Giving a voice to individuals with apraxia of speech
What is acquired apraxia of speech (AOS)?
What is acquired apraxia of speech
Acquired Apraxia of Speech (AOS) is a motor speech disorder caused by damage to areas of the brain involved in planning and programming the movements needed for speech. A person with AOS usually knows what they want to say, but the brain has difficulty organising the precise sequence and timing of movements needed to produce the intended sounds and words.
AOS can range from relatively mild difficulty producing certain words to severe difficulties where very little understandable speech can be produced
How speech planning works
Producing speech requires the brain to plan extremely rapid and coordinated movements of the lips, tongue, jaw, soft palate and other structures involved in speech.
Before a word is spoken, the brain must select and organise the movements required to produce its individual sounds and syllables. In acquired AOS, this planning and programming process becomes disrupted.
What goes wrong in AOS
The muscles used for speech may be capable of moving normally, but the person has difficulty organising the movements required for speech.
This can result in:
- distorted speech sounds
- incorrect or misplaced sounds
- difficulty moving smoothly from one sound to another
- slow or effortful speech
- unusual pauses
- disrupted rhythm and stress
- repeated attempts to produce a word correctly
AOS as a motor speech disorder
Acquired AOS is classified as a motor speech disorder.
This means that the primary difficulty concerns the planning and programming of speech movements rather than the person's intelligence or understanding of what they want to communicate.
AOS is different from aphasia, which primarily affects language, and dysarthria, which affects the execution and control of speech movements.
Common causes of acquired AOS
Acquired apraxia of speech can also occur following:
- brain tumour
- neurosurgery
- infection affecting the brain
- neurological injury
- other acquired brain conditions
A gradually worsening speech disorder requires a different type of investigation because progressive neurological conditions can also affect speech motor planning.
AOS following a stroke
Stroke is one of the most common causes of acquired apraxia of speech.
A stroke can damage areas of the brain responsible for speech planning and programming. AOS may occur on its own but frequently occurs alongside aphasia or dysarthria.
The type and severity of communication difficulty depends on the location and extent of the brain injury.
AOS following traumatic brain injury
Traumatic brain injury may also result in acquired AOS.
The speech presentation can vary considerably depending upon which areas and networks of the brain have been affected. People may also experience difficulties with language, memory, attention or other aspects of communication.
AOS following brain tumour or neurosurgery
Apraxia of speech can develop when a brain tumour affects areas involved in speech motor planning, particularly in the dominant hemisphere. AOS may also occur following neurosurgery if tissue or neural networks involved in planning and programming speech are disrupted.
Presentation can vary depending on the location, size and type of tumour, as well as the effects of surgery, swelling or other treatment
Acquired AOS compared with childhood apraxia of speech and progressive AOS
Acquired AOS compared with childhood apraxia of speech and progressive AOS
Acquired AOS should be distinguished from both Childhood Apraxia of Speech (CAS) and Primary Progressive Apraxia of Speech (PPAOS).
Acquired AOS occurs following neurological damage in someone who previously had established speech.
Childhood Apraxia of Speech is a developmental motor speech disorder beginning in childhood.
Primary Progressive Apraxia of Speech is associated with a progressive neurological condition and usually worsens gradually over time.
It is possible for more than one type of apraxia of speech to occur in the same person. For example, a child with pre-existing Childhood Apraxia of Speech (CAS) could later experience a stroke or other neurological injury and develop an acquired apraxia of speech in addition to their developmental speech disorder.
Recognising the Main Features of AOS
Sudden changes in speech
Acquired AOS often begins following an identifiable neurological event such as stroke or brain injury.
Someone who previously spoke normally may suddenly have difficulty producing words despite knowing what they want to say.
Any sudden new speech or language difficulty should receive urgent medical attention because it can be a symptom of stroke.
Slow effortfull or halting speech
Speech may become noticeably slower and require considerable effort.
The person may appear to concentrate intensely on producing individual sounds or words. Longer sentences can require considerably more effort than short or familiar phrases.
Sound distortions and distorted substitutions
Speech sounds may be produced inaccurately because the articulators do not reach exactly the intended position at the correct time.
