Apraxia and Dysarthria


Dysarthria in Children

Dysarthria is a neurogenic speech disorder that results in weakness, slowness, and/or incoordination of the muscles of respiration, phonation, articulation, resonance and feeding. Because the child has under-responsive muscles, feeding skills are compromised and the child is at risk for aspiration and choking. Additionally, the poorly functioning muscles lead to unintelligible speech.

Childhood Apraxia of Speech (CAS)

CAS, or verbal dyspraxia/apraxia, is a neuromotor articulatory speech disorder that interferes with a child's ability to correctly pronounce sounds, syllables and words. A child with CAS cannot consistently move his or her face, tongue, lips and jaw into the correct position to make speech sounds or produce syllables or words. Speech produced by an individual with CAS is often marked by inconsistent productions of the same sound or word (e.g., a child attempting to say the word “dog” three times produces the following: “ka”, “dog”, “ga”). In order for speech to occur, messages need to go from your brain to your mouth. These messages tell the muscles how and when to move to make sounds. When a child has apraxia of speech, the messages do not get through correctly. The child might not be able to move their lips or tongue in the right ways, even though their muscles are not weak. Sometimes, the child might not be able to say much at all. A child with CAS knows what they want to say. The problem is not how the child thinks but how the brain tells the mouth muscles to move. CAS is sometimes called verbal dyspraxia or developmental apraxia. Even though the word “developmental" is used, CAS is not a problem that children outgrow. A child with CAS will not learn speech sounds in typical order and will not make progress without treatment. It can take a lot of work, but the child’s speech can improve.

Signs and Symptoms

Not all children with CAS are the same. Your child may show some or all of the signs below. You should talk to your doctor and see an SLP if your child is older than 3 years and

  • does not always say words the same way every time;

  • tends to put the stress on the wrong syllable or word;

  • distorts or changes sounds; or

  • can say shorter words more clearly than longer words.

Children with CAS may have other problems, including

  • difficulty with fine motor skills;

  • delayed language; or

  • problems with reading, spelling, and writing.