Apraxia of Speech

Apraxia is the term for a set of neurological disorders that affect a person's ability to control fine and gross motor movement as well as gestures. Some people are born with apraxia, while some acquire it through brain injury. When the condition is acquired, it can spontaneously resolve, but people who are born with apraxia always requires therapy to manage the condition.

Apraxia can affect the ability to move one's facial muscles or the ability to move one's legs, feet, and toes. It can also affect communication abilities. People with apraxia often cannot perform controlled, purposeful movement, despite having the physical strength, thought, and desire to do so. It is believed that the various forms of apraxia stem from disorders in the parietal lobes of the brain.

What Is Apraxia of Speech?

Apraxia of Speech (AOS) is a type of apraxia that specifically affects the ability to use the tongue, lips, and jaw to form spoken words. The two main types of apraxia of speech are childhood apraxia of speech, when a person is born with it, and acquired apraxia of speech, when the condition results from a brain injury. AOS can have a mild to severe impact on people with the condition, making it difficult or actually impossible to communicate verbally.

Apraxia of speech is not a developmental disability, though people with childhood AOS often have family members who have been diagnosed with learning disabilities and other communication disorders. It is also not caused by weakness or paralysis of the speech muscles. AOS is a type of neurodivergence.

Research shows that childhood apraxia of speech is more common in male children than in female children, but the difference in diagnosis may be impacted by sexist bias, as in the case of autism.

There isn't a medical test to diagnose apraxia of speech. Instead, licensed speech-language pathologists (SLPs) rule out other conditions and look for a series of characteristics associated with the condition. Childhood AOS cannot be outgrown and requires consistent therapy sessions with a speech therapist to treat/manage.

How Do Speech Therapists Treat Apraxia of Speech?

Speech-language pathologists may work intensively with people who have apraxia of speech in order to improve their communication skills. Many children start off with three to five sessions a week.

The main goals of treatment are to plan the movements needed to say sounds, and make those movements the right way at the right time. This training will not include strengthening of the mouth muscles, but will include speaking exercises. Some therapeutic techniques used are: 

• Touch cues: Putting a finger on the lips to feel the motion that certain sounds make
• Visual cues: Speaking while looking into a mirror
• Listening cues: Recording sounds then listening to how they sound played back

Apraxia in the Classroom

In the classroom, students with apraxia have unique needs. While they generally receive information well and understand instruction, they may have difficulty effectively demonstrating what they have learned. This can lead to a great deal of frustration for students. Children with apraxia often benefit from the support of a special education specialist.

In some cases, sign language can be a helpful communication method. It is important however, to try using spoken language in addition to sign if the child is able to speak. Other communicative techniques include the use of augmentative and alternative communication (AAC) in the form of low-tech picture-boards or higher-tech tablets.

Occupational, physical, and speech therapists working with students can provide valuable information on how to adapt instruction and classroom materials to enable students to participate and to lower their frustration levels. In addition to specific techniques for improving and supporting speech, it's also important to provide children with apraxia with social supports such as peer buddy groups.

A Word from Verywell

Some parents fear their children won't want to talk if they have access to AAC, but there is no evidence to support the myth that AAC hinders verbal communication. In fact, a study revealed that 89% of AAC users showed increase in speech development after AAC intervention, with 11% showing no change, and 0% showing decrease in speech development.

If your child has no choice but to use sign or AAC, or prefers to use those forms of non-verbal communication, be accepting of the ways they are able to engage with you and the world. Be patient and kind with them.

Celebrate the access they now have to various communicative methods and do your best to learn sign language if they use it to communicate. It's alright if you can only fingerspell to start. Focusing on what your child can do instead of the barriers they face will build up your child's confidence and self-esteem. It will also show them that you accept and love them fully.