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Apraxia of Speech vs Speech Sound Disorders – Accurate Diagnosis is Key

The definition of apraxia, and experience to distinguish apraxia from speech sound disorders, are important for parents, teachers and speech therapists.

The American Speech-Language-Hearing Association (ASHA) has defined the top three characteristics of childhood apraxia of speech (CAS) in order to help speech therapists make an accurate diagnosis and distinguish it from other speech sound disorders.

In our video below, Svetlana walks you through what distinguishes apraxia, and what you can do to help. Or keep reading to see the tips in this blog.

The 3 criteria that identify apraxia of speech are:

  1. Inconsistent errors on consonants and vowels in repeated productions of syllables or words (meaning that if the child says the same word many times, it may sound differently each time)

  2. Lengthened and disrupted co-articulatory transitions between sounds and syllables (meaning that the child’s speech sounds choppy or disconnected due to trouble transitioning between sounds, or between words in older children)

  3. Inappropriate prosody, especially in the realization of lexical or phrasal stress (meaning that the rhythm, intonation, and stress of speech may sound off, the child may sound robotic, have incorrect phrasing, or stress the wrong words or syllables)

With the right diagnosis, your child will improve better.

Sound Disorders

(Source: ASHA)

We often will reinforce the fact that not all children are the same, and they may develop at different rates. However, as parents, you are much more familiar with the subtle differences that your child demonstrates. Is it a speech delay? A speech sound disorder? Or something more specific like apraxia?

Here is a list of some more possible characteristics of children with apraxia of speech. Listen for these and perhaps ask a close friend or relative to also listen for these cues:

  1. More mistakes are made as longer or more difficult words are attempted:

  2. 2 syllable words like “water,” “soccer,” or “doggy”

  3. 3 syllable words like “dinosaur,” “fantastic,” or “basketball”

  4. The number and variety of vowel sounds is low; or errors when producing vowel sounds (vowels include /a,e,i,o,u/ sounds)

  5. Sometimes “groping” behaviors are observed. This is when your child appears to struggle to place their tongue, teeth, lips or mouth in general to start or produce the syllable or word.

It is important to note that not all children show “groping” behaviors at all times. If your child does not demonstrate groping during speech attempts, it does NOT necessarily rule out apraxia of speech.

Differential diagnosis between apraxia of speech and speech sound delays or disorders are crucial in order to provide the right type of therapy.

Children with apraxia of speech require specific evidence-based childhood apraxia of speech treatment solutions that are unique to their needs. Therefore, a differential diagnosis between apraxia of speech and speech sound delays or disorders are crucial. Only a qualified speech language pathologist who has experience diagnosing or treating apraxia should be consulted to accurately assess a child’s speech and language abilities. Apraxia therapy should be performed by a professional and tailored to the specific child.


At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.


About the Author

Lenora Edwards

I am ASHA Board Certified Speech Language Pathologist and Chief Knowledge Officer with Better Speech. Since obtaining my CCC’s in 2010, I have worked with individuals of all ages from little ones who are learning to understand and express themselves to adults who want to improve their speaking skills and become a more fluent and effective communicator. I love to teach and educate others, in my spare time I like reading, cooking and traveling!



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