Sunday, July 10, 2011

Recently Collin's physical and speech therapists used certain words to describe some of the difficulties he has. I have done some quick research (Google) to try to understand the terminology.

His physical therapist mentioned ataxia, which describes a lack of muscle coordination during voluntary movements, such as walking or picking up objects. It usually results from damage to the cerebellum (where Collin's tumor was), the part of the brain that controls movement, muscle coordination, and balance. It can affect any part of the body. When it affects mechanisms of walking (as it does with Collin), there is instability with a tendency to fall. The gait appears "drunken" (I've told Collin he walks like a drunken sailor many times!) His balance is also affected; he may fall spontaneously or be unable to compensate for variations in the ground or a mild push from the side. He is making progress with walking, and the slower he walks, the better he does (the less he falls). I asked if the ataxia will eventually go away, but of course his physical therapist can't give me any guarantees.

His speech therapist used the words Apraxia and Dysarthria.

Apraxia of speech is a motor speech disorder. Children with apraxia of speech have great difficulty planning and producing the precise, highly refined and specific series of movements of the tongue, lips, jaw and palate that are necessary for intelligible speech. One of the most notable symptoms of apraxia is difficulty putting sounds and syllables together in the correct order to form words (I notice this in Collin). Longer or more complex words are usually harder to say than shorter or simpler words. People with apraxia also tend to make inconsistent mistakes when speaking. For example, they may say a difficult word correctly but then have trouble repeating it, or they may be able to say a particular sound one day and have trouble with the same sound the next day. People with apraxia often appear to be groping for the right sound or word, and may try saying a word several times before they say it correctly. Another common characteristic of apraxia is the incorrect use of the varying rhythms, stresses, and inflections of speech that are used to help express meaning.

Dysarthria is a condition that occurs when a nerve, brain, or muscle disorder makes it difficult to use or control the muscles of the mouth, tongue, larynx, or vocal cords, which make it difficult to pronounce words. Dysarthria often is characterized by slurred or slow speech that can be difficult to understand. In Collin's case, the dysarthria is the result of damage due to the location of his brain tumor, and from damage (from the tumor surgery) to the nerves that supply the muscles that help him talk. Collin is continuing to make progress with his speech, but no one knows how long it will take for the damaged nerves to recover, or the extent to which they will recover.