What Is Apraxia of Speech?
Neurological Motor Speech Disorder
Resources for explaining what Speech Apraxia is
Neurological Motor Speech Disorder
Apraxia occurs when there is a neural inefficiency disrupting 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.
https://speechapraxia.co.uk/about-sauk/f/more-than-a-diagnosis-we-are-not-just-apraxia-of-speec
Apraxia occurs when there is a neural inefficiency disrupting 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.
https://speechapraxia.co.uk/about-sauk/f/more-than-a-diagnosis-we-are-not-just-apraxia-of-speech?
Motor Planning Inefficiency
Resources for explaining what Speech Apraxia is
Neurological Motor Speech Disorder
The issue lies in planning and sequencing the precise movements needed for speech. Apraxia affects motor planning of speech, not language understanding, intelligence, or muscle strength. People with apraxia know exactly what they want to say but struggle to execute the motor movements. https://speechapraxia.co.uk/about-sauk/f/from-brain-to-mouth-understanding-speech-motor-planning?
Resources for explaining what Speech Apraxia is
Resources for explaining what Speech Apraxia is
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.
How to get a diagnosis for Childhood Apraxia of Speech
Can artificial intelligence help diagnose 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.
How to get a diagnosis for Childhood Apraxia of Speech
Can artificial intelligence help diagnose speech disorders?
Do We Really Know Apraxia of Speech?
Expert opinion
Expert opinion
Professor Emeritus Anita Van de Merwe who specialises in speech apraxia at Pretoria University, writes for Speech Apraxia UK-Apraxia of speech is a disturbance of the voluntary control of speech movements. It may occur in children as childhood apraxia of speech (CAS) or as acquired apraxia of speech (AOS) due to acquired damage of the are
Professor Emeritus Anita Van de Merwe who specialises in speech apraxia at Pretoria University, writes for Speech Apraxia UK-Apraxia of speech is a disturbance of the voluntary control of speech movements. It may occur in children as childhood apraxia of speech (CAS) or as acquired apraxia of speech (AOS) due to acquired damage of the areas in the brain responsible for motor planning. Both these conditions should be differentiated from a language disorder such as aphasia, and from dysarthria, which is a disorder of lower levels of motor control. Speech apraxia is a disorder in planning the place and manner of articulation of speech sounds.
Symptoms and Clinical Features
Recording and analysing speech resources
https://www.seeingspeech.ac.uk/ipa-charts/?chart=3
These resources include video and audio recordings of individual sound segments produced by a male and a female speaker.
https://teaching.ncl.ac.uk/ipa/consonants-pulmonic.html
A very useful website that allows you to type in phonetic symbols.
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.
Childhood Apraxia of Speech
Various names-same disorder
Childhood Apraxia of Speech (CAS)– US, UK
Developmental Verbal Dyspraxia(DVD) - UK
Previously Apraxia of Speech (AOS),
Dyspraxia of Speech,
Other terms
- Isolated developmental verbal dyspraxia (DAS)
- Pure childhood apraxia of speech
- Speech-language disorder type 1
- Speech and language disorder with orofacial dyspraxia
- Isolated CAS
- Pure CAS
Why Childhood Apraxia of Speech?
Consistency & insurance purposes
RCSLT-Childhood-Apraxia-of-Speech-CAS-Position-Paper-2024.pdf
How common is it?
Prevalence: 0.1-0.2% of all children with a speech sound disorder
The causes of childhood apraxia of speech are possibly genetic but not well understood
MRI scans have not been successful in identifying brain damage/differences in children with childhood apraxia of speech.
Male to female ratio is 2-3:1
Childhood Apraxia of speech (Developmental Verbal Dyspraxia)
What is it?
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.
Apraxia of Speech Series – Part Two: childood apraxia of speech
Difficulties that sometimes co-occur
Childhood apraxia of speech can occur on its own but other difficulties are fairly common, alongside including issues with-
Language and literacy, understanding and using language, grammar and/or sequencing difficulties, Difficulties with social interaction with others and Developmental Coordination Disorder (DCD/Dyspraxia).
Word finding difficulties in CAS
#GVTwitterTakeover on Childhood Apraxia of Speech - Wakelet
Vowel Errors
Vowel Errors
Vowel distortions are a hallmark of Childhood Apraxia of Speech (CAS) and can greatly reduce intelligibility. Unlike consonants, vowels are harder to “see” and require subtle tongue and jaw changes, making them particularly difficult for children with CAS. Errors may include distortions, substitutions, or reducing diphthongs (two-part vowels, e.g., /ai/ in eye). Many children shorten diphthongs to a single sound or confuse vowels with similar jaw positions, such as producing bed as bad.
