What occurs with speech apraxia?
Can apraxia of speech be present alone?
yes, Speech apraxia can be present on its own with no other conditions.
What other co-occuring conditions can there be?
With developmental apraxia of speech, people may find speech is a struggle generally, with conditions such as general dyspraxia common. Later acquired apraxia of speech commonly coincides with aphasia, stroke, or neurological diseases.
There may be less attention given to speech apraxia if individuals have conditions such as learning disabilities or communication impairments. We are against this ableism and feel everyone deserves the same access to speech apraxia assessment.
www.speechapraxia.co.uk/about-sauk/f/speech-apraxia-rarely-comes-alone?
When 'Normal' Speech Is Less Likely
Speech apraxia is not often a diagnosis in isolation: it may be:
- Idiopathic (isolated CAS) with no known cause.
- Syndromic, when part of a broader neurogenetic or neurodevelopmental profile.
- Acquired, following neurological damage or degeneration.
Neurodevelopmental and Neurological Conditions
Autism Spectrum Disorder (ASD) – CAS can co-occur in a subset of autistic children; some research suggests higher prevalence.
Global Developmental Delay / Intellectual Disability – CAS may be one component of a broader neurodevelopmental profile.
Epileptic encephalopathies (e.g. Landau–Kleffner syndrome, West syndrome) – may involve acquired or developmental speech apraxia.
Cerebral palsy (particularly with basal ganglia involvement) – though more often dysarthric, CAS features may also appear.
Acquired Conditions Associated with Acquired apraxia of speech (in older children or adults)
Stroke or Brain Injury
- Left hemisphere stroke, particularly in the inferior frontal gyrus, insula, or motor cortex areas responsible for speech planning.
- Traumatic Brain Injury (TBI) – if speech motor planning areas are affected.
Neurodegenerative Disorders
- Primary Progressive Apraxia of Speech (PPAOS) – a distinct neurodegenerative motor speech disorder, often linked to tauopathies.
- Primary Progressive Aphasia (PPA) – especially the non-fluent/agrammatic variant, where AOS may coexist.
- Corticobasal degeneration – can include apraxia of speech among other motor planning deficits.
Conditions that can co-exist
Aphasia
Aphasia, an acquired language disorder is common following a stroke. It is rare to have acquired apraxia of speech without some degree of aphasia.
www.speechapraxia.co.uk/about-sauk/f/acquired-apraxia-of-speech-after-stroke-what-we-know?
Auditory Processing disorder
ASHA guidance on APA—the roles of the Audiologist and Speech-Language Pathologist
Central Auditory Processing Disorder
Auditory Processing Disorder (APD) and Speech Apraxia
Auditory Processing Disorder | Nemours KidsHealth
Take a free auditory processing disorder test
Please note that this will not give you a diagnosis. If you suspect APD, contact an audiologist for a formal assessment. Treatment for APD typically involves speech and language therapy sessions. Additionally, auditory and language programs like Forbrain and Soundsory, recommended by Speech and Language Pathologists, can help address APD and related difficulties. DISCOUNT CODE 3A9906634 for 10% discount on all orders.
Autism Spectrum Disorder
Corticobasal Degeneration /Progressive Supranuclear Palsy
Apraxia of speech and autism- Whispered Words, Silent Struggles
Vitamin E, Autism and Speech Apraxia: Could Nutrition Play a Role
When Apraxia, Autism, and Epilepsy Overlap: Paxton’s Story
Lottie Berry's blog as a mother with to an autistic non-speaking son who has Suspected Childhood Apraxia of Speech
Corticobasal Degeneration /Progressive Supranuclear Palsy
Corticobasal Degeneration /Progressive Supranuclear Palsy
Corticobasal Degeneration /Progressive Supranuclear Palsy
Corticobasal degeneration and progressive supranuclear palsy are most commonly responsible for primary progressive apraxia of speech. nature.com/articles/s41467-021-23687-8
Cracking the Code of Progressive Apraxia of Speech
Developmental Dyspraxia
Corticobasal Degeneration /Progressive Supranuclear Palsy
Corticobasal Degeneration /Progressive Supranuclear Palsy
Developmental Dyspraxia (global apraxia). Developmental coordination disorder or dyspraxia refers to an overall motor incoordination which is commonly found alongside childhood apraxia of speech.