Difficulty sequencing sounds and syllables
Speech requires rapid transitions between different articulatory positions.
People with AOS may have particular difficulty moving smoothly from one sound or syllable to the next.
Longer or more complex words may therefore be more difficult than shorter ones.
Articulatory groping and trail and error speech
Some people visibly search for the correct position of the lips, tongue or jaw.
They may make several attempts at the same word before producing something closer to the intended form.
Not everyone with AOS demonstrates obvious groping, so its absence does not rule out the condition.
Syllable segmentation, pauses and reduced speech rate
Speech may sound broken into separate syllables rather than flowing naturally.
There may be unusually long pauses:
- between sounds
- between syllables
- within words
- between words
This can contribute to the characteristic slow and effortful quality of speech.
Abnormal stress, rhythm and prosody
AOS can affect prosody, the rhythm, stress, timing and melody of speech.
Someone may place approximately equal stress on syllables or have difficulty producing natural sentence rhythm.
How clinicians use patterns of speech features to support diagnoses
There is no single speech characteristic that confirms a diagnosis of acquired apraxia of speech. Speech and Language Therapists instead look for a pattern of features occurring across different speaking tasks. Clinicians consider:
- the combination of speech characteristics
- how consistently they occur
- whether they change with complexity
- performance across different speaking tasks
- whether aphasia or dysarthria is also present
Diagnosis therefore requires specialist motor speech assessment.
Not being able to communicate or make myself understood is so very difficult
Robert, Chest Heart & Stroke Scotland
How is acquired apraxia of speech diagnosed
Who diagnoses acquired AOS?
Why there is no single test for AOS
Speech and Language Therapists have a central role in assessing motor speech disorders.
Assessment may take place within:
- acute hospital services
- stroke services
- neurological rehabilitation
- community SLT services
- specialist neurological services
- independent Speech and Language Therapy
Why there is no single test for AOS
Why there is no single test for AOS
AOS is complex and no two cases are the same. There is no single test that definitively diagnoses acquired AOS. Assessment combines clinical examination, speech sampling and structured tasks, with formal assessment tools used where appropriate.
Taking a case and medical history
Assessment normally begins by establishing what happened before the communication difficulty developed.
Important information includes:
- when the speech difficulty started
- whether onset was sudden or gradual
- stroke or brain injury
- neurological diagnoses
- surgery
- previous communication abilities
- hearing
- other medical conditions
Understanding how and when the speech difficulty began
The pattern of onset can provide important diagnostic information.
Sudden onset may occur following stroke or traumatic brain injury.
Progressive deterioration over months or years requires investigation for a progressive neurological disorder.
Listening to spontaneous and conversational speech
The Speech and Language Therapist will usually listen carefully to spontaneous conversation.
This allows examination of:
- intelligibility
- speech rate
- sound accuracy
- prosody
- pauses
- effort
- sentence length
- functional communication
Testing speech across different tasks
Performance is usually compared across different tasks.
These may include:
- single sounds
- syllables
- single words
- longer words
- phrases
- sentences
- repetition
- automatic speech
- reading aloud
- conversation
Differential diagnosis: seperating AOS from other disorders
Assessment must distinguish AOS from other communication conditions.
Particular attention is usually given to differentiating:
- AOS and dysarthria
- AOS and aphasia
- mixed AOS and dysarthria
- cognitive-communication disorders
- progressive motor speech disorders
Reaching and explaining diagnosis
The clinician brings together information from the person's history and speech assessment.
Sometimes a diagnosis can be made relatively confidently. In more complex cases, the clinician may describe a probable or mixed motor speech disorder and monitor the presentation over time.
What happens during an AOS assessment
Case history and communication interview
The assessment usually begins by discussing:
previous communication abilities
onset of the difficulty
medical history
current communication concerns
everyday communication situations
personal priorities
Family members may also provide useful information where appropriate.
Oral motor examination
The clinician may examine movement of the:
lips
tongue
jaw
soft palate
face
This can help identify weakness, reduced coordination or other neurological signs that might suggest dysarthria or additional impairment.
