows up this line of thought in examining clinical material on apraxia, both temporally previous and subsequent to Merleau-Ponty's discussion. Additionally, it is contended that various paradigms in Bergson and within modern cognitive science (Edelman, Schacter) may be applied with some utility to the praxis of theatre spectatorship. This may lead to a better understanding of the mental participation of the spectator in the performance text as a modulation of present perception and past subjective experience. Such an understanding is compatible with a semiotic "encyclopedia" (Eco), possibly buttressing it with arguments extrapolated from neurology.
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Butler, Jennifer Annette. "Apraxia : analysis of assessment and rehabilitation." Thesis, Oxford Brookes University, 1998. https://radar.brookes.ac.uk/radar/items/e9325907-b728-4ada-8c1a-a90c2b209a6f/1/.
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This project explored two main areas: the assessment of apraxia and the intervention effectiveness in rehabilitation of the apraxic condition. This was achieved through a group study and a series of single case designs. Three experimental groups were used to investigate clinical tests and the kinematics ofmovement~ apraxic (n=17) and non-apraxic (n=13) left hemisphere damaged patients, and normal control subjects (n=ll). Using computergraphic techniques, the data provided evidence of disruption to the temporalspatial aspects of movement in apraxic people, which was not related to modality of testing, though some normal kinematic profiles were found within the apraxic group. Clinical assessments used to identify apraxia showed no relationship one with another which suggested each was identifying different aspects, or sub-types of a heterogeneous condition. Some tests were found to have low internal consistency, though inter-rater reliability through the observer-judgment process was high. A test devised for identifying agnosia was shown to relate to possible cognitive-perceptual processes or intact vision-to-action routes in the apraxic movement output. Dissociations found between clinical assessments for apraxia and kinematics of movement were explained in relation to different compensatory movement strategies employed by the apraxic patients, and/or as evidence for possible 'sub-types' of the apraxic condition. Analysis also suggested that different task demands might determine compensatory movement strategies and produce altered movement kinematics. This group study was followed by a series of single cases, two of which charted the 'natural history' process in recovery of apraxia using task performance and kinematic analysis as outcome measures. Evidence for spontaneous recovery over a six week period was shown in one case. Four single case ABA design investigations were then carried out on individuals with ideomotor and ideational apraxia to determine the effectiveness of intervention strategies. Specific sensory stimulation protocols were evaluated with no convincing evidence for effectiveness of the intervention, though both natural recovery improvements and learning effects were seen in the outcome measures. Variability of performance was a feature of all cases studied and could be considered a feature of the apraxic condition. Task break-down strategies were also evaluated in functional activities and demonstrated some effectiveness in a case of ideomotor apraxia, though a case with an ideational component indicated a more intractable condition. The strategy was not seen to generalise to other unpracticed tasks. In conclusion, the associations and dissociations found between movement kinematics and the clinical assessment tests for apraxia suggested the presence of 'sub-types' within the blanket diagnosis of the condition. Identification of such sub-types might be facilitated by the development of the agnosia test newly devised for this project. Finally, research into intervention effectiveness in apraxia calls for further investigation to determine what procedures might be used with different sub-types of the condition.
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Clopton, Sara L. "Articulation Errors in Childhood Apraxia of Speech." Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1212505684.
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Catrini, Melissa. "Apraxia: a complexa relação entre corpo e linguagem." Pontifícia Universidade Católica de São Paulo, 2011. https://tede2.pucsp.br/handle/handle/13518.
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Previous issue date: 2011-07-15Conselho Nacional de Desenvolvimento Científico e Tecnológico
This study was triggered by clinical questions related to the problem of Apraxia. When there is incontestable neurological disease, any articulation disorder is immediately assumed and labeled as a Speech Apraxia or Dysarthria (CRARY,1993) even if an organic damage cannot be effectively confirmed by medical diagnosis or technological devices. The fact is that clinical avaliation tends to follow the same direction: the neurological damage is not detectable, but does it exist! Under such a situation, the suspicion falls on Apraxia of Speech, a pathology usually defined as a motor speech disorder observable in articulatory and prosodic difficulties without muscle damage. Therefore, a question can be raised: what causes that articulatory (functional) symptom? . Apraxia affects the body and the body is, according to the medical viewpoint an object of physiology and pathology. I endeavoured to indicate and justify the strength of that theoretical and clinical discourse, which sustains itself on the philosophical dichotomic opposition between mind and body, i.e., between cognition and organism. Apraxia is, thus, traditionally approached, studied and defined through that perspective. In the present study, Freud is taken as a landmark because he introduced a completely different trend of reasoning which dissolves the philosophical and psychophysical dualism mindbody. Affected by the wreckage of hysteria and the holes of aphasia, he could be state that structure and body functions do not go side by side and a new and revolutionary conception of the body could be introduced and developed in studies of Apraxia the human body is bodylanguage. This thesis tried to follow Freud s theoretical direction concerning the relationship between body and language, this study is conducted in accordance with the reflections on languare pathology and clinic developed within the research group Language acquisition, pathology and clinic, coordinated by Lier-DeVitto and Arantes, at LAEL /PUCSP
A questão que move este trabalho foi deflagrada por questões clínicas relacionadas ao problema das Apraxias. Nos casos em que há incontestável comprometimento neurológico, qualquer presença de distúrbio articulatório é imediatamente assumida como uma Apraxia de Fala ou Disartria (CRARY, 1993). Mesmo quando o comprometimento neurológico não pode ser efetivamente confirmado pelo aparato diagnóstico médico, mas se suspeita de sua existência, o raciocínio clínico tende a seguir a mesma direção. Nessas condições, especificamente, a suspeita recai sobre Apraxia de Fala, patologia comumente definida como um distúrbio motor da fala em que se observam dificuldades articulatórias e prosódicas sem prejuízos musculares. Coloca-se, assim, a questão: o que causaria tais sintomas funcionais? Apraxias têm manifestação no corpo e corpo é, por tradição e direito, objeto (exclusivo) do campo da Fisiologia e da Patologia justifica-se, sem dúvida, a força da discursividade desses estudos sobre o tema que, como tratei de indicar, também opera no domínio da divisão filosófica mente/corpo - melhor entendido, da relação entre razão/cognição e corpo/organismo. É na esfera do dualismo corpo-mente que se inscreve (a)praxia. Entretanto, no presente estudo, Freud comparece dissolvendo o dualismo psicofísico. Nos escombros da histeria e nos furos da afasia, ele viu que estrutura e funcionamento não caminham lado a lado. Daí que outra concepção de corpo deve vir a figurar nos estudos sobre as apraxias. Trata-se do corpo que é Um, aquele que nasce com o ser de linguagem, o falasser, o corpolinguagem. Diante disso, esta tese procurou problematizar a apraxia a partir da relação entre corpo e linguagem. Tarefa cumprida a partir das reflexões encaminhadas no âmbito do Grupo de Pesquisas Aquisição, patologias e clínica de linguagem, coordenado por Lier-DeVitto e Arantes no LAEL/PUCSP
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Resende, Lorena Dias. "Apraxia da marcha em pacientes com demência: revalência, características motoras e fatores associados." Universidade Federal de Goiás, 2013. http://repositorio.bc.ufg.br/tede/handle/tede/3440.
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Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
Introduction: Gait apraxia is characterized by a deficiency in the integration of the sensorial, motor and cerebellar functions necessary for gait. The patients with this compromise have difficulty initiating and there is a congelation of the gait, mainly when turning ove their own axle. It is frequently associated with an emotional instability, a urinary bladder dysfunction and behavioral abnormalities. It is generally observed in gait disturbances high level cortical functions, but its relationship to disease progression and cognitive function is unknown. Objectives: To evaluate the gait apraxia in patients with dementia, its prevalence and association with other types of apraxia as well as observing what phase of the disease in which it appears. Methods: Gait apraxia has been researched in a universe of patients with dementia consecutively assisted in the HC-UFG Neurodementia Ambulatory. The instruments used were the Mini-Mental State Examination and Clinical Dementia Rating Scale (CDR) to evaluate the cognitive functions, Pfeffer's Questionnaire for the functional evaluation of the activities of the daily life, the Scale of Berg's Functional Balance (BERG) and the Timed Up and Go Test (TUG) for the balance mensuration, besides the evaluation of the gait and the posture of the trunk (AWS). Results: A total of fifteen patients, a sample 160, with gait apraxia were included in the study and all had some other associated apraxia. The prevalence of patients with dementia and apraxia of gait was 9,37%. Regarding the CDR showed that 33,3% of patients were mild stage of the disease, 46,7% in the moderate and 20% in the severe. In Pfeffer Questionnaire patients had an average of 19,6±1,40. There balance and coordination deficit in all patients, since the scores of the tests BERG and TUG showed inferior results. On the scale of BERG total score obtained average 11,07±8,06 and varying between 2 and 24 points. The TUG test was performed above 20 seconds for all the patients. In AWS the average score was 14,0±6,88 ranging between 7 and 27 points. The correlation between AWS and scale BERG was significant (p=0,001). Apraxia dynamics (90,9%), ideatory (72,2%) and kinetic members (63,6%) were more frequent among patients. Forms of dementia who had gait apraxia were corticobasal degeneration (53,3%), frontotemporal dementia (13,3%), Alzheimer's disease (6,6%), dementia with chronic subdural hematoma (6,6%), normal pressure hydrocephalus (6,6%), dementia in Parkinson's disease (6,6%) and multiple system atrophy (6,6%). Conclusion: Gait apraxia is little prevalent in the universe of dementia and it is always associated with corticcortical dementia. Other forms of apraxia frequently follow gait apraxia. The corticobasal degeneration is the type of dementia most associated with the gait apraxia.