Vowel Errors in Childhood Apraxia of Speech
Missed or Misunderstood: Why Childhood Apraxia Goes Unnoticed
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. Does CAS get better on its own?
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. You may get questions like "where are you from?" as others try to place your accent. Apraxia of speech can sometimes distort what we say, so they are just being curious.
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. See our 'Information sources for study and employment' Funding and support or see our resource hub for tips in work and study Apraxia Resource Hub
Who’s to say what ‘normal’ is? I personally really dislike the word ‘normal.’ Everyone is ‘different’ in some way or another.
Mikey Akers
Acquired Apraxia of Speech (AOS)
How do I get it
People are not born with it.
AOS occurs suddenly usually after a stroke, head injury, or neurological illness. Stroke Can Happen at Any Age — Let’s Not Take Speech for Granted
Symptoms
Slow, uneven or broken speech
Frustration due to being "stuck" on words
Inconsistent speech errors
Struggle with longer or unfamiliar words
CogNeuroApp—explains where breakdown can occur in processing
Support
Aphasia, dysarthia or apraxia of speech?
See our resources page Apraxia Resource Hub
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, dysarthia or apraxia of speech?
Aphasia, dysarthia or apraxia of speech?
Aphasia, dysarthia or apraxia of speech?
Aphasia can affect both receptive and expressive language, not just comprehension.There can be overlap in symptoms among acquired conditions, which complicates diagnosis and treatment planning.
Dysarthia effects muscle coordination or movement and may lead to symptoms like slurred speech.
But all can occur together after a stroke or other neurological event.
Ask the Expert Webinars - National Aphasia Association
Severity ranges
Aphasia, dysarthia or apraxia of speech?
Severity ranges
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
Aphasia, dysarthia or apraxia of speech?
Severity ranges
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.
Acquired apraxia of speech resources
Acquired apraxia of speech resources
Acquired apraxia of speech resources
ASHA evidence map for apraxia of speech
Conversations with aphasia learning resource
Aphasia resources
Acquired apraxia of speech resources
Acquired apraxia of speech resources
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. . Delayed progressive apraxia of speech is a rare presentation where motor speech difficulties develop later in the disease, without signs of language loss
Primary Progressive Apraxia of Speech (PPAOS) - National Aphasia Association
Delayed Progressive Apraxia of Speech:A Distinct Clinical Subtype
Primary Progressive Apraxia of Speech Understanding Delayed Progressive Apraxia of Speech
How common is it?
More commonly diagnosed in people aged 50–70. No study has yet looked into its prevalence. However, it can be estimated at 4.4 per 100,000 (Botha, H., & Josephs, K. A., 2019).
Studies suggest that PPAOS may account for about 20–30% of cases initially diagnosed as primary progressive aphasia (PPA) when speech motor impairments are the dominant symptom.
Due to overlap with other neurodegenerative diseases, the condition is often underdiagnosed or misdiagnosed in early stages.
Apraxia of Speech with Primary Progressive Aphasia
Corticobasal syndrome and speech apraxia
What are the symtoms
Primary Progressive Apraxia of Speech (PPAOS) can present in different ways, each affecting how your speech sounds.
Prosodic AOS
- Speech is slow and uneven.
- Words or syllables may be stretched or broken apart
- The rhythm can sound unnatural or robotic.
Phonetic AOS
- Speech sounds may be unclear or slightly distorted.
- You might visibly work to find the right mouth position for certain sounds.
Most people with PPAOS experience Prosodic AOS as their main difficulty, but Phonetic AOS can also be present. Many have a combination of both patterns.
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. ttps://www.itv.com/news/calendar/2022-12-13/kamara-suffering-with-balance-issues-and-weakness-due-to-thyroid-issue
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."
Chris is a former Leeds United, Sheffield United, and Bradford City player, from Middlesbrough,. (ITVX, 2025) Chris Kamara: Lost for Words - ITVX
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.
Possible genetic link
A positive family history for neurodegenerative disease is found in 25% of patients diagnosed with PPAOS (Duffy, J. R., Utianski, R. L., & Josephs, K. A., 2020)
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