What is apraxia of speech?

Apraxia is a rare type of speech disorder that makes it difficult to move the mouth in the way needed to produce sounds and words. A speech pathologist can often provide therapy that can help a person's speech to improve.

Apraxia occurs when the brain can't move the mouth, lips, jaw and tongue properly. Even though they know what they want to say, people with apraxia have problems pronouncing sounds, syllables and words.

The condition is usually noticed when a child is first learning to talk, but it can continue into adulthood. In adults, it can be caused by a brain injury or dementia.

Apraxia of speech is also known as dyspraxia, developmental verbal dyspraxia (DVD) or childhood apraxia of speech (CAS).

What are the symptoms of apraxia of speech?

Apraxia of speech can be very frustrating because it prevents people from communicating properly. Children with the condition are more likely to have reading and spelling difficulties, and may also have problems controlling both their small and large muscle movements. Sometimes they may also have other learning difficulties.

Signs a child may have apraxia of speech include:

• problems feeding as a baby
• babbling less than other babies
• not learning to talk as quickly as other babies their own age
• being very hard to understand, even by their own families
• visibly struggling to move their lips or tongue when trying to make a sound
• emphasising the wrong part of a word
• dropping or adding sounds to words (like 'umbararella' for 'umbrella')
• having a very limited vocabulary
• speaking more slowly than other children of their age
• struggling to form words or sounds
• making different mistakes when they try to say the same words
• having difficulty with intonations (speaking in a monotone or stressing the wrong part of words)

What causes apraxia of speech?

Apraxia of speech is sometimes caused by problems with a gene or by damage to the brain, for example due to a brain lesion or stroke.

It is also linked to some disorders, including Down syndrome, autism spectrum disorder, Koolen de Vries syndrome, floating harbour syndrome and 16p11.2 deletion syndrome.

Usually, however, no cause is found. Apraxia of speech is very rare, and only affects 1 or 2 children in every 1,000 who visit a speech pathologist.

How is apraxia of speech diagnosed?

If you are concerned about this condition, the first step is to see a maternal and child health nurse or a doctor, who may refer you to a speech pathologist. The speech pathologist will do several talking tests to look for signs that it might be apraxia of speech.

The condition often can't be diagnosed until a child is about 3 or 4, and there are many other causes of speech and language problems.

How is apraxia of speech treated?

Treatment involves working with a speech therapist to learn how to form the right sounds. The earlier the therapy starts, the better. Treatment works best if done several times a week by a therapist who has experience in apraxia of speech. As time goes on, the person may need therapy less often.

There are different types of therapy programs, depending on the age of the person with apraxia of speech. The treatment aims to teach them how to make certain sounds, words or phrases more clearly. For example, they might be taught to put a finger on their lips when they say the sound 'p' to remind them to close their lips.

People with apraxia must practise a lot to get better at speaking. It can be very tiring and frustrating for a child. Seeing a counsellor or psychologist might help. People with apraxia may also be seen by a physiotherapist or occupational therapist.

In severe cases, someone with apraxia of speech might need to learn different ways of communicating, such as sign language, using a computer or pointing to a book.

Resources and support

You can find a speech pathologist on the Speech Pathology Australia website, or you could talk to your doctor.