Introdução: Apraxia da marcha é caracterizada por deficiência na integração das funções sensoriais, motoras e cerebelares necessárias para a deambulação. Os pacientes com este comprometimento têm dificuldade em iniciar a marcha e há um congelamento desta, principalmente ao girar sobre o próprio eixo. É freqüentemente associada a uma instabilidade emocional, disfunção da bexiga e anormalidades comportamentais. É geralmente observada em distúrbios da marcha de alto nível das funções corticais, mas sua relação com aprogressão da doença e função cognitiva é desconhecida. Objetivos: Avaliar a apraxia da marcha em pacientes com demência, sua prevalência e associação com outras formas de apraxia, bem como observar em que fase da doença mais aparece. Métodos: Foi pesquisada a apraxia de marcha em um universo de pacientes com demência consecutivamente atendidos no ambulatório de neurodemência do HC-UFG, entre 2012 e 2013. Os instrumentos utilizados foram o Mini-Exame do Estado Mental e a Escala Clínica de Demência (CDR) para se avaliar o grau da demência, o questionário de Pfeffer para avaliação funcional das atividades instrumentais de vida diária, a Escala de Equilíbrio Funcional de Berg (BERG) e o Timed Up and Go Test (TUG) para a mensuração do equilíbrio; além da avaliação qualitativa da marcha e avaliação postural do tronco (AWS). Resultados: Um total de quinze pacientes, de uma amostra de 160, que apresentavam apraxia da marcha foi incluído no estudo e todos apresentaram alguma outra apraxia associada. A prevalência de pacientes com demência e apraxia da marcha foi de 9,37%. Em relação ao CDR observou-se que 33,3% dos pacientes estavam em estágio leve da doença, 46,7% no moderado e 20% no grave. No questionário de Pfeffer os pacientes obtiveram média de 19,6±1,40. Houve déficit de equilíbrio e coordenação em todos os pacientes, uma vez que a pontuação dos testes de BERG e TUG apresentaram resultados inferiores. Na escala de BERG a pontuação total obteve média de 11,07±8,06 e variação entre 2 e 24 pontos. O teste de TUG foi realizado com tempo acima de 20 segundos por todos os pacientes. Na AWS a média de pontuação foi de 14,00±6,88 variando entre 7 e 27 pontos. Houve correlação significativa entre AWS e a escala de BERG. A apraxia dinâmica (90,9%), ideatória (72,2%) e cinética de membros (63,6%) foram as mais frequentes entre os pacientes. As formas de demência que apresentaram apraxia da marcha foram: degeneração córtico-basal (53,3%), demência fronto-temporal (13,3%), doença de Alzheimer (6,6%), demência por hematoma sub-dural crônico (6,6%), hidrocefalia de pressão normal (6,6%), demência na doença de Parkinson (6,6%) e atrofia de múltiplos sistemas (6,6%). Conclusão: A apraxia de marcha é pouco prevalente no universo das demências e mostrou-se associada a demências córtico-subcorticais. Outras formas de apraxia frequentemente acompanham a apraxia de marcha. Degeneração córtico-basal é a forma de demência mais associada à apraxia de marcha.
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Mailend, Marja-Liisa, and Marja-Liisa Mailend. "Speech Motor Planning in Apraxia of Speech and Aphasia." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625882.
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Apraxia of speech (AOS) is a motor speech disorder that poses significant obstacles to a person's ability to communicate and take part in everyday life. Agreement exists between current theories of AOS that the impairment affects the speech motor planning stage, where linguistic representations are transformed into speech movements, but they disagree on the specific nature of the breakdown at this processing level. A more detailed understanding of this impairment is essential for developing targeted, effective treatment approaches and for identifying the appropriate candidates for these treatments. The study of AOS is complicated by the fact that this disorder rarely occurs in isolation but is commonly accompanied by various degrees of aphasia (a language impairment) and/or dysarthria (a neuromuscular impairment of speech motor control). In addition, the behavioral similarities of AOS and its closest clinical neighbor, aphasia with phonemic paraphasias, undermine the usefulness of traditional methods, such as perceptual error analysis, in the study of both disorders.
The purpose of this dissertation was to test three competing hypotheses about the specific nature of the speech motor planning impairment in AOS in a systematic sequence of three reaction time experiments. This research was formulated in the context of a well-established theoretical framework of speech production and it combines psycholinguistic reaction time paradigms with a cognitive neuropsychological approach.
The results of the three experiments provide evidence that one component of the speech motor planning impairment in AOS involves difficulty with selecting the intended motor program for articulation. Furthermore, this difficulty appears to be intensified by simultaneously activated alternative speech motor programs that compete with the target program for selection. These findings may prove useful as a theoretically-motivated basis for improving diagnostic tools and treatment protocols for people with AOS and aphasia, thus enhancing clinical decision-making. Such translational and clinical research aimed at developing sensitive and specific diagnostic tools and improving treatment approaches is the ultimate long-term objective of this research program.
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Kinsella, Angela. "Developmental limb apraxia in deaf children : an objective assessment." Master's thesis, University of Cape Town, 2001. http://hdl.handle.net/11427/2923.
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Bibliography: leaves 99-104.This study determines the presence of developmental limb apraxia in deaf signing children and in an oral hearing-impaired child who presents with oral apraxia. The VICON 370 Motion Analysis System was adapted to objecitvely assess the presence of this disorder and to illustrate differences in patterns of movement between the experimental and control subjects.The execution of motor performance of praxic functioning was analysed on a continuum of complexity across signs, gestures and meaningless movement sequence. Qualitative measures of kinematic abnormalities, spatial parapraxias, temporal qualities, quantitative elbow joint angles, resultant tractories of elbow position and wrist joint centre were obtained.
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Murray, Elizabeth Jane. "Treatment Efficacy for Children with Childhood Apraxia of Speech." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/10072.
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This thesis addresses treatment outcomes for idiopathic childhood apraxia of speech (CAS), a significant and persistent disorder of speech motor planning and programming. There is a need for greater external evidence to guide clinical decision making. A systematic review of CAS treatment research published from 1970 to 2012 found there are no published randomised control trials (RCTs) for CAS. Three treatments showed strong preliminary evidence to warrant inclusion in future RCTs: Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition Treatment (ReST) and Integrated Phonological Awareness intervention. A constraint on treatment outcomes is the lack of a validated, clinically replicable procedure for differentiating CAS from all other speech sound disorders (SSDs). A methodological protocol was developed for differential diagnosis of idiopathic CAS and a parallel group RCT. The diagnostic study examined 47 children referred with suspected CAS. CAS was determined from other SSDs using the current gold standard, expert judgment using the ASHA (2007) and the Shriberg, Potter and Strand (2009) feature lists. 100% diagnostic reliability was achieved. Assessment measures were analysed using discriminant function analysis and four measures in combination predicted the original diagnosis with 91% accuracy. Replication is required. The RCT compared the ReST and NDP3 treatments for 26 children aged 4-12 years in an intensive block (1 hour sessions, 4 days a week for 3 weeks) delivered by supervised speech pathology clinicians. The NDP3 showed significantly greater treatment gains within 1 week post treatment and the ReST treatment demonstrated greater maintenance and generalisation to pseudo-words. Overall ReST and NDP3 have strong evidence for treatment efficacy for CAS. The discussion argues that children with CAS can demonstrate strong treatment and generalisation effects when treatment considers best evidence, appropriate diagnosis and plans for generalisation.
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Navarro, Cruzat Johan Cristopher, and Santander Catalina Valeria Núñez. "Pesquisa de riesgo de dispraxia en niños chilenos, de 8 a 12 años, de un colegio particular de Santiago." Tesis, Universidad de Chile, 2012. http://www.repositorio.uchile.cl/handle/2250/117014.
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La Dispraxia en nuestro país es un tema poco investigado, subdiagnosticado y frecuentemente considerado sólo como un problema menor, pese a que trae considerables consecuencias en la vida del niño que la padece. Según cifras internacionales afectaría a un 5 a 6 % de la población en edad escolar. La presente investigación evaluó el rendimiento de 57 niños en edad escolar, de entre 8 y 12 años, de un colegio mixto de nivel socio-económico alto de Santiago, en la Escala Motora de la Batería Neuropsicológica de Luria-Nebraska - Revisión Infantil, para determinar la prevalencia de “riesgo de dispraxia”. Se definió como tal cuando el rendimiento del niño supera 10 puntos en la suma de los puntajes en la Escala Motora de la batería. Se comparó el “riesgo de dispraxia” según grupo etáreo y sexo. El principal hallazgo fue un alto “riesgo de dispraxia” en la muestra estudiada. No hubo diferencias significativas por edad o sexo. La determinación de “riesgo de dispraxia” con esta batería es un tamizaje; para diagnosticar Dispraxia propiamente tal, se deben efectuar evaluaciones clínicas a cada niño. El abordaje de los niños dispráxicos o en riesgo de ello puede ser un importante campo laboral en Kinesiología.The Dyspraxia in our country is a little-researched, under-diagnosed and often considered only a minor problem, although it brings considerable impact on the life of the child who suffers. According to international numbers affects 5-6% of school age population. This research evaluated the performance of 57 schoolchildren, aged 8 to 12 years, of a mixed school of high socioeconomic level of Santiago, in the Motor Scale Battery Luria-Nebraska Neuropsychological - Child Review for determine the prevalence of "risk of dyspraxia". Was defined as such when the child's performance exceeds 10 points in the sum of the scores on the Motor Scale of the battery. We compared the "risk of dyspraxia" according to age group and sex. The main finding was a high "risk of dyspraxia" in the sample studied. There were no significant differences by age or sex. The determination of "risk of dyspraxia" with this battery is a screening, to diagnose dyspraxia itself, clinical evaluations must be made for each child. The approach to dyspraxic children at risk or it may be an important field of work in Kinesiology.
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Felizatti, Patricia. "Aspectos foneticos - fonologicos da disartria pos-traumatica : um estudo de caso." [s.n.], 1998. http://repositorio.unicamp.br/jspui/handle/REPOSIP/270985.
