What is Apraxia?

I’m so happy to welcome April Vogt to Mommy Speech Therapy! April is not only an incredibly talented Speech Language Pathologist she is also a mother of two darling children. She will be sharing her experience and knowledge on various speech related topics here on Mommy Speech Therapy as well as answering some of your questions. In this post she answers common questions about the motor speech disorder called Apraxia. Questions like, “What is apraxia, what are the signs and symptoms of apraxia and what does treatment for apraxia look like?” If you have a minute, join me in welcoming April to Mommy Speech Therapy. Hopefully together we will be able to continue to share insightful and helpful information on speech and language topics for all of you wonderful parents at home.

What is Apraxia of Speech?

For a moment I want you to imagine (though this may not be too far off from reality for some) that you are the parent of a young child whose speech is severely unintelligible. People unfamiliar with your child cannot understand him or her when they attempt to speak, and sometimes even you, as a parent, have trouble trying to make sense of your child’s attempts at communication. Your child seems to understand language, but expressively the sounds and syllables of their words seem to be off target. You consult a speech language pathologist (“SLP”), who uses the term “apraxia” as a possible reason for your child’s speech difficulties—but what is apraxia?

What is Apraxia?

Apraxia is a type of motor speech disorder that affects the way the body is able to produce speech. Motor speech disorders are neurological in nature, meaning a child’s brain has difficulty coordinating the different body parts needed to produce speech—the tongue, lips, and lower jaw. Due to this neurological difference, children with apraxia struggle with sequencing and articulating sounds, syllables, and words when they are trying to communicate. As a result of these struggles, children with apraxia can be difficult to understand. Apraxia is different from other motor speech disorders in that it is not caused by muscle weakness, a limited range of motion, or paralysis of any muscles.

Below, I have addressed some frequently asked questions that parents may have when faced with the possibility of apraxia. It is important to note that apraxia can go by many other labels, including its more formal name—childhood apraxia of speech (CAS). Other labels include: dyspraxia, developmental apraxia of speech, developmental verbal apraxia, or verbal dyspraxia. These different terms can be found throughout the span of literature devoted to the subject, but for simplicity’s sake, I will simply refer to the disorder as “apraxia” for the remainder of this post.

What Causes Apraxia?

Apraxia is most often caused by neurological damage due to infection, illness, injury, or trauma. Apraxia can also be a secondary characteristic of other conditions including some genetic disorders, degenerative disorders, metabolic disorders, and even seizure disorders; however, not all children with these types of disorders will exhibit apraxia. There are also instances when the cause of apraxia will be unknown and there will not be any apparent neurological indicators for why a child is exhibiting apraxia in speech.

What Are the Signs and Symptoms of Apraxia?

Apraxia can be a perplexing disorder for parents due to its complexity. Part of the confusion associated with the disorder is that not all children with apraxia will exhibit the same types of signs or symptoms. Symptoms can also vary in their severity from mild to profound. The most common characteristics of apraxia include:

Late talking
Though this symptom can be indicative of many other speech or language disorders, if your baby does not coo or babble, or if your toddler is considered a “late talker”, apraxia could be involved.

Articulatory groping
This is a type of searching or struggling behavior that a child attempts with their tongue, lips, or lower jaw when they are trying to communicate. Attempts at coordinating these body parts may appear “off target”.

Errors are inconsistent
Different kinds of errors will occur on the same word when repeated over and over again.

Imitated vs. Spontaneous speech
Automatic speech (i.e. counting, singing the alphabet, social greetings, etc.) and imitated speech will be less affected then spontaneous speech.

Multisyllabic words are harder
The frequency of errors will increase the more complex the word or utterance.

Prosody
Prosody can be affected by a reduced rate of speech, monotone speech with little pitch variance, or the child may stress the wrong syllable or word.

Reduced speech intelligibility
Due to the inconsistency and frequency of their errors in speech, children with apraxia will be difficult to understand to unfamiliar listeners.

What Does Treatment for Apraxia Involve?

If you have concerns that your child may be exhibiting signs or symptoms of apraxia, it is important to have the child evaluated by an SLP. An SLP may be able to exclude other speech disorders to help determine if your child does have apraxia; this will also aid in determining a course of treatment. It is important to note that the labels “developmental apraxia of speech” or “childhood apraxia of speech” can be misleading. This is not a disorder that a child will grow out of. Many children can become intelligible speakers, but it takes time and commitment.