Developmental language disorder
People with CAS show elevated levels of antigliadin IgA antibodies and glutamate, along with reduced levels of GABA, unlike those with DLD.
www.speechapraxia.co.uk/about-sauk/f/biological-breakthrough-unpacking-the-cas%E2%80%93dld-divide?
Dysfluency
For individuals with apraxia of speech, periods of progress can be interrupted by sudden dysfluency, pauses, repetitions, or stuttering-like moments. Apraxia of speech and dysfluency are different conditions but can sometimes co-occur.
www.speechapraxia.co.uk/about-sauk/f/stuttering-and-apraxia-of-speech?
Speech Apraxia, Stuttering, or Cluttering: Knowing the Difference
Epilepsy
Fredreich's Ataxia
Epilepsy, autism and apraxia of speech can sometimes co-occur due to genetic influence.
Fredreich's Ataxia
Fredreich's Ataxia
While dysarthria (slurred speech) is common in Friedreich’s ataxia, some individuals may also show signs of apraxia of speech.
www.speechapraxia.co.uk/about-sauk/f/friedreich’s-ataxia-and-apraxia-of-speech-what’s-the-link?
Stroke/neurological injury/disease
You may acquire both apraxia of speech and ataxic dysarthria, particularly after complex neurological events like a cerebellar stroke, multi-focal brain injuries, or neurodegenerative diseases (e.g., Multiple System Atrophy or certain forms of progressive ataxia). In these cases, you may experience both impaired motor speech planning (speech apraxia) and motor execution/coordination difficulties (ataxia).
www.speechapraxia.co.uk/about-sauk/f/can-someone-have-both-speech-apraxia-and-ataxia?
Genetic, metabolic, or mitochondrial disorders
Cohen syndrome
49,XXXXY and Cornelia de Lange Syndrome
49,XXXXY and Cornelia de Lange Syndrome
In Cohen syndrome severe speech delay is observed in most children over 5 years, highlighting the need to screen for speech apraxia early.
49,XXXXY and Cornelia de Lange Syndrome
49,XXXXY and Cornelia de Lange Syndrome
49,XXXXY and Cornelia de Lange Syndrome
49,XXXXY and Cornelia de Lange syndrome (CdLS). Both conditions affect neurodevelopment, facial features, and motor skills. 49,XXXXY is associated with childhood apraxia of speech.
Creatine Deficiency Syndromes
49,XXXXY and Cornelia de Lange Syndrome
Creatine Deficiency Syndromes
Creatine Transporter Deficiency linked to Speech Apraxia
Creatine transporter deficiency can cause speech apraxia, not just language delay. Affected children may understand
more than they can say, due to motor planning difficulties. Motor-based speech therapy is key.
L-Arginine:Glycine Amidinotransferase (AGAT) Deficiency
Guanidinoacetate Methyltransferase (GAMT) Deficiency
Creatine Transporter Deficiency (CTD)
#creatinedeficiency
Association for Creatine Deficiencies - Advancing Creatine Disorder Research
Down Syndrome
Creatine Deficiency Syndromes
Many individuals with Down syndrome experience difficulties with speech intelligibility Recent parent-reported data shows that many people with down syndrome display hallmark features of apraxia, such as inconsistent speech errors and difficulty sequencing sounds.
Pioneering Treatment for Speech Apraxia in Down Syndrome
Apraxia of Speech and Down Syndrome: Do we really consider it?