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Orientador: Maria Irma Hadler CoudryDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem
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Resumo: Esta dissertação destina-se ao estudo dos vários aspectos (localizacionistas, neurolingüísticos [fonético fonológicos], neuropsicológicos) que envolvem um caso clínico de disartria. Tal pesquisa integra-se ao projeto da área de Neurolingüistica do Instituto de Estudos da Linguagem (IEL), especificamente ao estudo da relação entre dificuldades ártricas e práxicas relacionadas com a produção da linguagem oral. Neste trabalho, descreverei um tipo específico de disartria, cuja etiologia é de natureza traumática (póstraumática). Incluirei em sua descrição o fato de a localização da lesão ser difusa e multifocal (comprometendo tanto o hemisfério direito quanto o hemisfério esquerdo). O sujeito em estudo (LC) apresentou, como uma das s~qüelas, a paralisia do palato posterior (palato mole), implicando a ausência de ação do músculo elevador do véu palatino, acarretando uma grave ressonância nasal na voz e aI teraçoes na emissão das consoantes, as quais requerem a oclusão da passagem nasal. Os tópicos relativos à produção verbal analisados nesta dissertação dizem respeito à velocidade de fala, aos parâmetros intonacionais, à duração dos segmentos fônicos, às alterações vocais e à inteligibilidade de sua comunicação oral. A relação entre a menor velocidade de fala e a maior duração dos segmentos pode ser verificada na análise experimental desta pesquisa teórico-clínica. No presente estudo, além de descrever e analisar o quadro seqüelar de LC, são apresentados e discutidos os princípios e procedimentos avaliativos e terapêuticos programados para ele durante seu seguimento longitudinal. No capítulo quatro, procedeu-se à análise dos sinais acústicos de segmentos da produção oral de LC, para estudo de velocidade de fala, de duração e de voz. No quinto capítulo, apresento os dados referentes aos padrões atuais do sujeito e as conclusões obtidas através deste estudo
Abstract: Not informed.
Mestrado
Mestre em Linguística
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Oliveira, Ana Maria Souto de. "Movimentos de sentido : questões de linguagem na introdução de atividades teatrais no Centro de Convivencia de Afasicos." [s.n.], 2000. http://repositorio.unicamp.br/jspui/handle/REPOSIP/284161.
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Orientadores: Ivan Santo Barbosa, Edwiges Maria MachadoDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Artes
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Resumo: A ausência de bibliografia sobre atividades teatrais com afásicos motivou a busca de uma reflexão teórica capaz de subsidiar o desenvolvimento de uma metodologia voltada a este contexto. Foi nos servindo de pressupostos teórico-metodoiógicos do CCA que pensamos algumas questões relativas a produção de significação no exercício da linguagem. Assim, ao entendermos a atividade teatral como produtora de significação, a tomamos como constituída de uma trama de trocas simbólicas e de contextos, tal como ocorre nas diversas esferas da vida cotidiana. Nos limites de nossa Pesquisa, tratamos de pensar questões que julgamos relevantes para desenvolver urna metodologia de introdução a improvisação teatral. Conceitualmente, pensada como um exercício de linguagem, elegemos alguns aspectos envolvidos na produção de significação e na formação do sentido para delinear questões que vão aqui, subsidiadas por alguns episódios de nossa atividade
Abstract: Not informed.
Mestrado
Mestre em Multimeios
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Cormack, Francesca K. "Visual perception and constructional apraxia in dementia with lewy bodies." Thesis, University of Newcastle Upon Tyne, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399012.
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Suraweera, Amila. "Senataxin and Its Role in Ataxia Oculomotor Apraxia Type 2." Thesis, University of Queensland, 2007. https://espace.library.uq.edu.au/view/UQ:151312.
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Neurodegenerative disorders are heterogeneous in nature and include ataxia oculomotor apraxia (AOA) syndromes that are characterised by cerebellar ataxia and a combination of different ophthalmological and neurological symptoms. AOA includes ataxia-telangiectasia (A-T), ataxia-telangiectasia like disorder (A-TLD), ataxia oculomotor apraxia type 1 (AOA1) and ataxia oculomotor apraxia type 2 (AOA2). The gene mutated in AOA2, SETX encodes a novel protein, senataxin, which shares homology to the yeast Sen1p protein, a DNA/RNA helicase. The C-terminus of senataxin contains a classical seven-motif domain found in the superfamily I of helicases. Senataxin is therefore a putative DNA/RNA helicase protein. Due to its homology with Sen1p, senataxin is hypothesised to play a role in RNA metabolism and as a nuclear helicase which plays a role in splicing. To characterise and elucidate the function of senataxin, anti-senataxin antibodies were generated against the N- and C-terminal regions of the protein. Using these antibodies the expression of senataxin in cell lines and the lack of senataxin in cells derived from AOA2 patients was shown. Furthermore, by using immunofluorescence and cellular fractionation, senataxin was demonstrated to be a nucleoplasmic protein, absent from nucleoli and with only negligible amounts of protein present in the cytoplasm. Sensitivity of AOA2 cells to DNA damaging agents was investigated. Data presented here show that similar to A-T, A-TLD and AOA1, AOA2 is also characterised by a defective response to DNA damage. AOA2 cells showed an increased sensitivity to the DNA damaging agent H2O2 and sensitivity to H2O2 was rescued by transfecting full-length SETX cDNA into these cells. However, unlike A-T cells, AOA2 cells showed a normal response to ionising radiation. A normal response to UV radiation was also observed. No defect in the repair of DNA single strand breaks was observed, however, the kinetics of re-sealing H2O2-induced DNA double strand breaks was found to be slower in AOA2 cells compared to controls. However, the rate of repair of IR-induced double strand breaks was normal, suggesting that senataxin may protect cells against oxidative DNA damage and play a role in the repair of DNA double strand breaks that arise as a result of oxidative DNA damage. In order to elucidate the biological function of senataxin, senataxin interacting proteins were identified by immunoprecipitation followed by either mass spectrometry or immunoblotting. Using this approach, senataxin was found to interact with nucleolin, heterogeneous nuclear ribonucleolar protein M, polyadenylate binding protein II, poly(A) binding protein I, spliceosomal protein 155, RNA Polymerase II and SMN, strongly suggesting a role for senataxin in all aspects of RNA metabolism including transcription and splicing. The sites of interaction between senataxin and nucleolin, spliceosomal protein 155, RNA Polymerase II and SMN were mapped and were found to be DNA or RNA independent. Chromatin immunoprecipitation assays were used to determine whether senataxin played a biological role similar to Sen1p in the transcriptional regulation of SOD1, CYC, IMPDH2, CypA and RPL36 genes. The ChIP assay showed that there was significantly less RNA Polymerase II binding to the SOD1, IMPDH2, CYC and RPL36 genomic loci in AOA2 cells compared with control cells. This differential binding of RNA Polymerase II to these genomic loci in AOA2 cells was also reflected in mRNA levels. RT-PCR demonstrated a good correlation between the reduced level of binding of RNA Polymerase II seen for SOD1, IMPDH2, CYC and RPL36 with the ChIP assay, in mRNA levels, suggesting that senataxin, similar to Sen1p, could be required for the transcriptional regulation of these genes. A double reporter assay was used to determine RNA splicing efficiency in cells where the expression of SETX was knocked-down by RNAi. This assay showed that there was a reduced splicing efficiency in cells where SETX was knocked-down compared to control cells, indicating that senataxin may be an essential factor required for splicing. Furthermore, senataxin was also shown to play a role in alternative splicing of the minigenes Tra2β1 and SRp20 and the splicing construct HC5 (derived from the human tropomycin gene). RT-PCR demonstrated that in the absence of senataxin, the splicing pattern of the minigenes Tra2β1 and SRp20 and the HC5 construct was altered, suggesting that senataxin played a role in alternative splice-site selection. This was also observed for both the endogenous human Transformer-2-beta gene (Tra2β1) and the human serine-arginine rich protein 20 (SRp20) genes, which is in agreement with a role for senataxin in alternative splice-site selection. Together, these data show that like other AOA syndromes, AOA2 is also characterised by a defect in the repair of DNA damage and that similar to Sen1p, senataxin also plays a role in RNA metabolism. In conclusion it can be hypothesised that the progressive neurological defect seen in AOA2 patients may result due to mutations in SETX which result in the misregulation of transcription, splicing and alternative splice-site selection. Some of these misregulated genes may include those involved in oxidative stress and DNA damage, since data presented in this thesis has shown that AOA2 cells are in a state of oxidative stress and have a defect in the repair of DNA double strand breaks that arise as a result of oxidative DNA damage in cells.
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Marmora, Claudia Helena Cerqueira. "Uma hipotese funcional para (a) praxia no curso da doença de Alzheimer." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/270997.