There is not an easy fix for apraxia, and because apraxia can manifest itself differently in every child, SLPs may use a variety of techniques in therapy to achieve maximum results. Research does show that children with apraxia benefit most from receiving frequent treatment sessions. SLPs may also suggest alternative means of communication such as sign language, or augmentative communication systems that may be implemented if a child is severely impacted in his or her communication. These alternative means of communication can serve as a temporary means to establishing a less-frustrating way for children with apraxia to express themselves and communicate with those around them until their speech begins to improve with treatment.

Naturally, parents will wonder if their child will ever be able to communicate effectively. Treatment outcomes may depend on the severity of the child’s apraxia, as well as whether any other co-occurring problems are present, such as delayed language development, difficulties with fine motor movements, or sensory-related issues. Generally, with timely and appropriate treatment, children with apraxia can make some level of progress and attain certain levels of intelligible speech and effective communication.

What Can I Do to Help at Home?

SLPs will usually send home information and specific assignments for parents to complete at home with their child once a plan of treatment has been determined. Consistent practice and repetition are important and necessary keys to helping children with apraxia achieve their potential for intelligibility and communication. Though apraxia can be frustrating at times for both parents and children, providing a variety of opportunities for a child with apraxia to talk is vital. Parents can get creative and make practice time fun to help in breaking up the monotony of therapy. Speech practice can be done during story time, in the car, in the tub, or while playing a game—anything that encourages communication.

Most of all, children with apraxia will benefit from a supportive environment that will help them feel positive as they strive to increase their successful communication attempts. I hope this information has better helped you understand the components of apraxia and wish you the best of luck while helping your child with their speech.


April - Mommy Speech Therapy April Vogt, M.Ed. CCC/SLP is a speech-language pathologist who has worked with school-aged children through adults in educational, transitional, and medical settings for the past 8 years. She received both her Bachelor’s and Master’s degrees from Utah State University. April lives with her husband, Colby, and 2 daughters: Eleanor and Audriana. She enjoys skiing, watching movies, and riding motorcycles.

31 Responses to “What is Apraxia?”

  1. nick says:

    thank you so much…im dealing with my nephew who has some kind of speech disorder…and you have strengthened my resolve…and enlightened my ideas…tomorrow I will approach him with more games that involve repetition of familiar words…And more patience…TY

  2. Sanaz Amini says:

    Thanks for sharing! Great article and very informative :)

  3. Zia Mohiuddin says:

    My daughter is about 6years old & had fits 2nd time on Julyt 24 to August 05, 2013 after January 08th – 19th, 2011. Now she behave like a baby of 1 year & unablt to talk properly and also having issue with her vision. In 2011 she had fits at right sides & now mostly she had fits on left side.

    Now movement of her left side is effected & face part of left side is also effected. We are looking for the possible option for her fastest recovery as best as we could do.

    If there is anybody who can help us with usefull information for my daughter to be as normal as of a healty child or nearest.

    Her medical treatments are as follows:
    After 2011:
    Epival (3 to 5 ml twice a day)
    Lerace (1 to 1.25 ml twice a day)
    Phenobarbiton 30mg (1 tablet twice a day)

    After July 2013, having infection from epival (Liver effected joindace):
    Topamax 25mg tab (half tablet in morning & 1 tablet in night)
    Lerace (1.5 to 1.75 ml twice a day)
    Phenobarbiton 30mg (1 tablet twice a day)
    Folic Acid & Multi vitamin syrup for 30 days once a day

    Looking for better advice / help from expert medicen.

  4. Tamara L. Kaur-Singh says:

    Can this disorder develop from speaking two different languages in the home??

  5. hi my daughters child is 5year old he was born 6 weeks to earily and is a little slow in speech .i work with special needs under 5s and want to help the wee man .he is very shy and plays alone at school .his 3year old sister is outgoing child and gets all the notice he is in her shadow. please advise

  6. Hello,

    I regularly check this website and really enjoy reading the articles and browsing through worksheets. I stumbled upon this site because one of my dyslexic students also has Apraxia. She was undiagnosed when younger and is awaiting assessment now. I really enjoyed reading your article because I was very confused initially on what Apraxia is, and a friend of mine who is an SLP informally diagnosed it in my student.

