What Is Apraxia of Speech?
Neurological Motor Speech Disorder
Different from Other Speech Disorders
Neurological Motor Speech Disorder
Apraxia occurs when brain damage disrupts the pathways that carry messages from the brain to the mouth muscles. The brain knows what it wants to say, but cannot properly coordinate the movements needed to produce the sounds.
Motor Planning Inefficiency
Different from Other Speech Disorders
Neurological Motor Speech Disorder
The issue lies in planning and sequencing the precise movements needed for speech, not in muscle strength or intelligence. People with apraxia know exactly what they want to say but struggle to execute the motor movements.
Different from Other Speech Disorders
Different from Other Speech Disorders
Different from Other Speech Disorders
Unlike aphasia (language difficulty) or dysarthria (muscle weakness affecting speech), apraxia specifically impacts the brain's ability to coordinate the complex movements required for accurate speech production.
Symptoms and Clinical Features
Inconsistent Errors
Speech errors vary inconsistently—Sometimes pronouncing a word correctly, then struggling with the same word moments later. This inconsistency is a hallmark feature that helps distinguish apraxia from other disorders.
Sound Distortions
Difficulty pronouncing words correctly, with sounds or syllables being distorted, substituted, or omitted entirely. The person may struggle particularly with starting words or connecting sounds together.
Prosody Issues
Speech often sounds robotic with abnormal rhythm, stress patterns, and intonation. The person may speak very slowly with unusual pauses between syllables or words as they mentally plan each sound sequence.
Expressive or Receptive- where does Apraxia fit?
If you’ve ever found yourself wondering about the difference between expressive and receptive language disorders and how apraxia of speech fits into the mix, you’re not alone! It’s a common question, and understanding the basics is where it begins.
Let’s break it down:
Receptive Language: Understanding What’s Coming In
Receptive language is all about how we understand language. It’s our ability to:
- Follow directions.
- Understand spoken or written words
- Make sense of what people are saying
Think of it as the “input” side of communication. When someone says, “Can you grab your shoes?” and you understand what to do, that’s receptive language at work!
Expressive Language: Getting the Message Out
Our brain takes information in but also sends a message out, which is where expressive language comes in for tasks like
- Speaking
- Using gestures or facial expressions
- Writing
- Using signs or symbols
So, What About Apraxia of Speech?
Apraxia of speech is a motor speech disorder, and it falls under the expressive language umbrella. That’s because it affects the output of language specifically spoken language.
People with apraxia know what they want to say, but their brain has trouble planning and coordinating the movements needed for speech. It’s not about muscle weakness; it’s about the motor planning. So, while their ideas and understanding are there (receptive language is typically intact!), getting those thoughts out verbally can be a real challenge.
Childhood Apraxia of Speech
Various names-same disorder
Various names-same disorder
Various names-same disorder
Childhood Apraxia of Speech (CAS)– US
Developmental Verbal Dyspraxia(DVD) - UK
Previously Apraxia of Speech (AOS),
Dyspraxia of Speech,
Developmental Apraxia of Speech (DAS)
Why Childhood Apraxia of Speech?
Consistency & insurance purposes
Not meant to imply theoretical perspective on the disorder
How common is it?
Various names-same disorder
Various names-same disorder
Prevalence: 0.1-0.2% of all children with speech sound disorder
The causes of childhood apraxia of speech are not well understood
MRI scans have not been successful in identifying brain damage/differences in children with childhood apraxia of speech.
Research suggests possible genetic bases for CAS but it is not fully understood
Male to female ratio is 2-3:1
Childhood Apraxia of speech (Developmental Verbal Dyspraxia)
What is it?
Difficulties that sometimes co-occur
Difficulties that sometimes co-occur
Childhood Apraxia of Speech (CAS) is a neurological speech disorder that affects a person's ability to plan and produce the movements needed for clear speech. It is not caused by muscle weakness or paralysis. Individuals with CAS often struggle to consistently move their lips, tongue, and jaw into the correct positions for speech and have difficulty smoothly transitioning between sounds. They may also find it hard to sequence sounds into words.
Difficulties that sometimes co-occur
Difficulties that sometimes co-occur
Difficulties that sometimes co-occur
iLanguage and literacy difficulties:
-understanding and using language
-word order, grammar and/or sequencing difficulties
Pragmatics:Difficulties with social interaction with others
Developmental Coordination Disorder (DCD/Dyspraxia)
Eating difficulties.
Questions and answers
Can CAS still affect me as an adult?
While many improve with therapy, some adults continue to experience residual speech challenges, like difficulty with articulation, rhythm, or confidence when speaking.
What are the signs?
You might notice inconsistent speech errors, effortful or slowed speech, challenges with multi-syllabic words, or anxiety about speaking in social settings. These issues can fluctuate depending on fatigue, stress, or environment.
Can My Speech Still Improve?
Absolutely. While progress may be slower than in childhood, speech therapy with a specialist who understands motor speech disorders can help refine and improve fluency, and build confidence. Approaches may include motor-based therapy, prosody training, and assistive tools. Either go via the NHS or use ASLTIP for a private speech and language therapist in your area Find a speech therapist - ASLTIP and look here for adult therapy approaches Adult Therapy approaches | Adults with apraxia of speech
I get nervous about how people perceive my speech;what can I say?