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Orientador: Maria Irma Hadler CoudryTese (doutorado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem
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Resumo: Esta tese tem como proposta discutir o processo que conduz às modificações funcionais relacionadas à práxis humana durante o curso demencial na Doença ou Demência de Alzheimer (DA), sob uma perspectiva funcional do sistema nervoso e vincula-se à Neurolingüística discursiva, perspectiva em que se assenta a prática clínica com a linguagem aqui em foco. Alinhada a tal proposta, preconiza-se a eleição de procedimentos terapêuticos no campo da Fisioterapia que contemplem o tratamento de sujeitos/pacientes com demência. Inserida em uma perspectiva cognitiva, esta tese apresenta duas correntes que influenciaram inicialmente seu percurso teórico: a Neuropsicologia soviética e a Neurolingüística discursiva. Na primeira, toma-se, como principal referência, o conceito de sistemas funcionais complexos formulado por Alexander R. Luria, sobre o funcionamento cerebral dinâmico, integrado e plástico do cérebro. Na segunda, toma-se a linguagem como o elemento simbólico crucial que norteia as demais funções cognitivas (memória, percepção, praxia, atenção, etc.). Essa Neurolingüística é baseada em uma concepção de linguagem como atividade constitutiva historicamente concebida, abrangente e pública. Decorrem de tais influências, posições teóricas que levam em conta do papel central da cultura e da linguagem na evolução psíquica ou cognitiva ao longo da história humana. Consideramos inicialmente que a DA não pode ser explicada unicamente por fenômenos anátomo-orgânicos e que fatores sociais, culturais e históricos intrínsecos ao curso de vida podem influenciar e determinar a progressão da doença. Portanto, as lembranças e os esquecimentos são também partes integrantes não só da doença, mas também da vida dos sujeitos com demência. Posto isso, a hipótese desta tese é que o resgate da memória individual e coletiva por meio da linguagem, presente na história pessoal e social, ajuda a (re)construção da memória no curso demencial. Através da linguagem em funcionamento e como sistema simbólico de representações e de significações, mantêm-se vivas as relações do sujeito com o mundo e com o outro. Assim também se mantém a função práxica. O corpus da pesquisa foi obtido nas sessões de acompanhamento fisioterapêutico longitudinal, no interior do projeto de pesquisa: ¿Acompanhamento fisioterapêutico longitudinal de sujeitos com demência (Doença de Alzheimer): análise de processos práxico-cognitivos¿ CDP/Propesq: 039/02 do Departamento de Fisioterapia da Faculdade de Medicina na Universidade Federal de Juiz de Fora (UFJF), vinculado ao ¿Projeto Integrado de Pesquisa em Neurolingüística avaliação e banco de dados¿ (CNPq: 521773/95-4), sendo seu objetivo a investigação da função práxica no curso demencial em um grupo de sujeitos com diagnóstico de DA, em estado inicial e intermediário, acompanhados durante 12 meses. Os dados foram videografados e transcritos. Os expedientes metodológicos utilizados para avaliar a condição cognitiva e funcional dos sujeitos foram entrevistas individuais, uma avaliação fisioterapêutica e o questionário de declínio cognitivo do idoso (IQCODE). Os resultados mostram a importância dos príncipíos teórico-metodológicos desse tipo de intervenção fisioterapêutica, baseada na vivência da interlocução, com foco na gestualidade e na construção do sentido no campo da Fisioterapia
Abstract: This thesis has as proposal to discuss the process that leads to the functional modifications related to the human praxis in the demencial course in Alzheimer¿s disease (AD), under a functional perspective of the nervous system; this thesis is tied to a neurolinguistic discoursive approach that orientes towards the clinical practice with the language in focus. Lined up to such proposal, it has been elected therapeutical procedures into the Physiotherapy field that contemplate the treatment of subjects/patientes with dementia. Within in a cognitive perspective, this thesis presents two chains that had influenced initially its theoretical path: the soviet Neuropsychology and the discursive Neurolinguistics. In the first one, the main concept is the complex functional systems formulated by Alexander R. Luria, on the dynamic, integrated and plastic cerebral functioning. In the second perspective, language is the crucial symbolic element that guides the many cognitives functions (memory, perception, praxia, attention, etc.). This Neurolinguistics is based on a conception of language as a constitutive activity historically conceived, inclusive and public. Theoretical positions elapse of such influences that take into account the central role of the culture and the language in the psycho or cognitive evolution along the human history. We consider initially that AD cannot solely be explained by anatomic and organic phenomena, but social, cultural and historical factors intrinsic to the life course can influence and determine the progression of the illness. Therefore, the memories ¿ preserved and lost - are also integrant parts not only of the illness, but also of the subjects lives with dementia. Being like this, the hypothesis of this thesis is that the rescue of the individual and collective memory by means of the language, given by personal and social history, aid the (re)construction of the memory in the demencial course. Through the language in functioning and as a symbolic system of representations and meanings, one keeps "alive" the relations of the subjetc with the world and with the other. Thus also the praxic function is kept. The corpus of the research was collected in the sessions of the longitudinal physiotherapeutic sessions, as part of the research project: "Longitudinal physiotherapeutic treatment of subjects with dementia (Alzheimer¿s disease): analysis of the praxis and cognitive processes" CDP/Propesq: 039/02, Department of Physiotherapy of the College of Medicine in the Federal University of Juiz De Fora (UFJF), tied with the "Integrated Project of Research in Neurolinguistics evaluation and data base" (CNPq: 521773/95-4), being its objective the inquiry of the praxic function in the demencial course in a group of subjects with AD diagnosis, in initial and intermediate degrees, followed during 12 months. The data had been recorded in video and transcriptions. The metodological expedients used to evaluate the cognitive and functional condition of the subjects had been individual interviews, a physiotherapeutic evaluation and the Informant questionnaire of cognitive decline in the elderly (IQCODE). The results show the importance of these theoretical and methodological physiotherapeutic intervention, based in the experience of the interlocution, focused in gestuality and the construction of the sense in the field of Physiotherapy
Doutorado
Neurolinguistica
Doutor em Neurolinguistica
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Barrington, Jillian. "Apraxia: What Interventions can Elementary Teachers use to Address Communication Skills?" ScholarWorks@UNO, 2013. http://scholarworks.uno.edu/honors_theses/30.
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Frens, Rachel Ann. "Treatment for Individuals with Apraxia of Speech: A Motor-based Approach." The Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1391587101.
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Baker, Alison Marie. "Language Profiles And Development Of Children With Childhood Apraxia Of Speech." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1584791531745808.
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Maas, Edwin. "The nature and time course of motor programming in apraxia of speech." Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2006. http://wwwlib.umi.com/cr/ucsd/fullcit?p3219845.
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Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2006.Title from first page of PDF file (viewed September 5, 2006). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 247-260).
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Bolton, Sylvia. "When dyspraxia meets dyslexia at 11+." Thesis, n.p, 2001. http://dart.open.ac.uk/abstracts/page.php?thesisid=106.
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Van, Putten Steffany M. "The Production of Emotional Prosdy in Varying Severities of Apraxia of Speech." Fogler Library, University of Maine, 2001. http://www.library.umaine.edu/theses/pdf/VanPuttenSM2001.pdf.
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Hayes, Sydney A. "A DESCRIPTION OF AAC USE BY CHILDREN DIAGNOSED WITH APRAXIA OF SPEECH." Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1619955833449601.
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Gomez, Mirjana Maryane. "Treating Childhood Apraxia of Speech: Evaluating the Kaufman Speech to Language Protocol." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29624.
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A Cochrane review of the treatments used for childhood apraxia of speech (CAS) in 2009 identified the need for more well controlled studies (Morgan & Vogel, 2009). These same recommendations were echoed when the review was completed again in 2018 (Morgan, Murray & Liegeois, 2018). There is currently no gold-standard intervention recommended for children with CAS (Morgan et al., 2018). Since the first Cochrane study was published, research has been conducted to examine a small range of treatment approaches for CAS. Despite the increased publication of treatment research, speech-language pathologists continue to use treatment approaches that are not supported with empirical evidence. The Kaufman Speech-Language Protocol (K-SLP) is a treatment approach that uses successive approximations to improve speech in children with CAS (Kaufman, 2014). At the commencement of this PhD there was no published evidence for the K-SLP. The overall aim of this thesis is to investigate the effectiveness of the K-SLP. To do this, five research studies have been completed.
It is imperative to determine what speech-language pathology clinicians currently use to treat CAS in a clinical setting, and the proportion of speech-language pathologists that use the K-SLP to treat CAS. These questions were investigated quantitatively using survey research. The surveys also sought to establish what training, if any, the speech-language pathologists obtained prior to implementing a treatment approach, and whether they administered the treatment according to available protocols.
Following these studies, three treatment studies using single case experimental design method were conducted to evaluate the K-SLP. Participants for each of these studies were assessed to confirm their diagnosis of CAS using the diagnostic criteria outlined by the American Speech-Language-Hearing Association (ASHA), childhood apraxia of speech (CAS) technical report (ASHA, 2007). Treatment was provided according to a standardised treatment protocol by either the primary investigator or by trained student clinicians. The result of the three studies is an operationalised protocol for delivering the K-SLP. An additional two chapters exploring results across the three treatment studies are included. The results of our post-hoc analyses indicates that inconsistency should be used as an outcome measure to assess the effectiveness of CAS interventions. Additionally, it was found that the statistical analysis used to measure clinically relevant changes (i.e., effect sizes) impacted the evaluation of clinical research, therefore effect sizes that take into account children’s variable production at baseline (a common feature of CAS; see ASHA, 2007) should be used.
The research conducted indicated that the K-SLP was frequently used to treat CAS in the US. Results from the three treatment studies showed that the K-SLP was effective in improving the articulatory accuracy and speech consistency of children with CAS.
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Kingma, Rachel Mary Miles. "A controlled clinical application of motor learning principles with apraxia of speech." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/14216.
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Adults with acquired apraxia of speech (AOS) often do not generalise effects of treatment to untreated speech behaviours. Recent studies suggest that using the principles of motor learning (PML) approach may optimise retention and generalisation in AOS. PML guide the structure of motor practice along with the frequency and type of feedback provided during practice. This study aimed to investigate the effects of order of stimulus presentation and feedback frequency, on the acquisition, retention, and generalisation of speech skills in persons with acquired AOS plus aphasia. Four participants with AOS participated in a crossover design with multiple baselines across behaviours to compare two sets of motor learning principles– random order of stimulus presentation with low frequency feedback (R-L) ), considered more beneficial for learning, versus blocked order with high frequency feedback, considered less beneficial. All participants demonstrated significantly improved performance with treated words for both treatment regimes, both throughout treatment and on retention probes. There was a trend for better retention for some participants following the R-L condition. Performance data from treatment sessions did not support more rapid acquisition under either regime. Three of four participants showed generalisation of treatment effects to untreated related words, regardless of treatment conditions. Consistent with previous studies, individuals with chronic AOS responded positively to articulation-based intervention. The limited difference between the treatment conditions tested here suggests that the practice schedule and feedback frequency may be less important than the amount of practice provided; although the interaction of these principles and treatment dosage with other factors such as disorder severity require further investigation.
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Mahoney, Phillip Matthew. "Script Training and Feedback Type in the Treatment of Apraxia of Speech." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/602648.
