apraxia

Many disorders can affect our ability to speak and communicate. They range from saying sounds incorrectly to being completely unable to speak or understand speech. Causes include:

• Hearing disorders and deafness
• Voice problems, such as dysphonia or those caused by cleft lip or palate
• Speech problems like stuttering
• Developmental disabilities
• Learning disabilities
• Autism spectrum disorder
• Brain injury
• Stroke

Some speech and communication problems may be genetic. Often, no one knows the causes. By first grade, about 5% of children have noticeable speech disorders. Speech and language therapy can help.

NIH: National Institute on Deafness and Other Communication Disorders

When you look at an object, you're using several muscles to move both eyes to focus on it. If you have a problem with the muscles, the eyes don't work properly.

There are many kinds of eye movement disorders. Two common ones are:

• Strabismus - a disorder in which the two eyes don't line up in the same direction. This results in "crossed eyes" or "walleye."
• Nystagmus - fast, uncontrollable movements of the eyes, sometimes called "dancing eyes"

Some eye movement disorders are present at birth. Others develop over time and may be associated with other problems, such as injuries. Treatments include glasses, patches, eye muscle exercises, and surgery. There is no cure for some kinds of eye movement disorders, such as most kinds of nystagmus.

Neuromuscular disorders affect your neuromuscular system. They can cause problems with:

• The nerves that control your muscles
• Your muscles
• Communication between your nerves and muscles

These disorders can cause your muscles to become weak and waste away. You may also have symptoms such as spasms, twitching, and pain.

Examples of neuromuscular disorders include:

• Amyotrophic lateral sclerosis
• Muscular dystrophy
• Myasthenia gravis
• Spinal muscular atrophy

There can be different causes for these diseases. Many of them are genetic.This means they are inherited (run in families) or are caused by a new mutation in your genes. Some neuromuscular disorders are autoimmune diseases. Sometimes the cause is unknown.

Many neuromuscular diseases have no cure. But treatments may improve symptoms, increase mobility, and lengthen life.

If you are like most people, you walk thousands of steps each day. You walk to do your daily activities, get around, and exercise. It's something that you usually don't think about. But for those people who have a problem with walking, daily life can be more difficult.

Walking problems may cause you to:

• Walk with your head and neck bent over
• Drag, drop, or shuffle your feet
• Have irregular, jerky movements when walking
• Take smaller steps
• Waddle
• Walk more slowly or stiffly

The pattern of how you walk is called your gait. Many different diseases and conditions can affect your gait and lead to problems with walking. They include:

• Abnormal development of the muscles or bones of your legs or feet
• Arthritis of the hips, knees, ankles, or feet
• Cerebellar disorders, which are disorders of the area of the brain that controls coordination and balance
• Foot problems, including corns and calluses, sores, and warts
• Infections
• Injuries, such as fractures (broken bones), sprains, and tendinitis
• Movement disorders, such as Parkinson's disease
• Neurologic diseases, including multiple sclerosis and peripheral nerve disorders
• Vision problems

To make a diagnosis, your health care provider will ask about your medical history and do a physical exam. This will include checking your bones and muscles and doing a neurological exam. In some cases, you may have other tests, such as lab or imaging tests.

Treatment of walking problems depends on the cause. If the cause is a medical condition, treating that condition often improves your walking. Some common types of treatments for walking problems may include:

• Medicines
• Mobility aids such as walkers and canes
• Physical therapy
• Special shoes, insoles, splints, or braces
• Surgery

Aphasia is a language disorder that makes it hard for you to read, write, and say what you mean to say. Sometimes it makes it hard to understand what other people are saying, too. Aphasia is not a disease. It's a symptom of damage to the parts of the brain that control language.

The signs of aphasia depend on which part of the brain is damaged. There are four main types of aphasia:

• Expressive aphasia is when you know what you want to say, but you have trouble saying or writing your thoughts.
• Receptive aphasia affects your ability to read and understand speech. You can hear what people say or see words on a page, but you have trouble making sense of what they mean.
• Global aphasia is the loss of almost all language ability. You can't speak, understand speech, read, or write.
• Anomic or amnesia aphasia is when you have trouble using the right words for certain things, people, places or events.

In some cases, aphasia may get better on its own. But it can be a long-term condition. There's no cure, but treatment may help improve language skills.

Aphasia happens from damage to one or more parts of the brain involved with language. The damage may be from:

• Stroke, which is the most common cause of aphasia
• Brain tumor
• Brain infection or inflammation
• Brain injury
• Other brain disorders or neurologic diseases that affect the brain and get worse over time, such as dementia

Anyone can have aphasia at any age, but most people with aphasia are middle-aged or older. Most aphasia happens suddenly from a stroke or brain injury. Aphasia from a brain tumor or other brain disorder may develop slowly over time.

If a health care provider sees signs of aphasia, the provider will usually:

• Test the person's ability to understand language and speech. This includes asking questions and checking to see if the person can follow simple commands.
• Order an imaging scan to see if there's a brain injury and what part of the brain is damaged. Possible tests include:
  • MRI
  • CT scan

If imaging shows signs of aphasia, more tests may be needed. These tests measure how much the brain damage has affected the ability to talk, read, write, and understand. In most cases, the tests are done by a speech-language pathologist or speech therapist (a specialist who treats speech and communication disorders).

Some people fully recover from aphasia without treatment. But most people should begin speech-language therapy to treat aphasia as soon as possible.

Treatment may be one-on-one with a speech therapist or in a group. Therapy using a computer may also be helpful.

The specific therapy depends on the type of language loss that a person has. It may include exercises in reading, writing, following directions, and repeating what the therapist says. Therapy may also include learning how to communicate with gestures, pictures, smartphones, or other electronic devices.

Family participation may be an important part of speech therapy. Family members can learn to help with recovery in many ways, such as:

• Using simpler language
• Including the person with aphasia in conversations
• Repeating or writing down key words to help communicate more clearly

How much a person recovers depends on many things, including:

• What caused the brain injury
• What part of the brain was hurt
• How badly and how much of the brain was hurt
• The age and health of the person

You can help prevent aphasia by:

• Making heart-healthy lifestyle changes to lower your chance of having:
  • A stroke
  • Heart disease
  • Vascular disease (problems with your blood vessels)
• Protecting your brain from injury:
  • Wearing the right helmet for sports safety, such as when riding a bike
  • Taking action to prevent falls
  • Always wearing your seatbelt and driving safely

NIH: National Institute on Deafness and Other Communication Disorders

When you play the piano or hit a tennis ball you are activating the cerebellum. The cerebellum is the area of the brain that controls coordination and balance. Problems with the cerebellum include:

• Cancer
• Genetic disorders
• Ataxias - failure of muscle control in the arms and legs that result in movement disorders
• Degeneration - disorders caused by brain cells decreasing in size or wasting away

Treatment of cerebellar disorders depends on the cause. In some cases, there is no cure but treatment may help with symptoms.

NIH: National Institute of Neurological Disorders and Stroke

Children vary in their development of speech and language skills. Health care professionals have lists of milestones for what's normal. These milestones help figure out whether a child is on track or if he or she may need extra help. For example, a child usually has one or two words like "Hi," "dog," "Dada," or "Mama" by her first birthday.

Sometimes a delay may be caused by hearing loss. Other times it may be due to a speech or language disorder. Children who have speech disorders may have trouble making speech sounds correctly. They may hesitate or stutter when talking. Children with language disorders might have trouble understanding what others say or difficulty sharing their thoughts.

If you have concerns about your child's speech or language development, talk to your child's health care provider.

NIH: National Institute on Deafness and Other Communication Disorders