You can keep it simple and honest: “I have a speech motor disorder that makes some words come out differently, but I’m working on it.” People often appreciate the clarity, and it can reduce pressure during conversations.
Are there practical ways to manage speaking challenges in work or life?
Yes. You might try pacing strategies (like pausing between phrases), rehearsing key phrases ahead of time, using supportive tech (e.g. text-to-speech apps), or practicing public speaking in safe environments. Confidence often grows with preparation and support.
Acquired Apraxia of Speech (AOS)
How do I get it
How do I get it
How do I get it
People are not born with it.
Occurs suddenly usually after a stroke, head injury, or neurological illness
Typical speech development before the event
Symptoms
How do I get it
How do I get it
Slurred, slow, or broken speech
Frustration due to being "stuck" on words
Inconsistent speech errors
Struggle with longer or unfamiliar words
Support
How do I get it
Aphasia versus Apraxia of Speech
See our resources page
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
Aphasia versus Apraxia of Speech
What is acquired, not developmental
Aphasia versus Apraxia of Speech
What are the differences between aphasia and apraxia? Aphasia affects language comprehension and involves language processing areas of the brain.
Apraxia of speech is a motor planning disorder, not a language problem. The person knows what they want to say but struggles to coordinate speech movements.
But both can occur together after a stroke or other neurological event.
What is acquired, not developmental
What is acquired, not developmental
What is acquired, not developmental
Acquired Apraxia of Speech (AOS) is a disorder that people develop after childhood. Childhood Apraxia of Speech (CAS) or developmental verbal dyspraxia begins in early childhood (perhaps from birth) and is not usually due to a neurological event.
Therapy
What is acquired, not developmental
What is acquired, not developmental
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. See our therapy pages
Primary Progessive Apraxia of speech
What is it?
Primary progressive apraxia of speech (PPAOS) is a rare form of apraxia in the absence of dementia that develops insidiously and slowly
What is it?
Primary progressive apraxia of speech (PPAOS) is a rare form of apraxia in the absence of dementia that develops insidiously and slowly
Chris Kamara's Experience
Chris Kamara says he "suffered in silence" with speech problems for almost two years before he was diagnosed with a thyroid problem.
The former footballer, who has become one of the best-loved broadcasting pundits in the country, revealed he had speech apraxia earlier this year after television viewers noticed him slurring his words on air.
He later quit his job, but has continued to work in television and radio.
Speaking to ITV News ahead of a documentary about his condition, Kamara – known to millions by his nickname "Kammy" – said he wanted his experience to be a warning to other people.
He said: "Initially I was in denial. I'm a dinosaur. I suffered in silence for about 20 months and in that time my thyroid gland became virtually non-existent , so that could be the reason for all my problems along the line, by just not going to see a doctor.
"Now not only have I got an underactive thyroid, the apraxia of speech has come on, my balance is no good, I'm really weak."
The 64-year-old former Leeds United, Sheffield United and Bradford City player, from Middlesbrough, has been determined not to let his difficulties prevent him from working. He has continued to co-present ITV's Ninja Warrior as well as a BBC podcast. (ITVX, 2025)
Symptoms
Primary Progressive Apraxia of Speech (PPAOS) is characterized by a gradual decline in motor speech planning and programming, leading to a range of speech impairments.
Explanation:
PPAOS is a neurodegenerative condition where the brain gradually loses the ability to plan and program the movements required for speech. Unlike sudden-onset apraxia due to stroke, PPAOS progresses slowly over time, leading to increasing difficulty in speaking clearly and fluently.
Symptoms of Primary Progressive Apraxia
Speech Rate and Segmentation
Sound Errors and Utterance Complexity
Sound Errors and Utterance Complexity
Individuals with PPAOS often exhibit a slow speech rate and lengthened intersegment durations, with syllable segmentation occurring both within multisyllabic words and across phrases.
People with PPAOS tend to speak slowly, with noticeable pauses between syllables and words. This segmentation affects both long words and phrases, making their speech sound choppy or disjointed.
Sound Errors and Utterance Complexity
Sound Errors and Utterance Complexity
Sound Errors and Utterance Complexity
Sound distortions, distorted substitutions, and additions become more prominent with increasing utterance complexity or length.
As sentences become longer or more complex, speech errors increase. These may include slurred or imprecise sounds, incorrect substitutions, or adding extra sounds. This reflects the growing difficulty the brain has with organizing motor plans for complex speech.
Struggle Behaviours
Speech Motor Tasks (SMRs vs AMRs)
Speech Motor Tasks (SMRs vs AMRs)
Articulatory groping, false starts, and audible or visible effort are common, reflecting the struggle to initiate or sequence movements.
Visible signs of struggle—like repeated attempts to form words (groping), hesitations, and exaggerated effort—indicate the person's difficulty in starting or sequencing the precise motor movements needed for speech.