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Communication SciencesM.A.
Acquired apraxia of speech (AOS) is a type of motor speech disorder (MSD) characterized by deficits in the motor planning or programming of speech movements (Duffy, 2005). Because AOS is often a chronic condition that may severely impair intelligibility and, thus, significantly reduce quality of life (Ballard et al., 2015), it is necessary to develop efficient and effective treatment protocols. A previous study by Youmans, Youmans, and Hancock (2011), demonstrated the efficacy of script training in the treatment of AOS. Furthermore, extensive research in general motor learning has shown that feedback is one of the most important components of motor learning (Schmidt & Lee, 2011). Research devoted specifically to speech motor learning has generally favored this view, though few studies have distinguished between the two major types of feedback: feedback providing knowledge of results (KR) and feedback providing knowledge of performance (KP). The present study is the first to examine feedback type in treatment for AOS, and the first to examine the utility of script training specifically for a participant with AOS, but no aphasia. The findings from this single-case experimental design study reveal that, compared to KR, KP resulted in greater improvements in speaking rate. KR and KP feedback resulted in comparable gains for accuracy, but condition differences were difficult to interpret due to unexpected rising baselines for the KR scripts. Both KR and KP scripts, but especially the KP scripts, outperformed the untreated control scripts, providing further support for the efficacy of script training for AOS.
Temple University--Theses
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Beerman, Kathryn B. S. "The Occurrence of Vowel Errors Across Age Groups in Childhood Apraxia of Speech." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1306501638.
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Albinsson, Sophie, and Julia Berglund. "Testbatteri för talapraxi : Utformning och pilotnormering av ett artikulationstest." Thesis, Uppsala universitet, Logopedi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-143045.
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Talapraxi är en talmotorikstörning som drabbar planeringen och programmeringen av talet, vilket visar sig som avvikelser i artikulation och prosodi. I dag finns inget svenskt test för utredning av talapraxi. Syftet med studien var därför att utforma ett testbatteri på svenska som är känsligt även för lindriga grader av talapraxi. Detta test pilotnormerades på 50 friska deltagare. För att kunna studera hur kön, ålder och utbildningsnivå kan inverka på prestationen i testbatteriet, eftersträvades en jämn fördelning när det gäller dessa demografiska bakgrundsvariabler. Uppgifterna konstruerades baserat på tidigare forskning gällande de typiska perceptuella dragen vid talapraxi och på testuppgifter som tidigare har visat sig vara känsliga för talapraxi. Deltagarnas prestation varierade mellan testbatteriets olika uppgifter. På några uppgifter hade en stor andel av deltagarna alla rätt, medan andra uppgifter visade sig vara utmanande även för friska personer. Inga signifikanta könsskillnader fanns för prestationerna på någon av uppgifterna i testbatteriet. Utbildningsnivå och ålder påverkade däremot prestationen på vissa uppgifter. Generellt var effektstyrkorna för utbildningsnivå större än för ålder. Testbatteriet bör i framtiden kunna ge ett bra underlag för bedömning av huruvida talapraxi föreligger eller inte. Det bör också kunna användas vid bedömning av talapraxins svårighetsgrad. För att gå vidare med utvecklingen av testbatteriet bör man fortsätta normeringen på ett större antal personer samt kliniskt validera det på personer med diagnostiserad talapraxi.Apraxia of speech (AOS) is a motor speech disorder that affects the planning and programming of speech, resulting in articulatory and prosodic distortions. To this date there is no available test in Swedish for assessment of AOS. Therefore, the aim of this study was to construct a test battery that enables the assessment of level of severity of the disorder, including mild AOS. A pilot standardization was performed on 50 healthy speakers. In order to determine whether the performance on the test battery is affected by sex, age or level of education, the selection of participants was stratified by these variables. The tasks were constructed based on previous research regarding the perceptual characteristics of AOS, taking into account also the types of tasks that have proved to be challenging for patients with AOS. The performance varied between different tasks of the test battery. On some tasks a high portion of the participants got very high scores, while other tasks were shown to be challenging even for healthy speakers. No significant sex differences were found on any of the tasks. However, age and level of education significantly affected the performance on some of the tasks. Overall, the effect sizes for level of education were larger than for age. In the future, the test battery should be able to determine the presence or absence and severity of AOS. For further development of the test battery, the standardization should continue using a larger sample. A clinical validation on patients with diagnosed AOS is also of great importance.
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Marmora, Claudia Helena Cerqueira. "Linguagem, afasia, (a)praxia : uma perspectiva neurolinguistica." [s.n.], 2000. http://repositorio.unicamp.br/jspui/handle/REPOSIP/270992.
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Orientador: Maria Irma Hadler CoudryDissertação ( mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem
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Resumo: A Neurolingüística baseada em uma concepção enunciativo-discursiva da linguagem constitui-se atualmente como um amplo campo de investigação na área de pesquisas da cognição, incluindo a Fisioterapia. Tomam-se como referências principais para as opções teóricometodológicas assumidas, autores como COUDRY (1986/96, 1997) e MORATO (1996, 1999) no que se refere às concepções discursivas da Neurolingüística e LURIA (1966,1973,1981, 1987) e CHRISTENSEN (1987), no que se refere ao método de investigação baseado na teoria do sistema funcional complexo. A apraxia, tomada como um dos fenômenos cognitivos de estreita relação com a afasia, ainda é um ponto que motiva inúmeros pesquisadores nos estudos neuropsicológicos e neurolingüísticos. Neste trabalho, faz-se uma reflexão acerca da relação linguagem/praxia, discutindo-se a avaliação de praxias realizada nos testes neuropsicológicos com sujeitos cérebro-lesados afásicos. Estes procedimentos são usados como instrumentos de diagnóstico, sendo baseados em seores a partir dos resultados obtidos, o que muitas vezes leva a crer que os sujeitos não compreendem as instruções pedidas. Diante disso, a principal questão levantada por esse estudo é mostrar que a co-ocorrência da apraxia com a afasia se faz presente justamente pelo fato de existir linguagem envolvida e não necessariamente por problemas de movimento, já que a solicitação é quase sempre feita verbalmente. Argumenta-se a favor da inserção de princípios teórico-metodológicos neuropsieológieos e neurolingüístieos nos estudos de Fisioterapia, baseada quase exclusivamente em princípios neurofisiológicos. O eorpora de dados apresentados mostra a oposição entre uma avaliação e uma intervenção propostas discursivamente, e aquela, usada comumente nos testes-padrão
Abstract: The Neurolinguistics based on a discoursive conception of language is today an important field for investigation in cognition research, including Physiotherapy. The main authors wich orientaing this study, as long as theoretical and methodological principies are concerned, were COUDRY (1986/96) and MORATO (1996, 1999) as a reference to discoursive conceptions in Neurolinguistic and LURIA (1966, 1973, 1981, 1987), as well, CHRISTENSEN (1987) for the investigation method based on complex functional system theory. Apraxia, taken as a cognitive phenomena in close relationship to aphasia, reminds a point of interest wich results in a great number of neuropsychological and neurolinguistc studies. The author reflects about the relationship between /anguage and praxia, discussing the apraxia assessment in neuropsychological test batteries for aphasic subjects. These procedures, employed as diagnostic aids, are based on the results of the scores obtained, what may show that sometimes the subjects do not understand the instructions. The aim of this study is to show that apraxia occuring together with aphasia is a consequence of /anguage invo/vement and not as a consequence of movement impairment, because the tests instructions are usually verbal. It is suggested to insert neuropsychological and neurolinguistics theoretical and methodological principies in teaching and researching of Physiotherapy issues, traditionally based almost exclusively on neurophysiological principies. The data presented show differences and opposition between an assessment and intervention, based on a discursive approach and those largely used in traditional test batteries
Mestrado
Mestre em Linguística
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McNeill, Brigid. "Advancing spoken and written language development in children with childhood apraxia of speech." Thesis, University of Canterbury. Communication Disorders, 2007. http://hdl.handle.net/10092/1462.
