What is apraxia of speech?

Apraxia is a general term. It can cause problems in parts of the body, such as arms and legs. Apraxia of speech is a motor speech disorder. It is caused by damage to the parts of the brain related to speaking. Other terms include apraxia of speech, acquired apraxia of speech, verbal apraxia, and dyspraxia.

People with apraxia of speech have trouble sequencing the sounds in syllables and words. The severity depends on the nature of the brain damage.

Children can have apraxia, referred to as childhood apraxia of speech.

What are some signs or symptoms of apraxia of speech?

People with apraxia of speech know what words they want to say, but their brains have difficulty coordinating the muscle movements necessary to say those words. They may say something completely different, even made up words. For example, a person may try to say "kitchen," but it may come out "bipem" or even "chicken." The person may recognize the error and try again, sometimes getting it right, but sometimes saying something else entirely. This can become quite frustrating for the person. It may be hard to understand a person with apraxia of speech.

Apraxia of speech can be mild or severe. People with apraxia may have

• difficulty imitating speech sounds
• difficulty imitating non-speech movements (oral apraxia), such as sticking out their tongue
• groping when trying to produce sounds
• in severe cases, an inability to produce sound at all
• inconsistent errors
• slow rate of speech
• somewhat preserved ability to produce "automatic speech" (rote speech), such as greetings like "How are you?"

Apraxia can occur in conjunction with dysarthria (muscle weakness affecting speech production) or aphasia (language difficulties related to neurological damage).

How is apraxia of speech diagnosed?

A speech-language pathologist (SLP) can evaluate the individual. Results will determine the nature and severity of the apraxia. The SLP will look to see if there is any evidence of muscle weakness (dysarthria) or other communication or swallowing difficulties. An appropriate treatment plan can then be put in place.

To contact a speech-language pathologist, visit ASHA's Find a Professional.

What treatments are available to people with apraxia of speech?

An SLP can work with people with apraxia of speech to improve speech abilities and overall communication skills. The muscles of speech often need to be "retrained" to produce sounds correctly and sequence sounds into words. Exercises are designed to allow the person to repeat sounds over and over and practice correct mouth movements for sounds. The person with apraxia of speech may need to slow his or her speech rate down or work on "pacing" their speech so that he or she can produce all necessary sounds. In severe cases, augmentative and alternative communication may be necessary, such as the use of simple gestures or more sophisticated electronic equipment.

To contact a speech-language pathologist, visit ASHA's Find a Professional.

What other organizations have information about apraxia of speech?

This list is not exhaustive and inclusion does not imply endorsement of the organization or the content of the Web site by ASHA.

• National Institute of Neurological Disorders and Stroke
• National Institute on Deafness and Other Communication Disorders

What causes apraxia of speech?

Apraxia of speech is caused by damage to the parts of the brain that control muscle movement. In verbal apraxia, the messages to the mouth are interrupted and the person cannot move his or her lips or tongue to the right place to say sounds correctly. A common cause of acquired apraxia is stroke. Other causes include traumatic brain injury, dementia, tumors, and progressive neurological disorders, such as multiple sclerosis.

How common is apraxia of speech?

There is not a lot of research about how many people have apraxia of speech. Many times apraxia of speech occurs together with other communication disorders, such as aphasia. ASHA has developed a report—Communication Facts: Special Populations: Stroke—that includes information about apraxia of speech.

What does a speech-language pathologist do when working with adults with apraxia of speech?

The Preferred Practice Patterns for the Profession of Speech-Language Pathology outline the common practices followed by SLPs when engaging in various aspects of the profession. The Preferred Practice Patterns for motor speech assessment and intervention are outlined in Sections 32 and 33.