Apraxia: Signs, Symptoms, Causes, Diagnosis, Treatment

Medically Reviewed by Dr. K on 12 April 2021

Table of Contents:


  1. What Is Apraxia?
  2. Types of Apraxia of Speech
  3. What Is the Difference Between Apraxia of Speech and Aphasia?
  4. Symptoms of Apraxia of Speech
  5. Diagnosis and Tests for Apraxia of Speech
  6. Treatments for Apraxia of Speech


Apraxia: Symptoms, Causes, Tests, Treatments


What Is Apraxia?

Apraxia is a neurological condition that is poorly understood. Even if their muscles are regular, people with it find it difficult or impossible to perform some motor movements. Dypraxia refers to milder forms of apraxia.

Apraxia can manifest itself in a variety of ways. Orofacial apraxia is one type. People with orofacial apraxia are unable to perform certain facial muscle movements voluntarily. For example, they may be unable to lick their lips or wink. Another type of apraxia affects a person's ability to move their arms and legs on purpose.

Apraxia of speech is characterised by difficulty or inability to move one's mouth and tongue in order to speak. This occurs despite the fact that the person wishes to speak and that the mouth and tongue muscles are physically capable of forming words.

Types of Apraxia of Speech

Acquired apraxia and childhood apraxia of speech are the two types of apraxia of speech. People of all ages can develop acquired apraxia. However, it is most commonly found in adults. This condition causes people to lose their ability to communicate verbally.

Apraxia of speech in childhood is a motor speech disorder. This condition affects a child's ability to form sounds and words and is present from birth. Children with speech apraxia frequently have far greater abilities to understand speech than they do to express themselves verbally.

With the proper treatment, the majority of children with childhood apraxia of speech will see significant improvement, if not complete recovery.


What Is the Difference Between Apraxia of Speech and Aphasia?

Apraxia is frequently confused with aphasia, another type of communication disorder. The fact that the two conditions can coexist adds to the confusion.

People with apraxia and aphasia may have difficulty expressing themselves verbally. However, there are significant differences between the two. 

  • Aphasia: Aphasia refers to a problem with a person's ability to understand or use words on their own. This may make it difficult for someone who is suffering from that condition to speak, read, or write.

  • Apraxia: Apraxia, on the other hand, does not describe a problem with language comprehension. Apraxia is the difficulty a person has initiating and conducting the movements required for speech. This difficulty arises although the necessary muscles are not weak.

Symptoms of Apraxia of Speech

Apraxia can be related to a number of speech-related symptoms, including:

  • delayed first words
  • only being able to produce a few different types of sounds
  • syllables or sounds that are not put together in the correct order
  • saying the same word in different ways
  • lengthy pauses between sounds or difficulty moving between sounds and syllables
  • putting stress on the incorrect syllable of a word or using equal emphasis for all syllables
  • putting stress on the incorrect syllable of a word or using equal emphasis for all syllables
  • having more difficulty with longer words
  • having difficulties imitating what another person is saying
  • having to move the lips, jaw, or tongue several times in order to make a sound
  • appearing to understand spoken language better than they can speak it

Childhood apraxia of speech is uncommon on its own. It is frequently associated with other language or cognitive problems, which may result in:

  • Vocabulary limitations
  • Grammatical issues
  • Coordination and fine motor skills issues
  • Chewing and swallowing difficulties
  • Clumsiness

Causes Apraxia of Speech

Acquired apraxia is caused by brain damage to the areas of the brain that control the ability to speak. Head trauma, stroke, or a brain tumour are all conditions that can cause acquired apraxia.

Researchers aren't sure what triggers apraxia of speech in children. They believe it is inherited and could be linked to general language production or a problem with the brain's signals to speech muscles.

It's possible that the disease is part of broader, more complex disorders, such as:

  • autism
  • epilepsy
  • cerebral palsy
  • galactosemia
  • a neuromuscular disorder

Apraxia of speech in children may run in families. Many children with the disease have a family member that suffers from a speech disorder or has a cognitive difficulty. It tends to be more common in boys than in girls.