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Children with childhood apraxia of speech (CAS) are likely to experience severe and persistent spoken and written language disorder. There is a scarcity of intervention research, however, investigating techniques to improve the speech and literacy outcomes of this population. The series of 5 experiments reported in this thesis investigated phonological awareness and early reading development in children with CAS and trialled a new intervention designed to advance the spoken and written language development of those affected. In the first experiment (presented in Chapter 2), a comparison of 12 children with CAS, 12 children with inconsistent speech disorder (ISD), and 12 children with typical speech-language development (TD) revealed that children with CAS may be particularly susceptible to phonological awareness and reading deficits. There was no difference in the articulatory consistency and speech severity of the CAS and ISD groups, and no difference in the receptive vocabulary of the CAS, ISD, and TD groups. The children with CAS exhibited poorer phonological awareness scores than the comparison groups and had a greater percentage of participants performing below the expected range for their age on letter knowledge, real word decoding, and phonological awareness normative measures. The children with CAS and ISD performed inferiorly than the children with TD on a receptive phonological representation task. The results showed that the children with CAS had a representational component to their disorder that needed to be addressed in intervention. In the second experiment (presented in Chapter 3), a follow-up pilot study was conducted to examine the long-term effects of a previously conducted intensive integrated phonological awareness programme (7 hours of intervention over 3 weeks) on 2 children with CAS. The children aged 7;3 and 8;3 at follow-up assessment had previously responded positively to the intervention. Results showed that the children were able to maintain their high accuracy in targeted speech repeated measures over the follow-up period. One child was also able to maintain her high accuracy in phonological awareness repeated measures. The children performed superiorly on a standardised phonological awareness measure at follow-up than at pre-intervention. Non-word reading ability showed a sharp increase during the intervention period, while minimal gains were made in this measure over the follow-up period. The findings suggested that an integrated intervention was a potential therapeutic approach for children with CAS. In the third experiment (presented in Chapter 4), the effectiveness of an integrated phonological awareness programme was evaluated for the 12 children (identified in the first experiment) aged 4 to 7 years with CAS. A controlled multiple single-subject design with repeated measures was employed to analyse change in trained and untrained speech and phoneme segmentation targets. A comparative group design was used to evaluate the phonological awareness, reading, and spelling development of the children with CAS compared to their peers with TD over the intervention. The children participated in two 6- week intervention blocks (2-sessions per week) separated by a 6-week withdrawal block. Seven children with CAS made significant gains in their production of trained and untrained speech words with 7 of these children demonstrating transfer of skills to connected speech for at least one target. Ten children showed significant gains in phoneme awareness, and 8 of these children demonstrated transfer of skills to novel phoneme awareness tasks. As a group, the children with CAS demonstrated accelerated development over the intervention period in letter knowledge, phonological awareness, word decoding, and spelling ability compared to their peers with typical development. In the fourth experiment (presented in Chapter 5), the speech, phonological awareness, reading, and spelling skills of children with CAS and TD were re-evaluated 6- months following completion of the intervention programme. A measure of reading accuracy and reading comprehension in a text reading task was administered to the children with CAS. There was no difference in the performance of the children with CAS in post-intervention and follow-up assessments. The children with CAS and children with TD presented with similar relative change in phonological awareness, reading, and decoding measures over the follow-up period. The connected reading performance of children with CAS mirrored their phonological awareness and decoding skills. The findings demonstrated that children with CAS were able to maintain gains achieved during the intervention but may need further support to promote sustained development in written language. In the fifth experiment (presented in Chapter 6), the long-term effects of the integrated phonological awareness programme for identical twin boys who participated in the research intervention at pre-school were examined. The study examined Theo and Jamie's spoken language, phonological awareness, reading, and spelling development during their first year of schooling. The results pointed to the benefit of providing phonological awareness within a preventative framework for children with CAS. Theo and Jamie experienced continued growth in speech and phonological awareness skills. They exhibited age-appropriate reading and spelling development during their first year of formal literacy instruction. It was concluded from this series of experiments that children with CAS are particularly vulnerable to phonological awareness and early reading difficulty, and that an integrated phonological awareness intervention is an effective means of developing speech, phonological awareness, reading, and spelling skills in most children with CAS. The intervention appears to target processes underlying spoken and written language development in this population. The results are discussed within a phonological representation deficit hypothesis of CAS and clinical implications of the findings are highlighted.
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Mumby, Katharyn Joanna. "An investigation of apraxia of speech and grammar in connected speech following stroke." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493440.
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The nature of Apraxia of Speech (AOS) is poorly understood, particularly in connected speech, and there has been controversy about diagnosis, which has been based on clinical judgements without adequate measures of reliability. There have been few studies of AOS in connected speech rather than single words, fewer about grammar, and no investigations of AOS and grammar in spontaneous speech. The thesis adopts Text units ('TU's, which are smaller than traditional sentences), for segmenting connected speech when looking at AOS, and applies multilevel random-intercept logistic regression modelling to measure many factors concurrently. Three strands of evidence about AOS in connected speech are presented.
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Barbot, Maria Clara Barcelos de Morais. "Ataxia com apraxia oculomotora (AOA) como modelo para o estudo das ataxias recessivas." Doctoral thesis, Instituto de Ciências Biomédicas Abel Salazar, 2007. http://hdl.handle.net/10216/7234.
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Barbot, Maria Clara Barcelos de Morais. "Ataxia com apraxia oculomotora (AOA) como modelo para o estudo das ataxias recessivas." Tese, Instituto de Ciências Biomédicas Abel Salazar, 2007. http://hdl.handle.net/10216/7234.
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Meza, Patricia J. "Life Transitions of Children with Idiopathic Childhood Apraxia of Speech: A Qualitative Descriptive Study." eScholarship@UMMS, 2021. https://escholarship.umassmed.edu/gsn_diss/65.
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PURPOSE: The purpose of this qualitative descriptive study was to explore the experiences of emerging adults with idiopathic CAS, as they reflected on their transitions through childhood, adolescence, and young adulthood.
SPECIFIC AIMS: Describe the experiences of emerging adults with idiopathic CAS as they reflect on developmental stages of childhood, adolescence, and young adulthood, including the situational experiences of transition occurring between elementary, middle, high school, and post-secondary education, training, or work. Identify strategies and the effectiveness of the strategies utilized by emerging adults with idiopathic CAS to manage experiences during different developmental stages and situational experiences of transition occurring between elementary, middle, high school, and post-secondary education, training, or work.
FRAMEWORK: Meleis’ Transitions Theory.
DESIGN: A qualitative descriptive design with purposive sampling was used. Data was analyzed using thematic analysis.
RESULTS: Findings support the use of Transitions Theory. Three major themes were identified: The Child’s Environment, Implications of CAS, and Strategies. The school environment contributed to many implications for children. Older children were able to develop strategies to overcome challenges. In the school setting, children did not access nurses for concerns related to their CAS.
CONCLUSIONS: CAS creates many challenges for children. Emerging adults with CAS report that environments in which people are knowledgeable, patient, understanding, accepting, and supportive help them express themselves freely despite their speech impairment. The nurse’s role in supporting children with CAS during grade school is untapped as they were largely invisible to the children as a potential resource for anything other than an injury or illness. To better facilitate supportive environments in which children with CAS can flourish, nursing assessment and interventions are needed.
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Hancock, Janelle Louise. "Biochemical characterization of Aprataxin, the protein deficient in Ataxia with Oculomotor Apraxia type 1." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/28603/1/Janelle_Hancock_Thesis.pdf.
Full textAbstract:
Neurodegenerative disorders are heterogenous in nature and include a range of ataxias with oculomotor apraxia, which are characterised by a wide variety of neurological and ophthalmological features. This family includes recessive and dominant disorders. A subfamily of autosomal recessive cerebellar ataxias are characterised by defects in the cellular response to DNA damage. These include the well characterised disorders Ataxia-Telangiectasia (A-T) and Ataxia-Telangiectasia Like Disorder (A-TLD) as well as the recently identified diseases Spinocerebellar ataxia with axonal neuropathy Type 1 (SCAN1), Ataxia with Oculomotor Apraxia Type 2 (AOA2), as well as the subject of this thesis, Ataxia with Oculomotor Apraxia Type 1 (AOA1). AOA1 is caused by mutations in the APTX gene, which is located at chromosomal locus 9p13. This gene codes for the 342 amino acid protein Aprataxin. Mutations in APTX cause destabilization of Aprataxin, thus AOA1 is a result of Aprataxin deficiency. Aprataxin has three functional domains, an N-terminal Forkhead Associated (FHA) phosphoprotein interaction domain, a central Histidine Triad (HIT) nucleotide hydrolase domain and a C-terminal C2H2 zinc finger. Aprataxins FHA domain has homology to FHA domain of the DNA repair protein 5’ polynucleotide kinase 3’ phosphatase (PNKP). PNKP interacts with a range of DNA repair proteins via its FHA domain and plays a critical role in processing damaged DNA termini. The presence of this domain with a nucleotide hydrolase domain and a DNA binding motif implicated that Aprataxin may be involved in DNA repair and that AOA1 may be caused by a DNA repair deficit. This was substantiated by the interaction of Aprataxin with proteins involved in the repair of both single and double strand DNA breaks (XRay Cross-Complementing 1, XRCC4 and Poly-ADP Ribose Polymerase-1) and the hypersensitivity of AOA1 patient cell lines to single and double strand break inducing agents. At the commencement of this study little was known about the in vitro and in vivo properties of Aprataxin. Initially this study focused on generation of recombinant Aprataxin proteins to facilitate examination of the in vitro properties of Aprataxin. Using recombinant Aprataxin proteins I found that Aprataxin binds to double stranded DNA. Consistent with a role for Aprataxin as a DNA repair enzyme, this binding is not sequence specific. I also report that the HIT domain of Aprataxin hydrolyses adenosine derivatives and interestingly found that this activity is competitively inhibited by DNA. This provided initial evidence that DNA binds to the HIT domain of Aprataxin. The interaction of DNA with the nucleotide hydrolase domain of Aprataxin provided initial evidence that Aprataxin may be a DNA-processing factor. Following these studies, Aprataxin was found to hydrolyse 5’adenylated DNA, which can be generated by unscheduled ligation at DNA breaks with non-standard termini. I found that cell extracts from AOA1 patients do not have DNA-adenylate hydrolase activity indicating that Aprataxin is the only DNA-adenylate hydrolase in mammalian cells. I further characterised this activity by examining the contribution of the zinc finger and FHA domains to DNA-adenylate hydrolysis by the HIT domain. I found that deletion of the zinc finger ablated the activity of the HIT domain against adenylated DNA, indicating that the zinc finger may be required for the formation of a stable enzyme-substrate complex. Deletion of the FHA domain stimulated DNA-adenylate hydrolysis, which indicated that the activity of the HIT domain may be regulated by the FHA domain. Given that the FHA domain is involved in protein-protein interactions I propose that the activity of Aprataxins HIT domain may be regulated by proteins which interact with its FHA domain. We examined this possibility by measuring the DNA-adenylate hydrolase activity of extracts from cells deficient for the Aprataxin-interacting DNA repair proteins XRCC1 and PARP-1. XRCC1 deficiency did not affect Aprataxin activity but I found that Aprataxin is destabilized in the absence of PARP-1, resulting in a deficiency of DNA-adenylate hydrolase activity in PARP-1 knockout cells. This implies a critical role for PARP-1 in the stabilization of Aprataxin. Conversely I found that PARP-1 is destabilized in the absence of Aprataxin. PARP-1 is a central player in a number of DNA repair mechanisms and this implies that not only do AOA1 cells lack Aprataxin, they may also have defects in PARP-1 dependant cellular functions. Based on this I identified a defect in a PARP-1 dependant DNA repair mechanism in AOA1 cells. Additionally, I identified elevated levels of oxidized DNA in AOA1 cells, which is indicative of a defect in Base Excision Repair (BER). I attribute this to the reduced level of the BER protein Apurinic Endonuclease 1 (APE1) I identified in Aprataxin deficient cells. This study has identified and characterised multiple DNA repair defects in AOA1 cells, indicating that Aprataxin deficiency has far-reaching cellular consequences. Consistent with the literature, I show that Aprataxin is a nuclear protein with nucleoplasmic and nucleolar distribution. Previous studies have shown that Aprataxin interacts with the nucleolar rRNA processing factor nucleolin and that AOA1 cells appear to have a mild defect in rRNA synthesis. Given the nucleolar localization of Aprataxin I examined the protein-protein interactions of Aprataxin and found that Aprataxin interacts with a number of rRNA transcription and processing factors. Based on this and the nucleolar localization of Aprataxin I proposed that Aprataxin may have an alternative role in the nucleolus. I therefore examined the transcriptional activity of Aprataxin deficient cells using nucleotide analogue incorporation. I found that AOA1 cells do not display a defect in basal levels of RNA synthesis, however they display defective transcriptional responses to DNA damage. In summary, this thesis demonstrates that Aprataxin is a DNA repair enzyme responsible for the repair of adenylated DNA termini and that it is required for stabilization of at least two other DNA repair proteins. Thus not only do AOA1 cells have no Aprataxin protein or activity, they have additional deficiencies in PolyADP Ribose Polymerase-1 and Apurinic Endonuclease 1 dependant DNA repair mechanisms. I additionally demonstrate DNA-damage inducible transcriptional defects in AOA1 cells, indicating that Aprataxin deficiency confers a broad range of cellular defects and highlighting the complexity of the cellular response to DNA damage and the multiple defects which result from Aprataxin deficiency. My detailed characterization of the cellular consequences of Aprataxin deficiency provides an important contribution to our understanding of interlinking DNA repair processes.