    I found the question and answer section on Apraxia very helpful and just wanted to thank you for the information you have provided.

    Najia Siddiqi

  7. Emmanuella says:

    Hi April, I was reading your article very impress; I have a 4 year old just start preschool this year he have a speech delay problem the school is concern his not responding to his name I did get a hearing test for him and his hearing is fine, but sometime you need to call him 3 to 4 time to get him respond to you, and he really forget thing fast, you can tell him a word or phrase he will say it but just not remember them and his mind most of the time far.

    I saw speech therapist with him twice, they require to have one and one base with him with a speech therapist, which is the country I am leaving is a island were we do not have Speech therapist.

    I don’t have a friend or family member who leave abroad to leave him to get the treatment.

    How can you help please and what can be done for him with his speech to able to help more at home.

    He was born premature 8 months, he does everything else except not want to talk.

    Example if he want use the bathroom he say bathroom, most he will said up to 4 words, if he want something to eat he will say food , he know his animal sound , alphabetical, colours,

    His problem not doing phrase and not remember things

    Emma

  8. Birendra Kumar Shastri says:

    Dear Mam,
    My son 2years and 10 months old showing the symptoms of apraxia, he is going daily to a speech therapy centre since from last 5 months. Previously he was not responding to his name at all, but now after calling 2/3 times he is responding. He is showing slow but steady improvement. He seems to be very intelligent, but we are very much worried to see this. Financially also I am not sound. Please guide me how I can cure him in home. If you have any literature please send me.

    Regards
    B.K.Shastri
    F-576, CDA, Sector-6, Cuttack, Odisha, India

    07873846716

  9. Yvette Gutierrez says:

    Hi . I’m a mother of 3 boys. Ages 4 1/2 (Anthony) 3 yrs (Izack) & 1yr (Noah). My 2 oldest boys hve a problem with talking. However my oldest (Anthony) is talking but he’s not at the level were all kids his age should be. (As in talking). He is in school (transitional kindergarten). And his teacher is having difficulties with him sometimes. She understand him but not most of the time. Now my other son Izack is 3 and he isn’t talking at all. I want to get some help quick or at least give me some ideas because flash cards isn’t helping. They are both very smart and listen and understand. They just don’t talk. Please help a.s.a.p

  10. April says:

    Glad you found this helpful Nick! Good luck with your nephew!

  11. April says:

    Hi Tamara,
    The research available doesn’t show a connection between children developing apraxia and learning other languages in the home. Apraxia is usually considered a disorder that is neurological in nature and not one usually attributed to language development.

  12. April says:

    Hi Margaret,
    When you say that your grandson is “slow in speech” do you mean that he has a slow speaking rate, or that he has difficulty pronouncing and sequencing his words when he speaks? If you feel that his speech is irregular and is impeding his communicating with adults and peers then I would think you might want to consult a speech-language pathologist (SLP) to evaluate his speech and language skills. In the meantime you can encourage good speech and language skills at home by providing opportunity for your grandson to speak and by modeling good speech and language in your own speech productions.

  13. April says:

    Hi Zia,
    We’re sorry to hear about your daughter. It’s difficult for us to recommend specific courses of intervention without having the opportunity to see and evaluate your daughter, but it sounds like she has some underlying medical and neurological issues that would best be addressed by her doctor especially if she is having regression with her behavior and her ability to communicate. It would also be beneficial for you or your doctor to consult a speech pathologist to determine your daughter’s receptive and expressive language needs and whether or not she would benefit from alternative or augmentative modes of communication so that she can communicate her wants and needs with you and other people as effectively as possible. We wish you the best of luck through this difficult time.