Ectodermal dysplasia
Ectodermal dysplasias are a group of rare inherited conditions affecting structures such as teeth, hair, nails, and sometimes the ears and nerves. While speech apraxia is not a core feature, certain aspects of ectodermal dysplasia may increase the risk of motor speech difficulties. Oral differences, such as missing or malformed teeth and changes in palate shape, can make it harder for children to master precise speech movements. Hearing difficulties linked to inner ear development, may reduce the auditory feedback needed for speech learning. In rare cases, neurological involvement may affect the nerves or brain regions that coordinate speech planning. Repeated ENT issues and reduced oral-motor practice can further compound these challenges. Together, these factors may contribute to speech apraxia in some individuals.
Fragile X
Homocystinuria
Galactosaemia
Pragmatic difficulties, oral-motor coordination, attention deficits Fragile X Syndrome: Causes, Symptoms, and Treatment of the Most Common Inherited Intellectual Disability • FRAXA Research Foundation - Finding a Cure for Fragile X Syndrome
Fragile X Syndrome and Speech Apraxia: Unpacking the Connection
Galactosaemia
Homocystinuria
Galactosaemia
Galactosemia, a rare inherited metabolic condition in which the body cannot properly break down galactose (sugar in dairy), has a high co-occurrence with speech apraxia
Homocystinuria
Homocystinuria
Hypomelanosis of Ito
Children with homocystinuria, a rare metabolic disorder, can present with developmental delays, intellectual disability, and speech-language difficulties. Motor speech disorders, including childhood apraxia of speech (CAS), may occur due to the impact of homocystinuria on the nervous system and motor control. In such cases, apraxia therapy focuses on improving motor planning for speech, while also considering the broader cognitive, metabolic, and medical needs of the child. (please note photo may not reflect syndrome)
Hypomelanosis of Ito
Hypomelanosis of Ito
Hypomelanosis of Ito is a rare condition characterized by distinctive skin changes, in which areas of the body lack skin color (hypopigmentation). Speech Apraxia-like profiles in some cases (speech motor planning difficulties)
Joint hypermobility syndrome/Ehlers–Danlos syndrome
Individuals with joint hypermobility syndromes, including Ehlers–Danlos syndrome hypermobility type (EDS-HT), often experience a wider neurodevelopmental profile beyond joints and skin and can extend to oral motor control. (Baeza-Velasco, 2021).
Coexisting conditions
Sensory Processing Difficulties
Emerging evidence suggests a link between sensory processing and speaking.
Björelius, H., Tükel, S., Tsilingaridis, G., Malmenholt, A., & Terband, H. (2025). Sensory profiles in children with speech sound disorders. Folia Phoniatrica et Logopaedica. Advance online publication. https://doi.org/10.1159/000548782
Auditory Processing Disorder
ASHA guidance on APA—the roles of the Audiologist and Speech-Language Pathologist
Central Auditory Processing Disorder
Auditory Processing Disorder (APD) and Speech Apraxia
Auditory Processing Disorder | Nemours KidsHealth
How to support children in school with Auditory Processing Disorder.
Visual processing disorder /apraxia
Visual processing disorder /apraxia
Visual gaze apraxia
This is the only organisation in the world that focuses on eye glaze dyspraxia
About us - Our goals | For Small Steps ODV Sardinia
Visual processing disorder and learning difficulties
https://youtu.be/dnLpQvODZik?si=0xSRv5q8IzeCDzCF
Visual Cognition Assessment Tool for Children
Other factors
AAC
Enabling communication
Giving a Voice to the Nonverbal: Kendra Frank’s Mission
Drawing what talking is - the voices of children
Complex communication needs and Assistive Communication
To print your own AAC boards use this link fwpl.info/aac.
Spanish article on paralysed women speaking with AAC
Inteligência artificial: mulher paralisada após AVC volta a 'falar' através de um avatar digital
There are great FREE downloadable resources available at: Check out the following websites for more FREE downloadable resources:
http://thinksmartbox.com/.../paper-based-super-core...
https://www.totalcommunication.org/
Enabling communication
Enabling communication
Sign up to Communication Access
Home - Communication Access UK
Informing and Profiling Augmentative and Alternative Communication (AAC) Knowledge and Skills
Hearing impairements
Literacy, writing and phonological awareness
Hearing checks should be a standard part of a speech and language evaluation.
