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Speech Difficulty

What is apraxia of speech?

Apraxia of speech is a motor speech disorder. The messages from the brain to the mouth are disrupted, and the person cannot move his lips or tongue to the right place to say sounds correctly, even though the muscles are not weak.  The severity of apraxia depends on the nature of the brain damage.

What are some signs of apraxia of speech?

Individuals with apraxia of speech know what words they want to say, but their brains have difficulty coordinating the muscle movements necessary to say all the sounds in the words or move smoothly between sounds.

Individuals with apraxia may demonstrate:

  • difficulty imitating and producing speech sounds
  • make up words (e.g. “pidem” for “kitchen”)
  • difficulty self-correcting to produce the right word
  • inconsistent speech errors
  • groping of the tongue and lips to make specific sounds
  • slow speech rate
  • better automatic speech (e.g., counting, greetings) than purposeful speech
  • inability to produce any sound at all in severe cases

What causes apraxia of speech?

Apraxia of speech is caused by damage to the parts of the brain that control coordinated muscle movement, such as stroke, traumatic brain injury, brain tumors, and progressive neurological disorders.

How can we help?

We can diagnose apraxia of speech and determine the nature and severity of the condition using a variety of assessment methods. We will then plan a programme to help our client improve the planning, sequencing, and coordination of muscle movements for speech production. The muscles of speech often need to be “retrained” to produce sounds correctly and sequence sounds into words.  In severe cases, augmentative and alternative communication (AAC) such as electronic picture or word devices may be necessary to help our client communicate. 

Communication is extremely important for quality of life.  Patients with severe communication difficulties might feel frustrated or depressed.  We believe that early intervention with the right therapy and good family support is crucial to our client’s recovery.

What is dysarthria?

Dysarthria is a speech disorder. It results from impaired movement of the muscles used for speech production, including the lips, tongue, vocal folds, and/or diaphragm.

What are some signs or symptoms of dysarthria?

  • Slurred speech
  • Slow rate of speech
  • Rapid rate of speech with a “mumbling” quality
  • Reduced tongue, lip, and jaw movement
  • Abnormal pitch and rhythm when speaking

What causes dysarthria?

Dysarthria is caused by damage to the brain. This may occur at birth, as in cerebral palsy, or may occur later in life due to stroke, brain injury or neurological diseases such as Parkinson’s disease.

How can we help?

We will examine the movements of the lips, tongue, and jaw, as well as breath support for speaking to determine the nature and severity of the problem .   Following assessment, we will recommend appropriate exercises to treat the dysarthria.  Our therapy programme includes:

  • Increasing tongue, lip and jaw movements
  • Improving articulation/ clarity of speech production
  • Improving breath support to speak louder
  • Learning to speak at appropriate speech rate
  • Teaching family members strategies to communicate better with their loved ones with dysarthria

How effective are speech-language pathology treatments for dysarthria?

ASHA produced a treatment efficacy summary on dysarthria [http://www.asha.org/uploadedFiles/public/TESDysarthria.pdf] that describes evidence about how well treatment works.

Communication is extremely important for quality of life.  Patients with severe communication difficulties might feel frustrated or depressed.  We believe that early intervention with the right therapy and good family support is crucial to our client’s recovery.  

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