With help, kids can overcome apraxia of speech

Nancy E. Labaki, M.A., CCC-SLP
MedCentral Pediatric Therapy

As parents of most healthy kids know, speaking is easy for them after they've had a chance to practice syllables and words. But it isn't easy for children with apraxia of speech. This motor speech disorder prevents kids from consistently moving their face, tongue, lips and jaw into the correct position to make speech sounds or produce syllables or words.

Symptoms of apraxia of speech may include:

• Difficulty imitating mouth movements
• Use of vowels, grunting or single syllables for communication
• Limited ability to produce speech sounds
• Inconsistent speech sound errors
• Groping for correct placement of the tongue, lips and jaw during speech
• Abnormal voice quality
• Omission of words in sentences
• Unusual or lack of facial expression
• History of feeding difficulties
• Limited expressive language skills, in spite of good understanding of language.

When a physician suspects a child might have apraxia of speech, he or she might ask that a certified speech-language pathologist (SLP) assess the child's oral-motor abilities, melody of speech and speech sounds development. The SLP will determine if speech is developing normally, at a slower rate than typical or if the speech is truly disordered. A child's speech and language skills are considered to be developmentally delayed when the child is following the normal path of development, just at a slower rate. In contrast, some children are able to understand language (good receptive language skills), but have unclear speech - or no expressive speech at all. This might simply indicate an expressive language disorder; however, the child should be evaluated for the presence of a specific speech disorder such as apraxia. In addition to the unclear or absent speech we observe with apraxia, many kids also need to develop language skills, such as using appropriate word endings, verb tenses and sentence structure.

With some exceptions, most children with apraxia of speech learn to speak clearly. Some might have minor lingering differences in their speech patterns, and a few might even need alternative methods of communication. One thing that is certain is that learning to speak clearly is often very challenging for children with apraxia, and treatment might be necessary for a long time. Children with apraxia benefit most from intensive one-on-one treatment programs. Typical articulation and language therapy approaches are not very effective for these children. Kids with apraxia of speech benefit more from a combination of apraxia specific tools used by a SLP, in addition to oral-motor exercises, tactile "touch" cues, visual cues (watching in a mirror) and auditory feedback. The SLP will design a therapy regimen that best suits your child, and will modify that approach as your child's speech improves.

Because many of these children will become frustrated in their efforts to communicate, a strong family support system is critical. Encouraging children in their communication efforts and providing unconditional support will help them feel like and become successful communicators.

If you think your child may have any symptoms of apraxia, please discuss it with your physician, consult with a speech therapist in your area or visit the American Speech-Language-Hearing Association online at www.asha.org.

Last updated December 30, 2008