In today’s world, various known disorders cause a delay in a child’s speech and language development. One among these disorders is Apraxia of speech. When a child is suspected of having a speech and language disorder, it is always recommended to do a detailed assessment and make a correct diagnosis. This is needed so that the speech-language pathologist (SLP) can make an effective therapy plan for the child based on their requirements. That is why a complete speech and language assessment is needed to rule out other similar speech and language disorders.
So how do we differentiate between Apraxia and Language disorders?
Now that we know the importance of differentiating a disorder let’s look at some differences between Apraxia and language disorders.
1. Type of disorder: Apraxia is a speech disorder. Children with Apraxia have difficulty sequencing their articulators in order to produce speech.
2. Voluntary non-verbal movements:It is essential to assess oral movements when producing volitional movements. Several non-verbal movements (lip rounding, spreading, puckering, etc.) would be made by the SLP, and the child will be asked to imitate. When children are suspected of Apraxia, it is often found that they have difficulty imitating non-oral speech patterns and sequences. They may demonstrate inconsistent responses for repeated trials. It may look like the child is trying to position their articulators correctly. It might seem like a struggle or an articulatory arrest.
3. Voluntary verbal movements: Similarly, children with Apraxia struggle similarly with verbal movements. Difficulty noted while imitating speech. Imitation of speech gets worse as the complexity of the speech task increases, i.e., words vs. sentences.
4. Rate of Speech:The rate of speech can be assessed in various ways. The SLP will present verbal stimuli to the child and check if they can repeat them. Children with Apraxia tend to perform poorly when asked to alternate between slow and fast speech rates.
5. Production of consonants: Apraxia of speech can impair a child’s articulation at phoneme, syllable, word level, sentence, and conversational levels. Often children with Apraxia present with articulatory errors at the above levels. These include distortions, substitutions, omission, and addition of speech sound errors. The errors help determine the severity of Apraxia.
6. Vowel errors: Vowel errors can be a significant characteristic of Apraxia. Commonly occurring vowel errors are distortions and substitutions.
7. Consistency of errors and patterns: Errors, whether consonant-related or vowel-related, are commonly produced inconsistently in children with Apraxia. Children with Apraxia also have patterns of errors, i.e., trouble making lip movements, tongue movements, etc.
8. Multi-syllabic utterances: Many children with Apraxia have difficulty producing multi-syllabic utterances. As children with Apraxia speak longer utterances, the intelligibility of the speech reduces.
9. Spontaneous speech: Assessing spontaneous speech in children with Apraxia is important. Spontaneous speech is often found impaired. They use shorter phrases or sentences. Spontaneous speech is less complex, and children often resort to simple sentence productions. The clarity of spontaneous speech utterances is time and again found to be impaired in children with Apraxia. Since the context of spontaneous speech is not always known to the listener, it appears to be more affected than imitated speech.
10. Prosodic patterns: A common characteristic finding in children with Apraxia is the prosodic errors. They often have difficulty imitating the rate of speech, intonation patterns, and modifying the loudness at which they speak. Another difficulty that is commonly found is that these children place equal stress on each word. Thus, when equal stress is given to each word, it impairs the effects of co-articulation, and speech appears choppy.
Understanding the characteristics and differences of Apraxia of Speech can be quite challenging yet very important. While it can be difficult for your child to produce speech, it is very important to accept and work towards improving communication for them. The earlier the therapy is started, the better will be the prognosis of Apraxia. If you have any concerns about a child suspected of Apraxia of speech, please get in touch with a certified speech and language pathologist.
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