Diagnosis and evaluation of speech apraxia are often overlooked in hearing-impaired people.
www.speechapraxia.co.uk/about-sauk/f/the-overlooked-reality-of-apraxia-in-the-deaf-community?
Literacy, writing and phonological awareness
Literacy, writing and phonological awareness
Childhood Apraxia of Speech and Literacy
APAR - Assessment of Phonological Awareness and Reading - Home page
Charity promoting an education system where all children are taught literacy regardless of their label
Modified reading assessment for children with complex needs
Modified Bridge Table format Feb 2017
Development writing scale for children with complex needs (Sturm et al 2012)
Word identification and decoding | Literacy Instruction for Students with Significant Disabilities
Free phonics resources
Phase 1 Online Games – Letters and Sounds
Mechanism of speech
Do orthodontic appliances like braces create speech apraxia?
Chewing Efficiency in Children with motor speech difficulties
Is eye contact essential if you have speech apraxia?
From Brain to Mouth: Understanding Speech Motor Planning
Tracking Speech Trouble with a Simple Measure
Jaw-Dropping Facts: The Bones That Help You Talk
Multilinguilism and speech apraxia
Multilinguilism and speech apraxia
Multilinguilism and speech apraxia
This website has speech resources in over 100 languages.
Overview - Multilingual Children's Speech
Languages of the UK
Typical speech processes experienced by adults with bilingualism
4-typical-processes-bilingual-adults.pdf
English as additonal language framework
EAL Assessment Framework - The Bell Foundation
https://www.youtube.com/playlist?list=PLRXcSAl_dA7arRMrE0qdxLuzGChY1LgY2
Bilingual aphasia test
https://www.bellfoundation.org.uk/resources/eal-assessment-framework/
best-practice-cyp-bilingual-settings.pdf
Sharynne McLeod’s multilingual speech website
SPAA-C (Speech Participation and Activity of Children)
Speech Sounds in the World’s Languages
- Speech Accent Archive – George Mason University
Genetic and neurodevelopmental information
Genetic and Neurodevelopmental Syndromes
FOXP2-related disorders – classic association; FOXP2 gene mutations disrupt speech motor planning and sequencing.
GRIN2A-related disorders – associated with epilepsy–aphasia spectrum disorders and CAS.
CNTNAP2 mutations – linked with language regression, ASD traits, and CAS-like features.
Koolen-de Vries syndrome (17q21.31 microdeletion) – expressive language severely affected, with CAS features.
GALNT3-related or 16p11.2 microdeletion syndromes – may include CAS among other speech-language difficulties.
Down syndrome – while dysarthria and phonological delay are more common, CAS features can co-occur in some individuals.
22q11.2 deletion syndrome (Velocardiofacial/DiGeorge) – may present with CAS features alongside resonance and articulation difficulties.
Pitt-Hopkins syndrome – frequent motor speech planning difficulties resembling CAS.
FOXG1 and SCN1A mutations – associated with epilepsy, severe language impairment, and possible CAS.
Smith-Lemli-Opitz Syndrome
Smith-Magenis Syndrome(SMS)
Sotos Syndrome
Terminal 22q deletion syndrome
Symptoms include severe speech delay or absent speech
Triple-X Syndrome
Affects only girls. Females with Triplo-x have an extra X chromosomes in the cells of their body. Speech and language delays common.
Trisomy 9p
Tuberous Sclerosis
Veolcardiofacial Syndrome (VCF)
(also called Shprintzen Syndrome, DiGeorge Sequence and, 22q11.2 deletion
Research shows gene variants on chromosomes 3, 6, 7, 9 & 17 may affect speech development.
