Dear SLP,

My daughter is five and was recently diagnosed with apraxia. I'm a little overwhelmed with all the information on the internet. I'm a bit confused about the different between apraxia and an articulation disorder...what is the difference? If so, does therapy look different?


Asking About Apraxia

Dear Asking About Apraxia,

Your question is a great one – many families ask the same thing. It is understandably confusing as there are a lot of terms used to describe apraxia including verbal dyspraxia and childhood apraxia of speech. While ASHA's policy does differentiate between these, for your purposes, they can mean the same. When it comes to comparing apraxia to an articulation disorder, the key difference is that an apraxia is based in motor control and coordination, where an articulation disorder is developmental in nature. There are several characteristics you are likely to see in your daughter's speech that are not seen in an articulation disorder. These include: inconsistent sound errors (i.e., producing same sound/word differently), groping (i.e., extra oral movements indicating increased effort), vowel errors, inconsistent nasality on sounds, and/or atypical speech stress patterns (i.e., odd or incorrect timing for stresses and pauses in words/sentences). In general, children with apraxic speech patterns have difficulty with the coordination of speech production, compared to children with articulation disorders. The sequencing of sounds, co-articulation of phonemes, and performance of voluntary motor movements are significantly more difficulty for children with apraxia as compared to children with an articulation disorder. As such, the therapy approach will look slightly different. For children with apraxia like your daughter, the principles of motor learning should be included in her individualized treatment plan. These principles include the need for “massed practice” or many repetitions of her correct sound frequently  throughout the day/week. Children with apraxia need frequent, intensive opportunities for practice to encourage motor learning. Shorter, more frequentssessions mayl have a higher success than one single extended session. Teaching the motor plan for sounds to automaticity is key to a successful carryover. It can be helpful to include multimodal learning as well as multimodal cues (e.g., visual, tactile, auditory, etc.) in order to provide multiple access options for your child with the primary goal to increase her intelligibility as high as possible. Providing specific explanations to your daughter of what her goal is as well as providing biofeedback on her productions can help improve how quickly she gains the skill.  Integral stimulation is another common approach for children with apraxia, where the child completes a hierarchy of targets focusing on using visual and auditory stimuli to shape speech production. Prognosis for your daughter can be great, especially with parent support! Good luck!




American Speech-Language-Hearing Association (ASHA). (2007). Childhood apraxia of speech [Technical report]. Available from

Campbell, T.F. (2003). Childhood apraxia of speech: Clinical symptoms and speech characteristics. Proceedings of the 2002 Childhood Apraxia of Speech Symposium, p. 37-40.


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