Speech Motor Tasks (SMRs vs AMRs)
Speech Motor Tasks (SMRs vs AMRs)
Speech Motor Tasks (SMRs vs AMRs)
Speech motor tasks such as Sequential Motion Rates (SMRs) are typically deliberate, slow, and segmented, with distorted productions compared to Alternating Motion Rates (AMRs), which also often show inaccuracy in place or manner.
When asked to repeat sequences like “pa-ta-ka” (SMR), individuals perform slowly and with errors, showing how hard it is to shift between movements. Even simpler tasks like repeating “pa-pa-pa” (AMR) show mistakes, though typically less complex than SMRs. Both reveal underlying motor planning deficits
Who’s to say what ‘normal’ is? I personally really dislike the word ‘normal.’ Everyone is ‘different’ in some way or another.
Mikey Akers
Adults with childhood apraxia of speech
Mikey Akers is the founder of Mikey’s Wish Foundation, a registered charity that raises awareness of and supports people with speech, language and communication needs with an interest in Childhood Apraxia of Speech. Mikey was diagnosed with CAS when he was just 2 years old and has spent the last 10 years actively raising awareness of the diagnosis. He has travelled to America to speak at conferences, is an ‘Expert by Experience’ at Birmingham City University, travels England giving talks at conferences and schools. He has appeared in the documentary, Chris Kamara: Lost for Words. Mikey is working with a number of MPs to secure more funding for speech and language services after his petition was debated in Parliament earlier this year
Growing up with childhood apraxia of Speech
Jaron
Jaron
Jaron Talks about growing up with apraxia and living with it today.
Isela
Jaron
Living With Apraxia of Speech | BeautywithIsela
Isela describes what apraxia of speech is. She talks about how her childhood apraxia of speech continues to affect her as an adult.
Jordan
Growing Up with Verbal Apraxia (CAS) - Q&A
Jordan has a suite of videos and his own website, 'Flighting for my voice,' discussing the issues around apraxia of speech.
Carly
Carly
Joanne Bendel “If you are growing up with apraxia, or you grew up with apraxia, I want you to know that you are not alone. You see, I have it too, which means that we’ve probably faced similar challenges in life. Because we have a hard time putting sounds together, it makes communicating difficult. As you’re aware, not being well-understood means that we might have a few more obstacles in our path than other people do. But that’s what makes us unique. Woman with verbal apraxia: 'Don't ever give up'
Carly
Carly
Carly
Carly Fleischmann is an amazing person who doesn’t let nonverbal autism and apraxia of speech stop her. She uses technology to share her thoughts and ideas. Carly co-wrote the book “Carly’s Voice: Breaking Through Autism” and has her own YouTube show. Her story inspires neurodivergent kids all around the world.
Ronda Rousey UFC fighter
Ronda Rousey had a hard time communicating as a child
For the first six years of Ronda Rouey’s life, she struggled to form intelligible sentences. While at the time she was not diagnosed with Childhood Apraxia of Speech, as the condition was extremely rare and not well understood, Rousey did take speech therapy lessons as a child.
She told ABC News about it in 2015, saying, “At first I was tested for deafness. They thought maybe my pronunciation was off because I was hearing things differently. But it was really I had all these words perfectly arranged in my head, it’s just when they tried to come out of my mouth they sounded different. It was kind of like there was a divide between my brain and my mouth."
Ronda Rousey and her family believe that it may have been the fact that Rouey was born with her umbilical cord wrapped around her neck that caused the disorder. It’s ironic that someone who became known for choking out opponents was almost choked out in birth. It’s almost as if it was fate. Ronda was born a fighter, so she became one professionally as well.(Thesportstar.com, 2025) Ronda Rousey wants Becky Lynch at WrestleMania: Raw, Feb. 25, 2019
Adults with Acquired Apraxia of Speech
Gina
Gina was diagnosed with it after a cerebral vascular accident (small stroke) in October of 2015. She wanted to find others who have apraxia but really, couldn't find any good examples of adults like her. She decided she couldn't be the only one out there, so she posted videos of me and my progress. Click on the link to watch them.
Donna
Deonna Keiser is an artist who is living with the impacts of speech aphasia and apraxia as a result of a stroke. While Deonna is able to understand all spoken language, she sometimes has trouble formulating the words to speak. With the help of her dear friend Lisa Naser, and through her art, Deonna is able to communicate her day-to-day and emotional experiences. When Art Speaks: Living after Stroke with Speech Aphasia and Apraxia - YouTube
Primary Progressive Apraxia-Chris Kamara
Chris has primary progressive verbal apraxia
Chris Kamara Bravely Opens Up On His Battle With Apraxia | This Morning - YouTube
He’s known for his famous catchphrase ‘Unbelievable Jeff!’ during his football commentary each weekend, but in 2020 Chris Kamara found himself struggling with his speech. He was later diagnosed with a rare condition called Apraxia of Speech (AOS) which is the subject of his new documentary ‘Lost For Words’. Chris joins us today alongside his close friend Ben Shephard to share his story. . Watch his film Chris Kamara: Lost for Words - ITVX
