Apraxia of speech, also known as verbal dyspraxia, is a neurological disorder that affects a person’s ability to speak fluently and produce the correct sounds, syllables, and words. The condition involves the parts of the brain responsible for planning and coordinating the movements needed to produce speech, such as the motor cortex and the basal ganglia. Apraxia can be congenital (present at birth) or acquired through injury to the brain.
Apraxia of speech is not a problem with the muscles or nerves responsible for speech. Rather, it is a difficulty with the brain’s ability to plan and execute the precise movements necessary for clear and fluid speech. The signal from the brain to the mouth is disrupted. This can result in difficulty producing specific sounds, stringing sounds together to form words, and putting words together to form sentences.
What is apraxia of speech?
Apraxia of speech is a neurological motor speech disorder where the brain has difficulty planning and coordinating the precise movements needed to produce speech. The muscles themselves are not the problem; the disruption happens in the brain’s ability to sequence and execute the movement plan. It can affect children from birth (childhood apraxia of speech) or develop in adults following a stroke or brain injury.
What are the signs of apraxia of speech?
Signs of apraxia of speech can vary widely and may include:
- Difficulty producing specific sounds, such as “s”, “t”, or “r”
- Difficulty stringing sounds together to form words
- Difficulty putting words together to form sentences
- Struggling to initiate speech or keep pace in conversation
- Using unexpected or inconsistent word approximations
- Speaking in a flat tone or with limited variation in rhythm and stress
- Struggling to control volume or pace of speech
- Difficulty making voluntary movements with the mouth muscles when speaking
Who does apraxia of speech affect?
Apraxia of speech can occur at any age. In children, it is known as childhood apraxia of speech (CAS), a motor speech disorder where the brain has difficulty planning and sequencing speech movements during development. CAS is often accompanied by other developmental differences and may be identified as early as the toddler years.
In adults, apraxia of speech is typically acquired, often following a stroke, traumatic brain injury (TBI), or a progressive neurological condition. Adult-onset apraxia sometimes co-occurs with aphasia or dysarthria, which can make accurate assessment more complex and reinforces the value of working with a qualified SLP.
Why apraxia of speech can be difficult to diagnose
Apraxia of speech can be difficult to diagnose, as it is sometimes mistaken for other speech disorders such as dysarthria (difficulty controlling the muscles used for speech due to neurological damage) or aphasia (difficulty understanding or producing language due to brain damage). A thorough evaluation by a Speech-Language Pathologist, including a detailed history and a speech and language assessment, is needed to accurately diagnose apraxia of speech.
The severity of apraxia of speech can vary greatly from person to person. Some people may experience mild difficulties with specific sounds, while others have more significant challenges that affect their ability to communicate day to day. A qualified SLP can help identify the specific pattern and develop an individualized plan.
Treatment for apraxia of speech
Treatment typically involves speech therapy with a Speech-Language Pathologist. Approaches used for apraxia of speech may include:
- Articulation therapy: practicing the correct production of specific sounds and syllables
- Prosody therapy: working on the rhythm, stress, and intonation of speech
- Cognitive-linguistic therapy: supporting language skills such as word-finding and grammar
- Augmentative and alternative communication (AAC): using devices or strategies to support communication, such as picture boards or speech-generating devices
Research suggests that early intervention makes a meaningful difference for children with apraxia of speech. Children who receive early, frequent, and targeted therapy often make strong progress. That said, therapy at any age can be beneficial. Many adults with acquired apraxia also experience meaningful improvements in communication.
The right approach looks different for everyone. An SLP will tailor therapy to each person’s specific goals, communication needs, and how apraxia presents for them. Learn more about the speech-language pathology services offered at Arbutus Speech Therapy in Vancouver and across BC.
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