What is Apraxia of Speech? Diagnosis and Useful Advice for Speech Enhancement

  • 13 March 2023
  • Posted by Yasminah Abdullah, M.S., CCC-SLP
  • Comment

It’s a speech-sound disorder called apraxia of speech (AOS) often caused by a brain injury or stroke. Additionally, the individual has trouble producing the necessary oral movements to make the sound. Thus, AOS can occur even in the absence of muscle weakness. The person has normal muscle tone, strength, and mobility, but they can’t make any speech sounds.

In a typical case of AOS, the individual is visibly struggling to make the sound. Furthermore, he/she appears to be searching for where to position the speech muscles, such as the lips and tongue. Consequently, searching and groping are very prevalent in AOS. AOS can exist independently or in conjunction with oral apraxia.

Diagnostic Methodology

First of all, a speech-language pathologist will review the symptoms, medical history, speech muscles, speech sounds, words, and phrases to assess their condition.

The speech-language pathologist will evaluate the vocabulary, sentence structure, and speech comprehension skills.

CAS is diagnosed using multiple tests and observations. It really depends on the nature of the issues that have been observed. Your child’s age, level of cooperation, and the severity of the speech problem will all determine which tests will be administered during the evaluation.

When a patient has limited communication skills or is unable to engage with the speech-language pathologist, a diagnosis of CAS can be challenging.

Knowing whether or not an individual has CAS is important because it requires a different approach to treatment than other speech disorders. Even if the diagnosis is initially hazy, a speech-language pathologist may be able to advise you on the best course of treatment.

Examples of possible diagnostic procedures are: 

Hearing tests: If someone is having difficulty communicating, your doctor may recommend hearing tests to rule out hearing loss as a possible cause.

Evaluation of oral-motor skills: A speech therapist will check for tongue-tie, cleft palate, and other structural and functional issues with the lips, tongue, jaw, and palate. In most cases, CAS is not linked to low muscle tone, but it can be a symptom of other issues.

The speech-language pathologist will watch how the patient moves their mouth when they blow, smile, or kiss.

Speech assessment: The ability to form sounds, words, and sentences will be evaluated while the patient is engaged in play or other activities.

The patient may be asked to name pictures to identify any sounds, words, or syllables that he or she has trouble pronouncing.

The speech-language pathologist working with the patient may use speech tasks to assess his motor speech skills, such as coordination and fluency. Repetition of syllables like “pa-ta-ka” or the articulation of words like “buttercup” may be requested to gauge your child’s motor speech coordination.

If the patient is capable of forming sentences, a speech-language pathologist will listen to and record his speech to evaluate the melody and rhythm of his speech, including how he places emphasis on individual syllables and words.

A speech therapist may use cues like saying the word or sound more slowly or touching his face to help him produce more accurate responses.

Treatment for AOS often includes speech and language therapy. The following discussion provides some helpful tips that should be considered during AOS treatment.

Tips for Dealing with Speech Apraxia

  1. Participatory Session:

Make the session fun and engaging.

For the /b/ sound, for instance, the child could be given the following guidance:

  • Join your lips
  • Take a deep breath and hold it behind your lips.
  • Let your breath out immediately.
  • The sound can also be used in a practical manner. Pick words with short CVC and CV sequences to memorize. Examples include “bee,” “bow,” “boo,” etc.
  1. Incorporate a multi-sensory strategy: 

When dealing with AOS, it is best to employ a multi-sensory approach. To teach sound, you should use all of your senses, not just hearing and seeing. Let’s say we’re working on teaching the /b/ sound to the kid. Here are some of the things we can accomplish by utilizing multiple senses:

  • Put your lips together as a visual cue.
  • Pronounce the letter “b” three times. Audio cue: Say “ba” three times in a row.
  • The “b” sound can be felt as air is expelled from the mouth, so placing a hand in front of the mouth can serve as a tactile cue. 
  1. More frequent sessions of intensive therapy: 

First, consistent speech therapy sessions will be beneficial. Second, it’s best to schedule between three and five therapy sessions per week. A parent-focused program, however, is recommended. One way that these exercises are continued at home is through a program designed specifically for parents.

Moreover, due to a wide range of differences among people who have AOS, individualized treatment plans are likely to yield the best results. It’s best to begin with one-on-one sessions.

  1. Exercises to improve intonation and prosody:

People with AOS not only have problems with the sounds they make when talking, but they also have unusual rhythms and intonations in their speech. These people, in other words, stress and pause incorrectly and speak at an abnormal pitch. Stress, intonation, pitch, and rhythm are all aspects of prosody that can be used in therapy sessions. Afterward, kids can finish up by singing songs, rhymes, humming, chanting, etc.

When speaking to an adult, it is important to use the correct prosodic features along with the intended sound. Each individual word, phrase, and sentence is examined.

  1. Allowing ample practice to promote skill generalization:

Therapeutically, it’s crucial to allow time for the patient to practice the new skill in real-world contexts. This is a broad generalization. Allowing some time for the process of generalization aids in the application of lessons learned in one context to another. Having more opportunities to put what you’ve learned into practice boosts your likelihood of retaining that knowledge. Do it with the help of the therapist at first, and then try to reduce your need for their assistance over time.

  1. Giving session feedback—knowledge of results versus performance:

The importance of feedback in the acquisition of new abilities cannot be overstated. Knowing a client’s preferred method of instruction allows therapists to tailor their feedback accordingly.

In some cases, informing clients of the outcomes could be beneficial. It entails commenting on the correctness or incorrectness of the statement. If the therapist and client are working on the word “ball,” and the client says “all,” the therapist would correct the client by saying, “No, that is wrong.” Could you say ball?

There would be less restrictions placed on one’s knowledge of performance. The counselor would simply paraphrase the patient’s words and offer suggestions for improvement. If the therapist is working with the client on the word “ball,” and the client says “all,” the therapist might respond, “I heard it as all.” Please repeat that, but this time includes the letter “b” at the beginning.

If a brain injury or stroke has resulted in apraxia and a person is not able to say what they want to say even though there is no physical barrier, speech therapy can go a long way in correcting the problem. For the best speech therapy sessions in Baltimore, and Houston you can always contact Total Speech Therapy for help at 410-696-3301 or by sending an email to yasminah@totalspeechtherapy.com. We have specialized speech-language therapists who can help your loved ones regain their speech.

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