Apraxia is a motor speech disorder that primarily affects the motor center in the brain.
It disrupts the coordination of oral motor structures involved in producing specific sounds. Within our brains, a motor cortex is responsible for orchestrating muscle movements throughout the body. However, in the case of apraxia, the motor system dedicated to a child's speech is adversely impacted.
The impact of apraxia on a child's speech abilities is distinct and notable. Many children with apraxia may unintentionally substitute one word for another when attempting to articulate, such as saying "scamp" instead of "stamp." Although aware of the error, they struggle to correct it as their brain persists in guiding them to say "scamp."
Childhood apraxia of speech can be difficult to diagnose. A speech-language pathologist will often begin testing with an articulation evaluation, but if apraxia is suspected, it is best for the speech-language pathologist to complete an oral motor screening. This allows them to observe the strength and coordination of the oral structures and complete sound drills where children are prompted to make a series of sounds in different places in the mouth quickly (diadokinetics). Children who struggle with these diadokinetics, coordination, and strength of oral structures present with a broad range of articulation errors may indicate apraxia of speech.
Apraxia of speech is often difficult to diagnose, and there is some controversy within the speech therapist community about whether childhood apraxia of speech exists or if it is just severe speech impairment. However, there will be a difference in treatment to improve a child's language skills if apraxia is suspected.
Treatment for childhood apraxia is characterized by its higher intensity compared to typical articulation disorders. Apraxia, arising from motor cortex in coordination in the brain, necessitates speech-language pathologists to educate the motor cortex on precise movements of the tongue, teeth, and lips for consistent production of various sounds. Visual aids play a crucial role in apraxia treatment, wherein hand gestures and movements are employed in conjunction with speech sounds. Furthermore, clinicians utilize their own mouth movements as a form of support.
Speech therapists have developed specific programs designed to address apraxia of speech. These programs often emphasize the deconstruction of sounds into smaller units, commencing with visually prominent sounds (such as lip-based sounds like "b," "p," "m," and "w") and progressing toward less visually distinct sounds. Visual aids are frequently incorporated alongside these smaller sound units, enabling children to build upon the foundational sounds.
Speech sound disorders, such as articulation disorders, are the difficulty of producing speech sounds. Childhood apraxia of speech is slightly different in presentation: Apraxia of speech affects all motor coordination of speech movements, often making it difficult to produce any sounds appropriately. Apraxia affects a broader range of speech sounds and requires a slightly different approach in speech therapy.
Articulation speech disorders require support from a speech-language pathologist and increased speech practice with making sounds correctly to teach them the correct motor movements. Apraxia treatment typically requires visual aids, apraxia-based programs, hand gestures or movements, and breaking down sounds into smaller consonant and vowel sounds before practicing longer words.
Reach out to your local speech-language pathology clinic! They will need to complete several evaluations of your child's speech abilities, including an articulation evaluation as well as other oral motor observations, in order to determine how to approach your speech therapy session and your child's progress.