Conversation and connected speech
Natural speech provides information that cannot always be obtained from formal testing.
The clinician may examine:
speech rate
intelligibility
sound distortions
pauses
fluency
prosody
effort
Single words, phrases and sentences
Speech is often tested at different levels of complexity.
The clinician may compare performance on:
short versus long words
simple versus complex sound sequences
single words versus connected speech
familiar versus unfamiliar words
Speech repetition tasks
The person may be asked to repeat words or phrases.
Repeated productions can help clinicians examine whether errors remain the same or vary between attempts.
Automatic speech
Tasks may include:
counting
days of the week
familiar sequences
highly familiar phrases
Some people find automatic speech easier than deliberately planned novel speech.
Diadochokinetic rates-Alternating and sequential motion rates
Diadochokinetic rates—the speed and accuracy with which the individual can repeat a series of sounds, measured in repetitions per second. These include the following:
Alternating motion rates (AMRs)—AMRs are used to evaluate the speech and regularity of planning a single syllable and then repeatedly executing that one motor plan (e.g., /papapa/).
Sequential motion rates (SMRs)—SMRs are used to evaluate the ability to motor-plan for three different syllables (e.g., /pataka/) and quickly transition between them. Abnormal production of SMRs is common in AOS (Duffy, 2020).
Functional communication
Assessment should consider whether the person can communicate effectively in everyday situations.
This may include communication:
at home
socially
on the telephone
at work
with unfamiliar listeners
during medical appointments
AOS Assessment Tools and Tests
Apraxia Battery for Adults
The Apraxia Battery for Adults is a formal assessment that may be used when investigating acquired AOS.
Standardised tests can support assessment but should not be treated as definitive diagnostic tests.
The Apraxia of Speech Rating Scale
The Apraxia of Speech Rating Scale, or ASRS, provides a structured method of recording speech characteristics associated with AOS.
It is designed for professional use and should form part of a wider clinical assessment.
Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4254321/ (Accessed: 26 August 2026).
Appendix has copy of scale
The apraxia of speech rating scale: A tool for diagnosis and description of apraxia of speech - PMC
AOS, Aphasia and Dysarthria
What Is the Difference Between AOS, Aphasia and Dysarthria?
Acquired AOS frequently occurs alongside other neurological communication disorders. Aphasia, dysarthria and AOS can therefore sometimes be difficult to separate.
American Stroke Association
What Is Aphasia?
Aphasia is an acquired language disorder.
It can affect:
speaking
understanding
reading
writing
A person with aphasia may have difficulty retrieving or organising words even though the physical movements required for speech are intact.
What Is Dysarthria?
Dysarthria is a motor speech disorder caused by impaired control of the muscles involved in speech.
It may affect:
strength
speed
tone
range of movement
coordination
AOS Versus Aphasia
AOS primarily affects speech motor planning.
Aphasia primarily affects language.
However, the two conditions frequently occur together, particularly following left-hemisphere stroke.
AOS versus dysarthria
Speech Errors and Language Errors
In AOS, the primary difficulty concerns planning and programming movements.
In dysarthria, the primary difficulty concerns carrying out or controlling speech movements.
Someone can have both disorders simultaneously.
Speech Errors and Language Errors
Speech Errors and Language Errors
A person with AOS might struggle physically to produce the intended word.
Someone with aphasia may instead select the wrong word or have difficulty retrieving the word itself.
Careful assessment is required because these difficulties can appear similar during conversation.
Muscle Weakness Versus Motor Planning
Muscle Weakness Versus Motor Planning
Muscle weakness is not a defining feature of AOS.
Weakness, abnormal tone or reduced movement may be associated with some forms of dysarthria.
More then one disorder can occur
Muscle Weakness Versus Motor Planning
After neurological injury, someone may have:
AOS alone
aphasia alone
dysarthria alone
AOS and aphasia
AOS and dysarthria
all three conditions
Why Differential Diagnosis Matters
Why Differential Diagnosis Matters
Correct diagnosis helps clinicians determine appropriate therapy.
