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What is Apraxia?

ApraxiaBroadly defined, apraxia is a diminished ability to execute learned movements, in spite of the motivation and intent to do so.  Thus, apraxia is said to be a disorder of “motor planning.”  The root of apraxia is “praxis,” which is Greek for “act” or “work.”

What is “Apraxia of Speech”?

Developmental Apraxia of Speech (DAS) (sometimes referred to as verbal apraxia or dyspraxia) is diagnosed when children are unable to carry out oral motor commands and sequences due to poor motor planning and poor coordination (it is not due to weakness or paralysis of the muscles of the face, tongue, and lips).  As a result, children with DAS make inconsistent errors with articulation (e.g., a child may pronounce a word clearly one day, but poorly the next), make awkward oral motor movements (e.g., and appear to be “groping” with mouth positioning), make more frequent errors (especially as vocabulary and sentence length increase), and have poor “prosody” (or “melody”) of language (e.g., unusual rhythms, stresses, inflections).  Children with DAS generally have a much greater ability to understand language rather than produce language.

What are the causes of Developmental Apraxia of Speech (DAS)?

Developmental apraxia of speech (DAS) occurs more frequently in boys than girls.  DAS is different than a “language delay,” which occurs when a child follows the typical developmental sequence but just does so more slowly than most same-age peers.  While the cause (or causes) of DAS are not yet known with certainty, researchers believe it is a disorder of neurological origin that negatively impacts the brain’s ability to send the correct signals to move the speech muscles. It should be noted, though, that brain imaging studies have not yet found specific evidence of differences in brain structure in children with DAS versus children with typical language development.  There is a family history of language disorder and learning disability noted among children with DAS, which suggests that genetic factors may play a role in the disorder.

How is DAS diagnosed?

Speech-language pathologists, developmental pediatricians, and neurologists may all be involved in the diagnosis of DAS.  Formal testing, informal observation, and parent interviews are all used to collect information, rule-out other causes, and ultimately make (or rule out) a diagnosis of DAS.

How is DAS treated?

Children with DAS do not “outgrow” the problem.  Speech-language therapy can be helpful, and there are specific oral-motor and motor planning techniques within the field of speech-language therapy that may be indicated.  Every child responds differently to speech therapy, and outcomes are quite variable.  In addition to intensive one-on-one speech therapy, family members and friends need to understand, support, and encourage the child.