41
Hancock, Janelle Louise. "Biochemical characterization of Aprataxin, the protein deficient in Ataxia with Oculomotor Apraxia type 1." Queensland University of Technology, 2008. http://eprints.qut.edu.au/28603/.
Full textAbstract:
Neurodegenerative disorders are heterogenous in nature and include a range of ataxias with oculomotor apraxia, which are characterised by a wide variety of neurological and ophthalmological features. This family includes recessive and dominant disorders. A subfamily of autosomal recessive cerebellar ataxias are characterised by defects in the cellular response to DNA damage. These include the well characterised disorders Ataxia-Telangiectasia (A-T) and Ataxia-Telangiectasia Like Disorder (A-TLD) as well as the recently identified diseases Spinocerebellar ataxia with axonal neuropathy Type 1 (SCAN1), Ataxia with Oculomotor Apraxia Type 2 (AOA2), as well as the subject of this thesis, Ataxia with Oculomotor Apraxia Type 1 (AOA1). AOA1 is caused by mutations in the APTX gene, which is located at chromosomal locus 9p13. This gene codes for the 342 amino acid protein Aprataxin. Mutations in APTX cause destabilization of Aprataxin, thus AOA1 is a result of Aprataxin deficiency. Aprataxin has three functional domains, an N-terminal Forkhead Associated (FHA) phosphoprotein interaction domain, a central Histidine Triad (HIT) nucleotide hydrolase domain and a C-terminal C2H2 zinc finger. Aprataxins FHA domain has homology to FHA domain of the DNA repair protein 5’ polynucleotide kinase 3’ phosphatase (PNKP). PNKP interacts with a range of DNA repair proteins via its FHA domain and plays a critical role in processing damaged DNA termini. The presence of this domain with a nucleotide hydrolase domain and a DNA binding motif implicated that Aprataxin may be involved in DNA repair and that AOA1 may be caused by a DNA repair deficit. This was substantiated by the interaction of Aprataxin with proteins involved in the repair of both single and double strand DNA breaks (XRay Cross-Complementing 1, XRCC4 and Poly-ADP Ribose Polymerase-1) and the hypersensitivity of AOA1 patient cell lines to single and double strand break inducing agents. At the commencement of this study little was known about the in vitro and in vivo properties of Aprataxin. Initially this study focused on generation of recombinant Aprataxin proteins to facilitate examination of the in vitro properties of Aprataxin. Using recombinant Aprataxin proteins I found that Aprataxin binds to double stranded DNA. Consistent with a role for Aprataxin as a DNA repair enzyme, this binding is not sequence specific. I also report that the HIT domain of Aprataxin hydrolyses adenosine derivatives and interestingly found that this activity is competitively inhibited by DNA. This provided initial evidence that DNA binds to the HIT domain of Aprataxin. The interaction of DNA with the nucleotide hydrolase domain of Aprataxin provided initial evidence that Aprataxin may be a DNA-processing factor. Following these studies, Aprataxin was found to hydrolyse 5’adenylated DNA, which can be generated by unscheduled ligation at DNA breaks with non-standard termini. I found that cell extracts from AOA1 patients do not have DNA-adenylate hydrolase activity indicating that Aprataxin is the only DNA-adenylate hydrolase in mammalian cells. I further characterised this activity by examining the contribution of the zinc finger and FHA domains to DNA-adenylate hydrolysis by the HIT domain. I found that deletion of the zinc finger ablated the activity of the HIT domain against adenylated DNA, indicating that the zinc finger may be required for the formation of a stable enzyme-substrate complex. Deletion of the FHA domain stimulated DNA-adenylate hydrolysis, which indicated that the activity of the HIT domain may be regulated by the FHA domain. Given that the FHA domain is involved in protein-protein interactions I propose that the activity of Aprataxins HIT domain may be regulated by proteins which interact with its FHA domain. We examined this possibility by measuring the DNA-adenylate hydrolase activity of extracts from cells deficient for the Aprataxin-interacting DNA repair proteins XRCC1 and PARP-1. XRCC1 deficiency did not affect Aprataxin activity but I found that Aprataxin is destabilized in the absence of PARP-1, resulting in a deficiency of DNA-adenylate hydrolase activity in PARP-1 knockout cells. This implies a critical role for PARP-1 in the stabilization of Aprataxin. Conversely I found that PARP-1 is destabilized in the absence of Aprataxin. PARP-1 is a central player in a number of DNA repair mechanisms and this implies that not only do AOA1 cells lack Aprataxin, they may also have defects in PARP-1 dependant cellular functions. Based on this I identified a defect in a PARP-1 dependant DNA repair mechanism in AOA1 cells. Additionally, I identified elevated levels of oxidized DNA in AOA1 cells, which is indicative of a defect in Base Excision Repair (BER). I attribute this to the reduced level of the BER protein Apurinic Endonuclease 1 (APE1) I identified in Aprataxin deficient cells. This study has identified and characterised multiple DNA repair defects in AOA1 cells, indicating that Aprataxin deficiency has far-reaching cellular consequences. Consistent with the literature, I show that Aprataxin is a nuclear protein with nucleoplasmic and nucleolar distribution. Previous studies have shown that Aprataxin interacts with the nucleolar rRNA processing factor nucleolin and that AOA1 cells appear to have a mild defect in rRNA synthesis. Given the nucleolar localization of Aprataxin I examined the protein-protein interactions of Aprataxin and found that Aprataxin interacts with a number of rRNA transcription and processing factors. Based on this and the nucleolar localization of Aprataxin I proposed that Aprataxin may have an alternative role in the nucleolus. I therefore examined the transcriptional activity of Aprataxin deficient cells using nucleotide analogue incorporation. I found that AOA1 cells do not display a defect in basal levels of RNA synthesis, however they display defective transcriptional responses to DNA damage. In summary, this thesis demonstrates that Aprataxin is a DNA repair enzyme responsible for the repair of adenylated DNA termini and that it is required for stabilization of at least two other DNA repair proteins. Thus not only do AOA1 cells have no Aprataxin protein or activity, they have additional deficiencies in PolyADP Ribose Polymerase-1 and Apurinic Endonuclease 1 dependant DNA repair mechanisms. I additionally demonstrate DNA-damage inducible transcriptional defects in AOA1 cells, indicating that Aprataxin deficiency confers a broad range of cellular defects and highlighting the complexity of the cellular response to DNA damage and the multiple defects which result from Aprataxin deficiency. My detailed characterization of the cellular consequences of Aprataxin deficiency provides an important contribution to our understanding of interlinking DNA repair processes.
42
Knight, Ann Marie. "Interhemispheric transfer of praxis information using probable Alzheimer's disease as a model for disconnection apraxia." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010061.
Full text
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Chavez, David. "The Childhood Apraxia of Speech Parent Project| A grant proposal for an education-support group." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1592511.
Full textAbstract:
The purpose of this project was to locate a potential funding source and write a grant to establish an education-support group for parents/caregivers of a child diagnosed with Childhood Apraxia of Speech (CAS). An extensive literature review was performed, illustrating the need for emotional support and the advocacy skills needed to navigate the special education system. The Westside Family Resource & Empowerment Center, located in Culver City, California, would be the host agency.
The goals are to empower families by strengthening their advocacy skills and helping them manage the life-changing diagnosis of CAS. If funded, the CAS Parent Project would provide education and support to parents/caregivers, thereby benefiting the child with CAS as well. Five series of groups, serving a total of 50 to 60 parents/caregivers, would be implemented during the funding period.
Actual submission of the grant application was not a requirement for the completion of this thesis project.
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Bailey, Elizabeth Eileen. "The use of singing to improve articulatory accuracy in a child with apraxia and dysarthria." Scholarly Commons, 1987. https://scholarlycommons.pacific.edu/uop_etds/2136.