A language treatment designed primarily for aphasia will not necessarily target the motor-planning difficulties associated with AOS, while treatment for dysarthria may focus on different aspects of the speech system
Other Conditions and Differential Diagnosis
Non-Verbal Oral Apraxia
Some people have difficulty deliberately planning movements of the mouth or face that are not speech.
Examples might include difficulty deliberately:
- protruding the tongue
- blowing
- coughing
- licking the lips
Non-verbal oral apraxia and AOS can occur together but are not the same condition.
Cognitive-Communication Difficulties
Brain injury can affect:
- attention
- memory
- executive functioning
- organisation
- social communication
These difficulties may significantly influence communication even where the speech motor system itself is relatively intact.
Functional Neurological Speech Disorders
Functional neurological disorders can sometimes result in changes to speech.
Assessment may require collaboration between Speech and Language Therapy, neurology and other professionals.
Primary Progressive Apraxia of Speech
Primary Progressive Apraxia of Speech usually develops gradually rather than suddenly.
Speech motor planning becomes progressively impaired over time.
This presentation requires specialist neurological assessment.
Primary Progressive Aphasia
Primary Progressive Aphasia primarily affects language and progresses over time.
Speech production may also become affected, making differential diagnosis particularly important.
Mixed Motor Speech Disorders
Neurological damage does not always produce one neatly defined disorder.
Some people present with both AOS and dysarthria, requiring assessment and therapy to address both components.
Severe dysarthria
Severe dysarthria
Severe dysarthria
Severe dysarthria can substantially reduce speech intelligibility.
Where speech is very limited, clinicians need to determine whether the difficulty primarily involves motor planning, motor execution or both.
Measuring Communication Impact
Measuring the Communication Impact of AOS
Communicative Participation Item Bank (CPIB)
Assessment of acquired apraxia of speech should consider more than the accuracy of individual speech sounds. AOS can affect a person's ability to participate in conversations, maintain relationships, work, socialise and communicate independently.
Patient-reported, communication-partner and clinician-rated outcome measures can help identify the wider impact of the communication difficulty and monitor change over time. These measures do not diagnose AOS, but they can complement motor speech assessment.
Communicative Participation Item Bank (CPIB)
Communicative Participation Item Bank (CPIB)
The CPIB measures how much a communication disorder interferes with participation in everyday communication situations. It is particularly useful for AOS because it was designed for use across different communication disorders rather than for one specific diagnosis.
Communication Outcome After Stroke (COAST)
COAST is a UK-developed patient-reported measure examining functional communication and communication-related quality of life following stroke. It may be particularly useful where AOS developed following stroke, including where aphasia or dysarthria also occurs.
Carer COAST
Carer COAST provides the perspective of a family member or communication partner. It can be particularly useful when severe communication difficulties make self-report difficult or when clinicians want to compare different perspectives on functional communication.
Therapy Outcome Measures (TOMs)
TOMs allow clinicians to examine outcomes across impairment, activity, participation and wellbeing. They can therefore help demonstrate whether intervention is making a difference beyond performance on speech-production tasks.
Quality-of-life measures
Quality-of-life measures can identify the wider consequences of communication impairment, including effects on independence, emotional wellbeing and participation. Measures such as SAQOL-39g may be particularly relevant following stroke when aphasia is also present.
Communication Confidence
Some people may technically be capable of communicating but avoid conversations because of reduced confidence. Communication-confidence measures can provide additional information about the real-world consequences of a speech disorder.
Communication Partner Perspective
Family members and communication partners may provide information about communication in situations that cannot be observed during an assessment. However, proxy ratings should complement rather than automatically replace the person's own perspective.
Using Outcome Measures Over Time
Using Outcome Measures Over Time
Repeating appropriate measures can help establish whether communication participation, confidence and quality of life are changing alongside speech therapy.
Useful database
Rehabilitation Measures Database – Shirley Ryan AbilityLab
A free searchable database containing information about rehabilitation outcome measures, including purpose, scoring, psychometric evidence and populations in which measures have been studied.
Research on Diagnosis and Assessment
Research into AOS
The diagnosis of acquired AOS remains an evolving area of research. There is currently no single universally accepted diagnostic test or individual speech characteristic that independently establishes the diagnosis.