  14. April says:

    Hi Emma,
    I’m sorry to hear that you are having a hard time getting your son treatment for his language delay. There are some things you can do at home to encourage him to expand his language. there are some general things you can do to help encourage expressive language. It may seem like common sense, but talking to your child and exposing them to language is very important. Talk when you’re in the car, talk when you’re at the grocery store, talk while you’re making dinner, sing songs etc. That exposure to language will help in encouraging your child’s expressive language. Reading to your child is also very important. You don’t have to finish a whole book, but look for age-appropriate board or picture books that encourage your child to look at the book while you name the pictures. You can ask questions while you read like asking your child “what will happen next?” Reading will help create a language rich environment in your home. Finally, As you’re doing activities with your child, talk about what you’re doing as you do it and “think” out loud asking and answering your own questions “Where does this piece go?” “Oh, it goes right here.” This type of modeling will help show demonstrate to your child how to ask and answer questions. Also, you can check out our blogpost on 8 Ways to get your child to speak and the American Speech and Hearing Association has some great ideas listed here
    Good luck and we wish you the best!

  15. April says:

    Hi B.K.
    We’re glad to hear that your son is making progress. Sometimes progress with a disorder such as apraxia can seem slow, but as long as steady improvement is being made you can know that the speech therapy is helping. There is no “cure” for apraxia. In fact, apraxia treatment will vary from child to child based upon how severe that child’s apraxia is in their speech, and other factors that may be affecting their communication. Obviously we don’t know your child personally, so we cannot tell you precisely what will help him, but we will give you some general information that is usually included as key components of apraxia therapy.
    Speech therapy for apraxia usually includes principles of motor learning to help children coordinate the different body parts needed for speech i.e. lips, jaw, etc. Children will need a lot of practice and a lot of repetition as they practice syllables, words, multisyllabic words, etc. while the SLP works to shape their speech attempts, and the movements underlying them, into speech that is more accurate. As a parent you can practice these same target syllables and words at home so that your child can get as much practice as possible.
    Use of rhythm may help pace speech and help with naturalness of intonation, syllable and word stress patterns – a particular problem for children with apraxia of speech. The rate, intonation, and stress in speech are called prosody. Examples of the use of rhythm in speech therapy for children with apraxia may be clapping or tapping for each syllable or clapping harder when saying the syllable that should be stressed in a word.
    We strongly suggest that you meet and discuss your son’s progress with the SLP that is seeing him at the speech center where he is going. Ask for specific suggestions that you can do at home. The SLP should be able to provide word lists, etc. that will help you carry on that progress at home.
    Good luck!

  16. April says:

    Hi Yvette,
    If you feel your boys aren’t using enough expressive language then you can do a few tips I can suggest for you to try to get your boys talking and initiating a little more. As speech therapists, we often use the phrase “environmental sabotage” for setting up the child’s environment so that they HAVE to talk to get a wanted item, or snack, or whatever is motivating for them. Sometimes as parents we are very good at anticipating our child’s needs and so we will go ahead and refill a cup, get more crackers, or find a special toy for a child before they even have the opportunity to ask for it. In doing so we might be eliminating a valuable opportunity for our child to talk. Whether it’s at mealtime, or at playtime put desired objects just out of reach so that your child has the opportunity to initiate communication in order to get what they want. Basically, you want them to ask or request. For some children with lower language capabilities it might just be pointing at the object, but for children that have a vocabulary you’re going to want to encourage them to use their words or model a short phrase or sentence for them and have them repeat after you. You can make it a game too. During playtime have them request a toy, let them play with it for awhile, and then you request the toy back from them and you play with it for awhile until they request it back from you. Anything that you can do to create situations where your child has to speak or has to initiate communication in order to engage with you or their environment will be beneficial. Of course, if you feel that your child’s communication skills are delayed you will want to look into having them evaluated by a licensed speech language pathologist so that they can get intervention they need.

  17. Sarah King says:

    Hi. my son is 18months old and has been going to speech therapy for the last 3 months. I was told his diagnosis for now is expressive speech delay and because of his young age it’s a little hard to make any other diagnosis at this time. around what age is apraxia brought up? the reason I’m newly concerned about this is because my son has congenital ptosis, which is drooping of the eyelid. He is followed by an eye specialist, he has never been thoroughly tested, in my opinion, to rule out apraxia of the eye lid which is very similair to ptosis. apraxia of speech and the eyelid can go hand in hand. I just want to make sure im doing the best I can to help him and make sure we understand whats going on, I could be way off base and he may really have speech delay and ptosis instead of apraxia, is there anything specifically I should look for to know if he has apraxia of speech and what age can a diagnosis be better made? the last therapy session the SLP said he was a little concerned because he thinks its hard for my son to make words. I know this is a long post but any help would be appreciated. thanks in advance.

