Apraxia of Speech, also known as Developmental Apraxia of Speech (DAS) or Childhood Apraxia of Speech (CAS), is more than just difficulty speaking. It’s a neurological disorder in which the brain struggles to plan and sequence the precise movements required for accurate speech. Although the muscles themselves are generally not weak, the planning, timing, and coordination are disrupted. This has far-reaching consequences for how a child learns, interacts, and expresses themselves. Total Speech Therapy, serving families in Baltimore and Houston, sees firsthand how apraxia shapes communication skills and how therapeutic strategies can help mitigate its impact.

Key Impacts on Communication

1. Inconsistent Speech Production
   One hallmark of apraxia is that a child might correctly say a word one time and fail to replicate it another time—even in similar contexts. This unpredictability in articulatory accuracy frustrates both the child and listeners, slowing down conversation and understanding.
   
2. Difficulty with Sound Sequences & Complex Words
   Children with apraxia typically find chain transitions (moving from one sound to another) much harder, especially in multi-syllabic words. For example, “butterfly” or “hippopotamus” may be especially challenging. This leads children to simplify words, leave out sounds, or approximate them in ways that reduce speech clarity.
   
3. Slow or Halting Speech, Increased Effort
   Because every sound or syllable may need conscious planning, speaking can be slow and effortful. Children may pause between syllables or words, struggle with longer utterances, or avoid words they anticipate will be difficult. All of these places an extra cognitive load on both planning and producing speech.
   
4. Impacts Beyond Speech: Language and Learning
   While apraxia is fundamentally a motor planning issue, its effects often spill into language development. Some children with apraxia also show delays in expressive language (forming sentences) and sometimes receptive language (understanding) when their speech is so impaired that they have fewer opportunities to engage in conversation. Research shows that co-occurring motor coordination or developmental delays in other domains are common.
   
5. Social, Emotional, & Participation Effects
   Communication difficulty can lead to frustration, reduced willingness to talk, low self‐esteem, and social withdrawal. According to studies, children with apraxia may have fewer interactions, avoid speaking in settings like school, and struggle with social bonding because their speech isn’t reliably understood. These impacts affect participation in daily life.

Effective Therapy Options & How They Help

Though the communication challenges are significant, there are proven approaches that help children with apraxia make meaningful progress.

1. Multisensory Techniques
   Therapies that engage visual, tactile, and auditory feedback, such as using mirrors, tactile cues, or auditory modeling, help children understand what articulatory movements are needed. The PROMPT model, for example, uses touch on the lips, jaw, and face to guide accurate placement.
   
2. Augmentative and Alternative Communication (AAC)
   AAC devices or systems (low tech or high tech) play a critical role, especially for children with severe apraxia or those who are minimally verbal. These tools don’t replace speech; they support communication while speech skills develop. Research shows that using speech-generating devices improves both communicative interaction and language development in children with severe CAS.
   
3. Structured and Repetitive Practice
   Because apraxia is about planning and programming speech, repetition, frequent practice, and gradually increasing complexity are essential. Techniques often emphasize syllable practice, moving to words, then phrases and sentences, always under guidance to mitigate errors. Therapy should be dynamic and consistent.
   
4. Addressing Co-occurring Challenges
   Many children with apraxia also have associated motor difficulties, attention or coordination issues, or expressive language disorders. An effective therapy plan takes these into account—sometimes coordinating with PT/OT to support fine/gross motor skills and ensuring tasks aren’t too demanding in terms of coordination load.
   
5. Environmental and Emotional Support
   A supportive environment, both at home and at school, makes a big difference. That means patience from caregivers, reduced pressure in communication situations, encouragement, and the use of supportive tools like visual schedules. Celebrating small successes helps build motivation and resilience.

Why Choose Total Speech Therapy for Apraxia Support?

At Total Speech Therapy, we specialize in delivering individualized, evidence-based apraxia therapy in Baltimore and Houston. Our speech therapists evaluate each child’s unique profile of speech planning skills, language abilities, motor coordination, and emotional readiness, and then develop comprehensive treatment plans that incorporate some of the strategies mentioned earlier. We work closely with families to ensure proper home practice, the use of assistive technology when necessary, and ongoing support. We believe communication isn’t optional—it’s vital to your child’s self-esteem, social interactions, and future success.

If you think your child may have apraxia of speech—perhaps they have difficulty saying longer words, are inconsistent, or find speech frustrating for them or you—don’t wait. Early intervention can make a significant difference. Contact Total Speech Therapy to schedule a comprehensive evaluation. We’re here providing a path toward clearer speech, stronger confidence, and fuller participation. Because your child’s voice and their ability to share it matter.