Research increasingly supports examining patterns of speech characteristics across multiple tasks, alongside differential diagnosis and structured clinical judgement.
Assessment of Acquired Apraxia of Speech: Pilot Study With the CBO Protocol
.Costa and Ortiz (2026) investigated a structured protocol for assessing acquired apraxia of speech in adults with neurological communication difficulties.
The assessment incorporated several speech tasks, including spontaneous speech, picture description, word repetition and rapid syllable production. The study explored whether combinations of speech characteristics could help identify AOS and distinguish it from associated disorders. Results demonstrated the importance of examining speech across multiple tasks rather than relying on one type of production. Although a pilot study with a limited sample, it provides useful evidence supporting systematic assessment protocols and highlights the value of combining perceptual observations with structured motor-speech tasks during AOS assessment.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12948468/
Reference: Costa, B. M. and Ortiz, K. Z. (2026) ‘Assessment of acquired apraxia of speech: Pilot study with the CBO protocol’, Arquivos de Neuro-Psiquiatria, 84(2), pp. 1–9. doi: 10.1055/s-0046-1816038.
Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12948468/ (Accessed: 26 August 2026).
Differential Diagnosis of Apraxia of Speech in Children and Adults: A Scoping Review
Allison, Cordella, Iuzzini-Seigel and Green (2020) reviewed research examining how apraxia of speech is differentiated from other speech disorders in both children and adults.
The authors identified a wide range of proposed diagnostic characteristics, including articulatory errors, prosodic abnormalities, speech timing, inconsistency and measures of speech motor control. They found considerable variation in the diagnostic criteria and methods used across studies, demonstrating the lack of a universally accepted diagnostic standard. The review emphasises the importance of using multiple sources of evidence and highlights the need for better validated diagnostic markers capable of distinguishing AOS from dysarthria and other speech disorders.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7890226/
Reference: Allison, K. M., Cordella, C., Iuzzini-Seigel, J. and Green, J. R. (2020) ‘Differential diagnosis of apraxia of speech in children and adults: A scoping review’, Journal of Speech, Language, and Hearing Research, 63(9), pp. 2952–2994. doi: 10.1044/2020_JSLHR-20-00061.
Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7890226/ (Accessed: 26 August 2026).
Diagnosing Apraxia of Speech in Children and Adults When There Is No Gold Standard:
Diagnosing Apraxia of Speech in Children and Adults When There Is No Gold Standard: A Scoping Review About the Diagnostic Process
Haley, Jacks and Mailend (2026) examined how clinicians and researchers diagnose apraxia of speech when no definitive gold-standard diagnostic test exists. The review found substantial variation in diagnostic procedures, criteria and terminology across studies. Many diagnoses were based on expert perceptual judgement combined with selected speech characteristics rather than independently validated diagnostic tests. The authors discuss the risk of circular reasoning when research participants are diagnosed using the same features subsequently investigated as diagnostic markers. They argue for greater transparency in diagnostic decision-making and recommend using converging evidence from multiple measures rather than relying on any individual symptom, test or rating scale.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12994722/
Reference: Haley, K. L., Jacks, A. and Mailend, M-L. (2026) ‘Diagnosing apraxia of speech in children and adults when there is no gold standard: A scoping review about the diagnostic process’, American Journal of Speech-Language Pathology, 35(2), pp. 840–859. doi: 10.1044/2025_AJSLP-25-00178.
Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12994722/ (Accessed: 26 August 2026).
The Apraxia of Speech Rating Scale: A Tool for Diagnosis and Description of Apraxia of Speech
The Apraxia of Speech Rating Scale: A Tool for Diagnosis and Description of Apraxia of Speech
Strand, Duffy, Clark and Josephs (2014) examined the Apraxia of Speech Rating Scale (ASRS) as a structured method for identifying and describing features associated with apraxia of speech. The scale was designed to improve consistency when clinicians judge characteristics such as sound distortions, segmentation, slowed speech and abnormal prosody. The authors found that the ASRS could help quantify the presence and severity of AOS characteristics and support differentiation from other communication disorders. The paper is particularly useful clinically because it demonstrates how systematic rating of multiple speech features can strengthen assessment rather than relying on one diagnostic characteristic alone.
