Apraxia of speech is a motor speech disorder that targets the motor center in the brain.
Apraxia manifests as an incoordination of the oral motor structures to make specific sounds. Our brains have a motor cortex, a part of the brain that is responsible for coordinating our muscle movements. This is used for every motor system, but apraxia affects the motor system of speech and the required speech sound movements.
The way apraxia affects speech sounds is unique: A client will attempt to say a word and will accidentally say another, such as saying "scamp" instead of "stamp." In most cases, the client will be aware of this error and attempt to fix it, but their brain will continue to tell them to say "scamp."
We typically see this neurologic speech disorder in adults after a stroke or another traumatic head injury.
Apraxia of speech can be a challenging language disorder to diagnose. One of the first things speech-language pathologists look for is an injury that may have started the symptoms of apraxia. Clinicians will often begin testing with an articulation evaluation, but if apraxia is suspected, it is best for the clinician to complete an oral motor screening. This allows them to observe the strength and coordination of the oral structures and complete sound drills where adults are prompted to quickly make a few speech sounds in different places in the mouth (diadokinetics). Adults who struggle with these diadokinetics, coordination, and muscle weakness in oral structures and present with a broad range of articulation errors or difficulty physically producing the correct words may indicate apraxia of speech.
Apraxia of speech treatment is more intensive than other articulation disorders. Since apraxia is caused by incoordination of the brain's motor cortex, speech-language therapy teaches the motor cortex how to move the tongue, teeth, and lips to make different sounds the right way every time. Apraxia treatment often involves augmentative and alternative communication tools such as visual aids, using hand gestures or movements alongside making speech sounds, and the clinician using their own mouth movements and speech muscles as support.
There are also programs created by speech therapists to target apraxia of speech. Often, these programs will focus on breaking sounds down into smaller units, starting with more visual sounds (lip-based sounds, such as "b," "p," "m," and "w") and ending with fewer visual sounds. They often include visual aids alongside these smaller units of sound and allow adults to build off the beginning sounds in order to promote speech production.
While apraxia of speech and aphasia both affect your ability to communicate effectively, they are two separate disorders. Aphasia impacts your language development, and apraxia impacts your ability to plan the speech production and movements needed for speech.
Reach out to your local speech-language pathologist! They will need to complete an articulation evaluation as well as other oral motor observations in order to determine how to approach therapy.