Genetic answer to speech apraxia-for some.
https://geneticalliance.org.uk/news/our-rare-story-foxp2/
Blogs, FREE training and web resources
Want to do some training? The Power of Patient Advocacy in Genomics. -FREE e-learning course, The course is hosted on FutureLearn, is open to a global audience
Genetic answer to speech apraxia-for some.
https://geneticalliance.org.uk/news/our-rare-story-foxp2/
What Can Genes Tell Us About Speech Apraxia?
When Genes Shape Speech: Understanding the 16p11.2 Connection
Speech and Language Challenges, Children with 7q31 deletions
The need for genetic testing for speech and language difficulties
Orphanet: Isolated childhood apraxia of speech
FOXP2 - Centre of Research Excellence in Speech and Language
In a 2013 study, researchers determined that Whole Exome Sequencing (WES) was a helpful process in finding genetic causes of speech apraxia. They wrote “Among potentially deleterious variants, clinically reportable findings of interest occurred on a total of five chromosomes (Chr3, Chr6, Chr7, Chr9 and Chr17), which included six genes either strongly associated with CAS (FOXP1 and CNTNAP2) or associated with disorders with phenotypes overlapping CAS (ATP13A4, CNTNAP1, KIAA0319 and SETX). A total of 8 (80%) of the 10 participants had clinically reportable variants in one or two of the six genes, with variants in ATP13A4, KIAA0319 and CNTNAP2 being the most prevalent.” (Worthy et. al., 2013)
New research from JSLHR highlights genetic and long-term outcomes in speech sound disorders, including childhood apraxia of speech. The Cleveland Family Speech and Reading Study reveals key links between genes, speech, and literacy development. https://speechapraxia.co.uk/about-sauk/f/genetic-and-long-term-insights-into-speech-sound-disorders
Resource and free training on genomics
Genetic, testing factors and support
Red flag for genetic condition
Red flag for genetic condition
Red flag for genetic condition
Child Apraxia of Speech (CAS) may be due to unknown cause, trauma or genetic cause.
Research has identified CAS is a Red flag for a genetic (rare) condition, identifying 1 in 3 cases are due to genetic cause.
Over 30 genes have been identified linked to CAS
Genetic Testing
Red flag for genetic condition
Red flag for genetic condition
If you are considering genetic testing, contact your GP or Paediatrician.
This guide from Genetic Alliance UK and the NHS UK website explains more
Genetic services and testing - Genetic Alliance
Genetic and genomic testing - NHS
For lots of information about Genetics of Speech, The Translational Centre for Speech Disorders, part of The Murdoch Children's Research Centre
website is an excellent place to start
Home - Centre of Research Excellence in Speech and Language
This includes factsheets, research, and resources
Rare conditions
Charities and support
Charities and support
Conditions associated with candidate genes for childhood apraxia of speech - Centre of Research Excellence in Speech and Language
Other conditions we have studied that include speech and language disorder presentations - Centre of Research Excellence in Speech and Language
Rare Diseases (conditions) affect 1 in 2000 people. Rare Diseases are individually rare but collectively common. There are over 3.5 million people in the UK with a rare condition. 1 in 17 people will be affected by a rare disease at some point in their life I Am Number Seventeen - 1 in 17Medics For Rare Disease is a registered charity driving an attitude change towards rare disease amongst medical students and doctors in training.
England Rare Diseases Action Plan 2025: main report - GOV.UK
Charities and support
Charities and support
Charities and support
Rare Disease Day is the last day of February, the rarest day of all. Rare Disease Day 2026 - raising awareness and generating change for the 300 million people worldwide living with a rare disease, their families and carers.
Unique - Unique | Understanding Rare Chromosome and Gene Disorders
Is a UK charity which supports families across the world with rare chromosome and gene disorders.
Their website has free disorder guides on conditions, practical guides, and genetics.
A closed Facebook group supports families, as well as the opportunity to register the genetic informationn, for free, to the Unique database.
There is also the possibility of contacting other families with the same condition.