  18. tiffany says:

    At the end of this month my son will be 4 he began saying mama and Dada at 9 months even said dog a few times, around 1 yes old he just stopped and was just mumbling. At 1 1\2 he began lashing out with loud hollars and kicking. I thought maybe he had autism since also had weird ocd issues. I seemed help from a speech therapist, during our appt. My sons father had closed the door to the room he didn’t like that so he started throwing horrible fits and hollaring this lasted 3 hours. During this time he would still point to things on the pictures the speech therapist was asking him to point to. After determining my son was not going to calm down his dad took him to the waiting room. Once he was out of the room I broke down in tears. The speech therapist asked me if this was a constant behavior. And it was the tantrums would go on for hours and happened every day at least 5 times a day if not more. I love my child and I understood and was as patient as anyone can be with a child who can’t tell u what is wrong or just simply that he wanted a drink or what show he wanted to watch. I know it must have been horrible for him to not be able to make the words sound the way he heard them when anyone else says them. So, she sent me down the hall to a behaviorist who put him on the top of the list for a program in my city called first steps. We had 3 amazing people come over 4 times a week just to interact with my son. They taught him the basic signs for the most common requests my child would have on a daily basis. After 3 weeks I saw a huge improvement on his attitude and fits. Since my son was potty trained before they even started coming over he was immediately placed on a list for early childhood development which is really just a school. He started the day after his 3rd birthday. Which I might add was sad day for this mommy. Also a happy day though! In class to communicate with others his 3 wonderful teachers made him a book. The front of the book had Velcro strips and inside were little laminated pics with words so he could form a sentence on the front. That worked very well. However this year they have hit it right on the spot. They have this electronic board he uses which have buttons and different sheets to slide in the board depending on the theme of the week. When he pushes the button the board says the word out loud. For example during snack he can press a button for I WANY and then pick the snack or drink he wants and the board will then have said the full sentence out loud. Since using this board my son has gone from under 100 words to over 1000 being understood without errors. Not only that but his confidence and slef esteem as well as his overall interaction with children has grown past what any of his teachers or daily people in his life would have ever dreamt about. Before when asked to say a word he would just look down and say no. Now he always makes an attempt. That’s all a parent could ask for in these circumstances. He does still struggle with the n sound and sometimes we have to tell him our ears aren’t working and ask him to say it again or if he can show us what he’s saying. As his mom I see how smart my child is and know he has the potential to be anything he wants when he grows up. I mean he is very smart he is above a 2nd grade level on what he knows and he even takes any plastic or cardboard out of the trash and puts it outside in the recycle bin. He has been doing that since he could walk, except now it comes with a “mom that’s not trash” lol. Also a helpful tip to all parents or others who interact with a child with apraxia, I have noticed that since I started to repeat what he’s saying back to him just basically letting him know I know what your saying, he has made an attempt to try all words and he even laughs at me and says haha mommy not what I said. Before he would get down about his words but between my repeating everything he says, and the new board at school, and his teachers he has learned to just try his hardest and laugh when he gets it wrong. I wish all younmparents the best of luck in hopping this small milestone in ur child’s journey of life. Just remember when u feel like ur getting frustrated because ur child’s frustrated walk away and remind yourself that they are trying the best they can and its way more frustrating for them than it is you! Thank you for reading my story and I hope something that has worked for me works for you as well!

  19. April says:

    Tiffany,
    Thank you for sharing your experience with your son, and thank you for your helpful tips to parents that may be experiencing similar struggles with their children with apraxia. I’m so glad to hear that your son has made so much progress since you first started on this journey, and that he has become a functional communicator. Thank you again!

  20. Victoria van Pelt says:

    Dear April,
    My son has apraxia , he is 18. He does not say anything but does type in foods he wants . In his sleep he spoke as clear as you or I in a complete sentence with his voice, that I have never heard the sound of , by the way. Anyway , I was thrilled to tears but at the same time confused as to what do I do who do I tell? Why can’t he do that in waking life? What’s the missing ingrediant? He had done it once before and I never thought it would ever happen again and with everyday stress I forgot about it all. He takes Geodon and Trileptal both of which are not probably at the perfect levels and he craves sugar and has hypoglycemia.

