The term "developmental apraxia of speech" (DAS) has been a confusing one since Morley, Court and Miller (1954) first applied it to articulatory patterns of a specific group of children. Until recently, the differentiation of diagnostic features of DAS in children as compared to other articulatory disorders has been difficult. One evaluation tool, developed by Blakeley (1980), to assist in differential diagnosis of DAS is the Screening Test for Developmental Apraxia of Speech (STDAS). This study examined the validity of this tool by comparing its results with the evaluations by three Speech-Language Pathologists knowledgeable in the area of developmental and/or acquired apraxia of speech. Twenty subjects, ranging in age from 4-5 to 7-7 years, participated in this study. The subjects were independently screened by four evaluators. The first evaluation was conducted by this researcher, administering the STDAS to each subject. The other three evaluators screened each subject using their own procedures, excluding the STDAS. The STDAS resulted in a probability rating for DAS. The three evaluators were instructed to rate each subject on probability of DAS based upon their individual methods of assessment. To determine the relationship between the three evaluator pairs (BC, BD, CD) the index of association used was the Pearson Product - Moment Correlation Coefficient (Pearson-r). The results indicated the evaluators only slightly agreed with one another. Although they were in general agreement as to what characteristics constitute DAS, their perceptions of each subject were quite varied. In correlating the STDAS (A) with each evaluator (B, C, D) using the Pearson-r, the results ranged from slight correlation of AB (.20) to high correlation of AD (.73). This outcome may indicate that the STDAS tapped more of the components of apraxia (in the sense of comprehensiveness) than any single evaluator measure. Two factors seemed to contribute to the varied results among evaluators: (1) lack of information about the subjects' history of development, including familial history and management history; and (2) varied amount of structure used among the evaluators. When comparing the STDAS results with an evaluator who used a highly structured method of assessment, the correlation was high. This evaluator had the advantage of objective data, as well as clinical judgment upon which to base the final rating for each subject. The inconsistency among the evaluators' assessment results is an excellent argument for a screening instrument that uses the current body of knowledge concerning DAS. The STDAS forces the examiner to assess the child more objectively. The resulting data of this study support Blakeley's intention for the STDAS to be used as part of a differential diagnosis of DAS. When combined with other measures, such as case history, clinical judgment and neurological assessment, the STDAS can play an important contributing role in differentiating DAS from other articulatory disorders.

This thesis deals with a) The investigation of the problem of clumsiness resulting from developmental apraxia and agnosia ; b) the development of effective screening tests particularly suitable for employment by medical practitioners and specialist schoolteachers for the identification of these children. Chapter 2 reports the detailed initial investigation in Great Britain of 21 such clumsy children who had been referred for diagnosis and management. This study in turn stimulated a clinical survey of developmental clumsiness in Western Australian schoolchildren described and analysed in Chapters 3 and 4. It was anticipated that this survey would yield information regarding the magnitude of the problem and would provide normative data regarding motor performance in children. Subsequently these data were to be the basis of a set of standardized tests of motor proficiency in children (Chapter 4). In order to obtain information efficiently and to develop these tests it seemed most rational to commence with a pilot study of a relatively small number of children, when after statistical analysis it would become evident which tests were the most reliable, effective and convenient (Chapter 3). A comprehensive review of the subject of developmental apraxia and agnosia constitutes the final chapter of this thesis (Chapter 5).

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.

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.

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.

Orientador: Maria Irma Hadler Coudry / Dissertação ( mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem / Made available in DSpace on 2018-07-27T06:28:14Z (GMT). No. of bitstreams: 1 Marmora_ClaudiaHelenaCerqueira_M.pdf: 44945956 bytes, checksum: 434b2fa5ca32b827ed4398ab8150e5d5 (MD5) Previous issue date: 2000 / 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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No. of bitstreams: 2 Dissertacao Lorena Dias Resende - 2013.pdf: 1401725 bytes, checksum: b4f101e9ff3343d1112e15b4cb3e94f5 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-10-01 / 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.

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.

The purpose of this investigation was to determine if public school children with moderate and severe articulation disorders exhibit dyspraxic characteristics on a standardized developmental dyspraxia screening test.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 80-92).