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Apraxia of speech in adults and oral apraxia
In apraxia of speech the muscles are strong, but the brain struggles to plan and program the sequence of speech movements; speech is slow, with distortions, syllable segmentation and groping, and errors grow as words get longer and more complex.
Why it matters in the exam
The exam mainly tests differential diagnosis: apraxia of speech versus dysarthria (no weakness, errors depend on complexity), versus conduction aphasia (speech is fluent and errors are wrong phonemes that are well articulated) and versus oral apraxia (difficulty with non-speech movements on request, such as puffing the cheeks). Another question: which task is most sensitive to mild apraxia — repeating words of increasing length.
Treatment is asked too: sound production treatment (SPT), integral stimulation ("watch me and listen"), and motor learning principles — as accuracy rises, feedback frequency is reduced and feedback is slightly delayed, and practice moves from blocked to random. You should also know primary progressive apraxia of speech: speech that worsens gradually while language is normal. Apraxia of speech often occurs together with Broca's aphasia, and a gap between written and oral naming can hint that part of the difficulty is motor rather than linguistic.
Key points
- Apraxia = planning and programming, without weakness.
- Slow, distortions, syllable segmentation, groping; errors grow with length.
- Conduction = fluent with clear wrong phonemes; dysarthria = consistent errors and weakness.
- Oral apraxia = non-speech movements on request.
- Treatment: integral stimulation and SPT, with gradual fading of feedback and random practice.
Summary table
| Feature | Apraxia of speech | Dysarthria | Conduction aphasia |
|---|---|---|---|
| Mechanism | Planning and programming of movement | Execution: weakness, spasticity or incoordination | Language: selection and order of phonemes |
| Error type | Distortions and distorted substitutions, syllable segmentation, groping | Consistent distortions across all tasks | Wrong phonemes produced clearly, with repeated attempts to correct |
| Effect of length and complexity | Errors grow with word length | Small effect | Errors grow in repetition |
| Fluency and prosody | Slow, segmented, abnormal prosody | Depends on type | Fluent, normal prosody |
| Automatic speech | Better than initiated speech | Similar | Similar |
| Typical site | Left frontal lobe and insula | By type | Left posterior area (link between language areas) |
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Sources
- Duffy, Motor Speech Disorders: Substrates, Differential Diagnosis, and Management, 4th edition (2020) — Apraxia of speech
- ASHA Practice Portal, 2024 — Acquired Apraxia of Speech
- Wambaugh et al., Journal of Medical Speech-Language Pathology, 2006 — Treatment guidelines for acquired apraxia of speech
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-02. The text may contain errors; when in doubt, check the source.