  21. Ali says:

    Hi,
    My son is 3 and he has difficulty pronouncing words. He has words but they are difficult to understand. His nick is e-bu but when is asked his name he tells o-bo. I am trying to get appointment from a speech doctor but process is very slow. I am not sure if its a neurological issue or weakness of muscles. I know the final diagnosis will come from doctor but is there a way I can help him improve? And my biggest worry is that am I too late in consulting speech therapist? I mean what are the chances of his recovery?
    Thanks and best regards.

  22. Julianna says:

    I was born with apraxia. I am now 18, and am an actress. I have a large vocabulary and love tongue twisters. The only reason I can do these things is because of my mom. I can not express enough how important parental support is. I was supposed to be mentally retarded and now I am an honor student of high regard. Any child can do anything if you work hard enough.

  23. Jessica says:

    Very interesting article, we have been keeping an eye on our almost 4 yr daughter. We had an appointment with a speech therapist per our request at her 3rd birthday but we had not had any luck with an occupational therapist we saw for problems with eating. We ended up canceling thinking that we were jumping the gun and she was just slow to develop her articulations correctly. This past year I have worked with her on certain sounds she has trouble with (f , s were two sounds she never made) she has improved a little in my mind but many outsiders have a hard time understanding her especially larger words or sentences. We can but we have listened to her for years now and know what her “sounds” mean. This makes me wonder if we should have her seen after all.

  24. Mandi says:

    Hi I am a bit worried about my 18 month old daughters speech. She says about 5 words but seems to have trouble with even those 5 words. She says “all done” but she just says “da” (with her palms held up like I do when I say it to her). She also waves and says “daaa” for “bye”. She says “tu” for thank you, a kind of a “didi” sound for doggie and well you get the point. She doesn’t say mama or dada. All of these words and more are repeated TONS to her on a daily basis but she can’t seem to improve her pronunciation, say more than one simple sounding syllable at a time, or learn any more simple words. When she was around 9 months, she would repeat the words “mama”, “dada”, and wave and say “buh” for bye all much clearer than what she says now. Around that age she also seemed to repeat words clearly once but wouldn’t say them again. She babbles tons now, sings along(babbled singing of course) to songs, and is very expressive otherwise. Any suggestions on what I can do to help her at home? I live in France right now and am worried I will be unable to get help from a speech therapist whom speaks English so suggestions/feedback/thoughts are appreciated. Thanks

  25. April says:

    Hi Mandi,
    Thank you for your question. Your daughter’s age is a tricky one, because there is a lot of variability with children’s communication milestones around that age. It is not surprising that her speech is not clear at that age. Usually for children 18-24 months we find that speech intelligibility falls around 25-50% and the only speech sounds that usually are emerging in speech are the sounds: b, d, h, m, n, and p. I agree with you that it is concerning that she doesn’t say previously learned words anymore like “mama” and “dada”. Another concern that I have is the amount of words she uses. Typically 18 month olds say anywhere between 10-20 words; however there is much variability with these numbers as well. I recommend that you continue to provide a language rich environment for her. Play, talk, read, sing, and listen to your child. Don’t be as concerned about correcting your child’s speech pronunciation or articulation. Focus on recasting what her intended meaning is i.e. if she says: “didi” for “doggie” you can say “yes! That’s a doggie”, making sure that you use clear, correct speech when you speak with her. The pronunciation and articulation will continue to become more accurate the older she gets. Exposing her to constant language and social routines will only help increase her receptive and expressive language skills. If you don’t feel that she is adding more words to her language repertoire, or if you notice other warning signs, such as regression with fine motor skills or social skills then you will want to consult with her pediatrician or a speech language pathologist, if you can find one. Childhood apraxia of speech is usually not diagnosed before the age of 3, and many times a lot of the same warning signs at such a young age can be attributed to other speech/language disorders such as phonological disorders. Good luck!