Reference: Strand, E. A., Duffy, J. R., Clark, H. M. and Josephs, K. (2014) ‘The apraxia of speech rating scale: A tool for diagnosis and description of apraxia of speech’, Journal of Communication Disorders, 51, pp. 43–50. doi: 10.1016/j.jcomdis.2014.06.008.
Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4254321/ (Accessed: 26 August 2026).
Appendix has copy of scale
The apraxia of speech rating scale: A tool for diagnosis and description of apraxia of speech - PMC
Differential Diagnosis Research
The Apraxia of Speech Rating Scale: A Tool for Diagnosis and Description of Apraxia of Speech
A major research priority is identifying measures capable of reliably distinguishing AOS from:
- aphasia
- dysarthria
- phonological errors
- progressive motor speech disorders
- mixed neurological communication disorders.
What Happens After an AOS Diagnosis?
Understanding the Diagnosis
The Speech and Language Therapist should explain:
- what AOS is
- how it affects speech
- the person's particular presentation
- associated communication difficulties
- what assessment has found
Information should be provided in a format that the person can understand and access.
Establishing Severity
AOS can range from mild to very severe.
Severity should not be considered solely in terms of how accurately someone can pronounce words. The impact on everyday communication is equally important.
Identifying Other Communication Difficulties
Treatment planning should consider whether the person also has:
- aphasia
- dysarthria
- cognitive-communication impairment
- swallowing difficulties
- AAC needs
Communication Strengths
Assessment should identify what already works.
This may include:
- writing
- gesture
- drawing
- familiar phrases
- communication aids
- supportive communication partners
Setting Therapy Goals
Goals should be meaningful to the individual.
Rather than concentrating exclusively on test performance, therapy might target activities such as:
- saying family names
- ordering food
- making telephone calls
- participating in conversations
- communicating at work
Choosing AOS Treatment
Treatment may involve intensive and repetitive speech practice designed to improve speech motor planning and programming.
The specific approach should be based on the person's presentation and therapy goals.
AAC and Communication-Partner Support
AAC does not have to replace speech.
It can supplement speech while the person continues to work on speech production.
Family members and communication partners may also benefit from strategies that make conversations easier.
Useful Resources After an AOS Diagnosis
Stroke Association – Communication Problems After Stroke
A practical guide for stroke survivors and families about speech, language and communication difficulties after stroke.
https://shop.stroke.org.uk/product/communication-problems-after-a-stroke
Headway
A UK charity supporting people affected by acquired brain injury and providing extensive rehabilitation information.
https://www.headway.org.uk/
Communication Matters
Provides UK information and support for people who use or may benefit from AAC.
https://www.communicationmatters.org.uk
Ace Centre
Specialist UK support for AAC and assistive communication technology, including assessment and training.
https://acecentre.org.uk
Monitoring Recovery
Monitoring Recovery
AOS can change considerably following neurological injury.
Regular review allows clinicians to:
- monitor improvement
- adjust treatment goals
- change communication supports
- identify new difficulties
Progressive deterioration rather than recovery should prompt appropriate medical or neurological investigation.
Useful Resources and Further Learning
Northumbria Healthcare NHS Foundation Trust – Adult Speech and Language Therapy
NHS information on adult speech and language therapy for acquired neurological communication difficulties, including motor speech disorders.
https://www.northumbria.nhs.uk/our-services/therapies/speech-and-language-therapy-adult/adult-speech-and-language-therapy-community
Norfolk and Norwich University Hospitals – Apraxia of Speech Information
A clear NHS patient information leaflet explaining acquired apraxia of speech, common features and communication difficulties.
https://www.nnuh.nhs.uk/publication/download/apraxia-of-speech-information-leaflet-v5
ASHA – Dynamic Assessment
A free four-module online learning resource introducing dynamic assessment and how response to support and cueing can inform clinical assessment.