Full textAbstract:
A single subject, diagnosed as having severe oral apraxia and dysarthria, participated in an eight-week research experiment designed to study the effects of singing on speech articulation. A simultaneous treatment design was used in which the subject participated in both the e xperimental and control conditions. In the control condition spoken words were repeated by the subject, while in the experimental condition the words were sung. The words used were the lyrics to two popular folk songs. Articulatory accuracy (intelligibility) was judged by two graduate level speech therapists, based on audiotape samples of the subject's responses, recorded on a "Language Master" machine. Judges were also asked to rate their degree of confidence about their judgements. Results indicated significantly higher scores at the .05 level for the singing condition than for the non-singing condition. Degree of confidence ratings were similar for both conditions. It was also observed that a significantly greater number of consonant blends were correctly articulated in the singing condition than in the nonsinging condition.
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Gifford, Taylor. "Nonword Repetition Errors in Childhood Apraxia of Speech, Speech Sound Disorder, and Developmental Language Disorder." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1588167731541878.
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Skinder, Amy E. "The relationship of prosodic and articulatory errors produced by children with developmental apraxia of speech /." Thesis, Connect to this title online; UW restricted, 2000. http://hdl.handle.net/1773/8204.
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Lewis, Anne Marie. "Phonological and Speech Motor Abilities in Children with Childhood Apraxia of Speech and Phonological Disorder." Thesis, Curtin University, 2018. http://hdl.handle.net/20.500.11937/73606.
Full textAbstract:
This thesis investigated whether childhood apraxia of speech (CAS) differs from phonological disorder (PD) regarding their causal origin. After developing and validating measures targeting components of phonology and speech motor control, we explored if speech motor ability constrained phonological development in CAS more than in PD. This thesis demonstrated children with CAS show a distinct profile of speech impairments but little evidence that their motor deficit constrains phonological development in a way distinct from PD.
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Ambron, Elisabetta. "Exploration of closing-in behaviour in dementia, development and healthy adulthood." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/4472.
Full textAbstract:
Closing-in Behaviour (CIB) is the tendency observed in copying tasks, both graphic and gestural, in which the copy is made inappropriately close to or on top of the model. It is classically considered as a manifestation of Constructional Apraxia (CA) and it is often observed in patients with dementia. CIB is not only a symptom of pathology, but it is also observed in children’s first attempts at graphic copying. However, CIB shows an inverse pattern in development and dementia: while its frequency increases in severe dementia, CIB progressively decreases with development. The cognitive origins of CIB are still unclear. Two main interpretations dominate CIB literature: the compensation and the attraction hypotheses. The first hypothesis interprets CIB as a strategy specific to copying tasks that the patient adopts to overcome visuospatial and working memory deficits. In contrast, the attraction hypothesis considers CIB as a primitive behaviour, not specific to copying, and characterized by the default tendency to perform an action toward the focus of attention. This thesis aimed to study the characteristics and the cognitive origins of CIB in dementia, development and healthy adulthood. It has three main sections. The first and second sections explore CIB in patients (with Alzheimer’s disease- AD and Frontotemporal dementia) and in pre-school children, using survey and experimental studies, to investigate if CIB might have common characteristics and cognitive substrates in these different populations. The results provided converging evidence for the similar nature of CIB in development and dementia. For instance, survey studies in patients with dementia (Chapter 3) and preschool children (Chapter 6) showed that performance in attentional tasks predicted the appearance of CIB. In a similar vein, experimental studies showed support for the attraction hypothesis of CIB in a single patient with AD (Chapter 4) and pre-school children (Chapter 7 and 8). These results were not, however, replicated in a larger cohort of patients with AD due to practical reasons (Chapter 5). The last section was devoted to modelling CIB in normal participants, using complex graphic copying (Chapter 9) and dual task paradigms (Chapter 10). The results showed further support for the attraction hypothesis of CIB and underlined the difficulties of eliciting this default bias in normal adults. To conclude, this thesis radically changes the classical consideration of CIB as a manifestation of CA and demonstrates that CIB is a general default tendency, not specific to copying tasks. This work indicates avenues for new studies, which might consider the possible expression and consequences of this behaviour in patients’ daily lives.
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Ishara, Cinthia. "A-fa-si-a : um sujeito em cena." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/270977.
Full textAbstract:
Orientador: Maria Irma Hadler CoudryTese (doutorado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem
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Resumo: Este trabalho apresenta o estudo de caso de um sujeito afásico (CN). Através de seu acompanhamento longitudinal, realizado com base em uma abordagem discursiva da afasia, buscou-se compreender as características de sua afasia, discutindo as classificações propostas na literatura e a relação entre sua caracterização e o processo terapêutico. Esta tese destaca as características singulares de um caso que se recusa a encaixar-se nas tipologias existentes, evidenciando a heterogeneidade do fenômeno afásico e as contribuições de um processo terapêutico que não exclui o sujeito. Os dados mostram as relações entre os níveis lingüísticos e apontam que os gestos articulatórios não caminham dissociados de outros aspectos da linguagem em seu funcionamento. O esforço para conter cadeias de associações fônicas e a constante re-instauração da cena enunciativa na produção de seus enunciados se destacam enquanto características do funcionamento da afasia de CN. O processo terapêutico mostra que não se trata de ensinar ou treinar os aspectos alterados pela afasia. O processo com CN ensina que a opção por uma teoria de linguagem que inclua o sujeito, ao invés de uma teorização voltada apenas para o sintoma e para o que falta em sua fala, se mostra decisiva para promover e explicar as mudanças que CN faz durante o período do acompanhamento
Abstract: This thesis presents a case study of an aphasic person (CN). We longitudinally examine the performance of CN in different situations. The study adopts the aphasia¿s discursive approach (Coudry, 1986/88). We try to understand changes in CN¿s language functioning and the characteristics of CN¿s aphasia. The CN¿s aphasia presentation differs from typical aphasias described in traditional typologies. CN¿s language exhibits unique characteristics that lead us to consider the heterogeneity in aphasia and the advantages of a therapeutic process based on a specific view about the relationship between language and subject. Our findings support the relationship between linguistic levels and the relation between articulatory gestures and other language aspects. The effort to limit phonic associations and to build the enunciative scene is frequent and constitutes a typical aspects that demonstrates how language works in this case. The improvements in CN¿s language functioning from our initial evaluation provides support for the language¿s view that includes the subject in its scope and the therapeutic process that is not limited to following training programs or educational treatments
Doutorado
Doutor em Linguística
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Martins, Fernanda Cristina Reis Merli. "Apraxia de fala em crianças de 4 a 7 anos diagnosticadas no Transtorno do Espectro Autista: avaliação de quatro pacientes." Pontifícia Universidade Católica de São Paulo, 2018. https://tede2.pucsp.br/handle/handle/21262.
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Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
Objectives: Assessment of oral and verbal praxias in four 4 to 7-year-old children diagnosed in Autistic Spectrum Disorder. Method: This research is an exploratory study on the evaluation of praxias in four autistic children. Oral Praxias: First, the responses presented to verbal commands are observed, and, in case of no response, performance of movement by imitation is tried. For the verbal praxias, a situation of playful interaction with the child for the recording was developed.Results: Evaluation of Oral Praxias: the assesment of praxias voiced had its worst performance presented by the youngest child, and the absence of achievement lies on two motor acts. The assessment of oral-facial praxias presented the worst performance for the youngest child. Praxias assessment with increased difficulty action being imitation the privileged way recognized by everyone in the children’s achievement. In praxias assessment involving parallel movements, Child One presents the worst result, performing one movement only, the simplest in the series. Child Three uses imitation for most achievements and finally, Child Four does not perform two movements, precisely those involving sounds. Verbal Praxias Assessments: In general the main features presented were breathy and monotonous voice, heightened pitch and intersected speech with alternations in rhythm. Every participant involved in the research showed a strong tendency to centralize the sounds in their emission. The prosody is altered in two cases, the youngest child still uses a very childish prosody, Child Two, in its turn, alters the vocal tone. Conclusion: The praxic configuration condition verified in each patient points to disorders that seem to be linked to superior processes of motor planning, called apraxia. This research has made it possible to present data that show that these children present a co-occurrence of alterations: autism and apraxia. However, these findings do not confirm a direct connection of such co-occurrence in all children with ASD
Objetivos: Avaliar as praxias oral e verbal em quatro crianças de 4 a 7 anos de idade diagnosticadas no Transtorno do Espectro Autista. Método: Esta pesquisa é um estudo exploratório sobre a avaliação de praxias em quatro crianças autistas. Praxias Orais: Em primeiro lugar são observadas as respostas apresentadas a comandos verbais, sendo que, no caso de não resposta, tenta-se a realização do movimento por imitação. Para as praxias verbais, foi criada uma situação de interação lúdica com a criança para a gravação. Resultados: Avaliação das Praxias Orais: Avaliação das praxias sonorizadas, O pior desempenho, apresentado foi da criança menor, sendo que a ausência de realização se localiza em dois atos motores. A avaliação das praxias orofaciais apresentou o pior desempenho para a criança menor. A avaliação de praxias com movimentos em sequência a dificuldade tem um incremento, sendo a imitação a maneira privilegiada por todos na realização das crianças. A avaliação de praxias envolvendo movimentos paralelos, a criança um apresenta o pior desempenho, realizando apenas um movimento, o mais simples da série. A criança três utiliza imitação para maior parte das realizações e por fim, a criança quatro não realiza dois movimentos e exatamente os que envolvem sonorização. Avaliação das Praxias Verbais: De um modo geral as características principais apresentadas foram voz soprosa e monótona, pitch agudizado e fala entrecortada, alterando o ritmo. Todos os participantes envolvidos na pesquisa apresentam uma forte tendência a centralizar os sons em sua emissão. A prosódia está alterada em dois casos, a menor de todas as crianças se utiliza de uma prosódia ainda muito infantil, a criança dois, em sua vez, altera a tonicidade vocabular. Conclusão: A condição práxica verificada em cada paciente, aponta para desordens que parecem ligadas a processos superiores de planejamento do ato motor, o que se denomina dispraxia. Esta pesquisa permitiu apresentar dados que comprovam que nestas crianças há uma co-ocorrência de alterações: autismo e dispraxia. Entretanto, estes achados não permitem apostar que tal co-ocorrência será verificada em todas as crianças com TEA