  26. April says:

    Hi Jessica,
    If you still have concerns, it’s never too late to get a consultation with an SLP. Around the age of 3-4, other adults not familiar with your daughter should typically be able to understand about 75% of what your child is saying. If her speech intelligibility is a factor inhibiting her from communicating effectively with her peers and other adults then speech therapy might be appropriate for her to help improve not only her articulation, but her overall communication as well. Good luck!

  27. April says:

    Hi Sarah,
    You don’t need to apologize for one second about a long comment :) I think you bring up some very valid concerns. According to best practices recognized by the American Speech Hearing Association for the treatment of apraxia, the diagnosis of apraxia is usually not given before the age of 3. This is because a lot of your child’s motor and language skills are still widely variable and still developing at a rapid rate. It is difficult to give an accurate diagnosis at this age, because signs of apraxia may look like a few other speech/language disorders such as an expressive language delay, or a phonological processing disorder. That doesn’t mean that your son doesn’t have apraxia, or is displaying signs or symptoms related to apraxia now, but before the age of 3 it is quite tricky to get a differential diagnosis and rule these other disorders out completely. Now, I know that’s not the answer that is helpful for you right now, but if your son’s SLP feels that your son has a hard time making words, there is no reason the SLP couldn’t integrate therapy techniques for apraxia into your son’s existing therapy plan, even without an official diagnosis. Your son’s overall communication is the most important goal of his therapy. Whatever means the SLP needs to use to help achieve optimal communication, he should do it, so long as he chooses effective and hopefully evidence-based therapy techniques. Good luck with your son, and I hope that he continues to progress with his therapy!

  28. April says:

    Hi Ali,
    There are a number of reasons that a child may struggle with articulating speech sounds or using age-appropriate language structures. One reason may be apraxia. I described some of the signs or symptoms in the article above, but apraxia is usually not diagnosed until after the age of 3. This is because there can be other reasons for speech and language difficulty at a young age, and many of the signs and symptoms look the same. It may be that a child has a phonological processing disorder, an expressive language delay, a hearing loss, or neurologically based issues such as dysarthria, or apraxia. You are doing the right thing by going to see a doctor or a speech-language pathologist about your concerns because they will be able to evaluate your child’s overall communication skills including their receptive language, expressive language, articulation, oral musculature, and phonological patterns, to determine how to best help your child communicate more effectively. You can help at home by providing a language rich environment and being a good speech model. Make sure you are talking, reading, singing, playing verbally, labeling objects, and exposing your child to as much language as possible. Speak slowly and clearly, annunciate sounds and syllables, and praise your child for times when he attempts to imitate you. I don’t think it’s ever too late to consult a speech therapist, but if parents are concerned it’s always good to do it the earlier the better. Your SLP will be able to provide you with a prognosis for his recovery, or his ability to progress with therapy. I do know that most children respond very well with therapy and do progress. Good luck with your child and therapy!

  29. April says:

    Hi Victoria,
    I assume your son has a speech-language pathologist he is working with to address his apraxia? You should relay your concerns to your SLP, or if your son is no longer working with an SLP you might want to bring up your concerns to his medical doctor, or consider having him re-evaluated by an SLP. Apraxia is a very tricky disorder, and symptoms can change, especially as a person grows older and has medication involved. Make sure to keep the focus of his therapy on having him effectively communicate with those around him i.e. being able to communicate wants/needs etc. Good luck!

  30. Lubna says:

    Hi,my 5 yrs old kid has a speech delay problem , i cant exactly examine him whether he has apraxia or not but some signs are similar. He always likes to talk and u can say he is a chatterbox but he talks in his language. His language is limited to words only not sentences.he is an active kid but his only problem is speech, he sometimes becomes hyper and shout a lot in loud voice but when i compare my kid with other kid of his age ,he is not capable as other kids are of his age . He holds pencil and write but not proper manner and he diverts her attention very quickly … Somewhere in google i read about dmg and tmg behaviour balance liquid … What u say about these?? Can i give him for his development … Waiting for reply.. Thanks !

  31. Heidi says:

    Hi Lubna,

    You are right, his speech is delayed compared to kids his age. I would recommend you see a Speech Language Pathologist for an evaluation. They will be able to give you counsel and recommendations regarding his speech development.

    All the best!