https://www.asha.org/practice/multicultural/dynamic-assessment/
National Aphasia Association – PPA/PPAOS Educational Series
A free webinar and recording series covering Primary Progressive Aphasia and Primary Progressive Apraxia of Speech for clinicians, individuals and families.
https://aphasia.org/series/ppa-ppaos-educational-series
ASHA – Acquired Apraxia of Speech Practice Portal
A comprehensive professional resource covering the characteristics, assessment, differential diagnosis and treatment of acquired AOS.
https://www.asha.org/practice-portal/clinical-topics/acquired-apraxia-of-speech/
NIDCD – Apraxia of Speech
Accessible information from the US National Institute on Deafness and Other Communication Disorders explaining causes, symptoms, diagnosis and treatment of apraxia of speech.
https://www.nidcd.nih.gov/health/apraxia-speech
Royal College of Speech and Language Therapists – Stroke
UK professional information and resources relating to communication and swallowing difficulties following stroke.
https://www.rcslt.org/speech-and-language-therapy/clinical-information/stroke/
Headway – Speech Difficulties After Brain Injury
UK information explaining speech difficulties following acquired brain injury, including dysarthria and dyspraxia/apraxia of speech.
https://www.headway.org.uk/about-brain-injury/individuals/effects-of-brain-injury/communication-problems/speech-difficulties/
Stroke Association – Communication Problems After Stroke
Stroke Association – Communication Problems After Stroke
A practical UK resource for stroke survivors and families covering communication difficulties and support following stroke.
https://shop.stroke.org.uk/product/communication-problems-after-a-stroke/
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Communication Matters – AAC Information and Resources
Rehabilitation Measures Database – Shirley Ryan AbilityLab
Stroke Association – Communication Problems After Stroke
A UK charity providing information and training about Augmentative and Alternative Communication for people with severe communication difficulties.
https://www.communicationmatters.org.uk
Ace Centre – AAC and Assistive Technology
Rehabilitation Measures Database – Shirley Ryan AbilityLab
Rehabilitation Measures Database – Shirley Ryan AbilityLab
A UK specialist organisation providing AAC assessment, information, training and assistive communication resources.
https://acecentre.org.uk
Rehabilitation Measures Database – Shirley Ryan AbilityLab
Rehabilitation Measures Database – Shirley Ryan AbilityLab
Rehabilitation Measures Database – Shirley Ryan AbilityLab
A free searchable database of rehabilitation assessment and outcome measures, including information on scoring, validity, reliability and clinical use.
https://www.sralab.org/rehabilitation-measures
Books and Professional Resources
Neurology for the Speech-Language Pathologist
A practical neurology text written specifically for Speech and Language Pathologists, covering the nervous system, neuroanatomy, motor control for speech, traumatic brain injury, neuroimaging and neurological speech-language disorders; useful background for understanding the neurological basis of acquired apraxia of speech.
Acquired Speech and Language Disorders: A Neuroanatomical and Functional Neurological Approach
A broader text covering communication disorders caused by acquired neurological conditions. It is useful for putting AOS into context alongside aphasia, dysarthria and other acquired communication problems, particularly following stroke or brain injury.
Motor Speech Disorders: Substrates, Differential Diagnosis, and Management – Joseph R. Duffy
Motor Speech Disorders: Substrates, Differential Diagnosis, and Management – Joseph R. Duffy
A major clinical reference for acquired motor speech disorders. It covers apraxia of speech and the different dysarthrias in depth, with strong sections on neurological mechanisms, perceptual characteristics, assessment and differential diagnosis. This is probably the most useful single professional textbook if your focus is adult acquired AOS.
Acquired Apraxia of Speech (AOS)
How do I get it
Acquired Apraxia of Speech (AOS) is a motor speech disorder that affects a person’s ability to plan and coordinate the movements needed for clear, accurate speech. It is not caused by muscle weakness or paralysis; instead, the brain has difficulty organising and sending the correct messages to the muscles used in speech.
AOS most commonly appears after a brain injury, such as a stroke, traumatic brain injury or a neurological condition. Individuals with AOS usually know what they want to say but the words may come out incorrectly, distorted or with unusual pauses and effort. Speech can be inconsistent, the same word might be spoken clearly one moment and be difficult the next, which can be frustrating and confusing.