Current research is examining whether it is possible to identify the brain abnormalities that result in apraxia of speech. Another area of investigation is the search for genetic causes of apraxia. Some studies are being conducted to determine which parts of the brain are associated with the condition.

Diagnosis and Tests for Apraxia of Speech

There is no single test or procedure for diagnosing childhood apraxia of speech. The diagnosis process is complicated by the fact that speech-language pathologists disagree about which signs signify the presence of the disorder.

However, most experts look for the presence of multiple, common apraxia symptoms. They may test a patient's ability to repeatedly repeat a word. Alternatively, they may assess a person's ability to recite a list of increasingly difficult words, such as “play, playful, playfully."

A speech-language pathologist may communicate with a child to determine which sounds, syllables, and words the child can produce and understand. Additionally, the pathologist will examine the child's mouth, tongue, and face for any anatomical abnormalities that could be contributing to the child's apraxia symptoms.

When doctors make a diagnosis of apraxia, they can look for the existence of additional symptoms. For example, they may search for areas of weakness or difficulty with language comprehension. Both of these symptoms are suggestive of other disorders, and their presence would help rule out apraxia. An MRI of the brain may be beneficial in determining the extent and location of any brain damage in individuals who have possible acquired apraxia.

A diagnosis of childhood apraxia of speech is typically not made before a child turns 2 years old. Most children are unable to understand or perform the tasks required to determine the presence of apraxia before this age.

Treatments for Apraxia of Speech

In some instances, acquired apraxia resolves spontaneously. This is not true for childhood apraxia of speech, which does not resolve on its own.

Aphasia is treated in a variety of ways. Their effectiveness varies according to individual. To achieve the best results, apraxia treatment must be tailored to the unique needs of each individual. The majority of children with apraxia of speech benefit from three to five one-on-one sessions per week with a speech-language pathologist. They may also need to practise their newly acquired skills with their parents or guardians.

Speech therapy for children with apraxia of speech helps to enhance control of speech. Exercises may include the following:

  • Repetition of sound and word formation and pronunciation
  • Practicing string sounds for speaking
  • Utilizing rhythms or melodies

Utilizing multisensory techniques, such as watching oneself in a mirror while attempting to form words or touching one's face while speaking.

Numerous therapists believe that sign language can help children who struggle to be understood. They frequently suggest that children attempt to say the words they are signing in order to practise making the necessary mouth movements.

Sign language may also benefit individuals with more severe cases of acquired apraxia. They may also use assistive electronic devices, such as computers that can generate words and sentences.

There are very few studies examining the relative effectiveness of various treatment modalities for childhood apraxia of speech. Part of this can be due to ongoing experts' debates as to which apraxia should be diagnosed for symptoms and characteristics.


Referenced on 10.4.2021

  1. https://www.webmd.com/brain/apraxia-symptoms-causes-tests-treatments
  2. The Childhood Apraxia of Speech Association of North America.
  3. National Institute on Deafness and Other Communication Disorders: “Apraxia of speech."
  4. American Speech-Language-Hearing Association: “Childhood Apraxia of Speech."
  5. National Institute of Neurological Disorders: “NINDS Apraxia Information Page."
  6. American Stroke Association: “Aphasia vs. Apraxia."
  7. Children's Hospital of Philadelphia: “Childhood Apraxia of Speech Causes, Symptoms and Treatment."
  8. https://www.healthline.com/health/apraxia-of-speech#causes 
  9. Acquired apraxia of speech. (n.d.).
  10. Apraxia of speech. (2017).
  11. Apraxia of speech in adults. (n.d.).
  12. Childhood apraxia of speech. (n.d.).
  13. Childhood apraxia of speech. (n.d.).
  14. How does your child hear and talk? (n.d.).
  15. Language and speech disorders in children. (2018).
  16. Mayo Clinic Staff. (2017). Childhood apraxia of speech.

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