Apraxia of speech

Apraxia of speech is a rare type of speech condition. It is caused by problems in the way your brain plans movements for speech.

People with apraxia know what they want to say. But their brain can't move their mouth, lips, jaw and tongue properly.

You may have problems saying sounds, syllables and words. But you can move your face and mouth for facial expressions and eating.

Apraxia is sometimes called developmental verbal dyspraxia and is a lifelong condition.

There are many different signs of apraxia. These may change as your child gets older or as the condition changes.

Young children with apraxia may:

• have problems feeding as a baby
• babble less than other babies
• use a limited number of sounds when they begin to talk
• visibly struggle to talk
• be very hard to understand, even by their own families

Older children with apraxia may:

• struggle with longer words or phrases
• drop or add sounds to words (like 'umbararella' for 'umbrella')
• say the same word in different ways
• stress the wrong part of a word

Some children are better at understanding what is said to them than talking themselves.

The condition is usually noticed when a child is first learning to talk, but it can continue into adulthood. Apraxia of speech can be very frustrating because it prevents you from communicating properly.

Childhood apraxia of speech may occur as an isolated condition. It is sometimes caused by a genetic or chromosome difference.

Apraxia can sometimes occur together with other disorders, including:

• Down syndrome
• epilepsy
• fragile X syndrome
• Prader-Willi syndrome

Sometimes apraxia can happen after a brain injury in early childhood. This may be caused by a stroke, infection or brain cancer.

However, often no cause is found.

Apraxia of speech in adults

In some people, childhood apraxia of speech can persist into adulthood.

Apraxia can also occur for the first time in adulthood. This is due to changes in the parts of the brain responsible for speech. The most common causes are:

• stroke
• traumatic brain injury
• tumour
• a progressive disease like dementia

This is called 'acquired apraxia of speech'.

If you are concerned about your child's speech, see a maternal and child health nurse or a doctor. They may refer you to a speech pathologist.

Your speech pathologist will get your child to do a number of talking tests. The specific tests and treatments will depend on your child's age, symptoms and other conditions.

They will check your child's hearing, mouth movements and functional communication.

It's important that you see a speech pathologist who is experienced in assessing and treating apraxia. You can ask about this before you book your appointment.

Currently, there are no diagnosis guidelines for adolescents or adults.

Treatment involves working with a speech pathologist to learn how to form the right sounds.

There are different types of treatment programs, depending on your age. The most recent evidence supports the use of the following programs:

• Rapid Syllable Transition Treatment (ReST) — suitable for use with older children or those with milder speech issues.
• Nuffield Dyspraxia Programme 3^rd edition (NDP3) — suitable for younger children or those with more severe speech issues.
• Dynamic Temporal and Tactile Cuing (DTTC) — suitable for younger children or those with more severe speech issues.
• Integrated Phonological Awareness (IPA) — suitable for use with older children or those with milder speech issues.
• Ultrasound biofeedback — suitable for use with older children with milder speech issues.

Research shows that the best way to do ReST and NDP3 therapy is doing:

• one hour a day
• 4 days a week
• for 3 weeks

You can then have a break for 4 to 6 weeks, before repeating.

The more therapy you do the more effective it will be.

In severe cases, you may need to learn different ways of communicating, such as sign language or using a device.

Childhood apraxia of speech is a neurological disorder that cannot be prevented.

However, acquired apraxia of speech occurs due to damage that happens to your brain.

Children with apraxia of speech are more likely to have trouble learning to read and spell.

People with apraxia may also have:

• other communication difficulties
• difficulties with their mental health
• other difficulties — such as sensory processing difficulties and developmental coordination disorder

It can be very tiring and frustrating for a child living with apraxia. Seeing a counsellor or psychologist might help.

Speech Pathology Australia (Opens in new tab) has produced a Communication Milestones Kit (Opens in new tab). The kit aims to help parents and carers who are concerned about their child's speech, language and communication. You can also call them on 1300 368 835.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.