Speech and Language Therapists diagnose AOS through detailed assessment and provide tailored therapy. Support often focuses on motor-based speech practice, repetition and techniques to strengthen the brain’s planning and speech movement connection. Additional communication tools, such as gestures, writing, communication books or communication apps (low and high tech Augmentative and Alternative Communication) may also help individuals communicate confidently.
Because AOS varies from person to person, assessment by a Speech and Language Therapist is important. With early, consistent support and understanding from family and the community, many people with AOS make meaningful progress in their communication skills. Thank you for taking the time to learn more about this important condition. Raising awareness helps ensure that people feel supported, heard and empowered during their recovery.
Why does it occur
Organisations that support the health event can have great information, such as the Stroke Association, which has loads of helpful resources. Types of communication problems | Stroke Association
CogNeuroApp—explains where breakdown can occur in processing
Top 10 things to know about AOS
https://www.instagram.com/p/DQpRtCjjFPK/?igsh=Nzh5NDZrMTNmcW9q
Meet a therapist, Kimberley Williams Founder, Nova Speech Therapy
My name is Kimberley Williams, founder of Nova Speech Therapy in West Yorkshire and I have a keen professional interest in supporting individuals with communication difficulties, particularly Acquired Apraxia of Speech (AOS). She has contributed to the contect of this section. Kimberley has done a fantastic podcast for our 'Talking Speech Apraxia' series.
Severity ranges and symptoms
Some people experience subtle prosodic disturbances (e.g. rhythm or speed of speech) that might go unnoticed by unfamiliar listeners.
Others have severe forms, struggling to produce any intelligible speech and may use AAC instead.
Acquired Apraxia of Speech: A Treatment Overview | The ASHA Leader Archive
Therapy apps
Therapy focuses on improving speech clarity, coordination, and confidence.
Exercises may include sound repetition, syllable practice, and structured word-building.
Visual cues, gesture support, and written prompts can help speech planning.
Sessions are personalised to suit your goals, abilities, and communication style
Therapy apps such as Cuespeak can be really effective.
Speech Apraxia UK undertook an impartial review of this excellent product.
Common signs
Sounds may come out in the wrong order, even after several attempts.
The person often knows it’s wrong but can’t fix it (e.g., saying hos-ti-pal).
Some words may be spoken clearly, while others are much harder.
Speech errors can vary from one attempt to the next, with hesitations or struggles to shape the word.
Automatic speech (like days of the week) may be easier than creating new sentences.
ASHA Resources
- Aphasia
- Apraxia of Speech in Adults
- Assessment Tools, Techniques, and Data Sources
- Childhood Apraxia of Speech
- Dynamic Assessment
- Focusing Care on Individuals and Their Care Partners
- Person-Centered Focus on Function: Acquired Apraxia of Speech [PDF]
- Speech Sound Disorders: Articulation and Phonology
- Apraxia of Speech (Childhood)
Other Resources
- American Stroke Association: Aphasia vs. Apraxia
- National Institute on Deafness and Other Communication Disorders (NIDCD): Apraxia of Speech
- United States Society for Augmentative and Alternative Communication
Frequently co-occurring condition—Aphasia
Acquired apraxia of speech resources
ASHA evidence map for apraxia of speech
Conversations with aphasia learning resource
Communication partner training for carers
Microsoft Word - Communication Partner Training Handout.docx
Acquired apraxia of speech article in RCLST bulletin
Relearning communication
Aphasia & Apraxia Recovery and Healing
It is important to see a registered speech and language therapist /pathologist to get an adequate assessment. Some people also find doing excersises helpful. Books like these are not a substitute for speech and language therapy but can start to rebuild confidence.
Aphasia & Apraxia Recovery and Healing
Aphasia & Apraxia Recovery and Healing
Aphasia & Apraxia Recovery and Healing
The Aphasia & Apraxia Recovery and Healing Workbook is a practical, supportive tool designed to help individuals improve communication skills and rebuild confidence after a stroke or brain injury.