Comparison of Childhood Apraxia of Speech, Dysarthria

and Severe Phonological Disorder

(Some or all of these characteristics may be present. Consult with a Speech-Language Pathologist who is
experienced in the diagnosis of motor speech disorders for a definitive differential diagnosis)

Verbal Apraxia Dysarthria Severe Phonological Disorder

No weakness, incoordination or Decreased strength and coordination No weakness, incoordination or

paralysis of speech musculature of speech musculature that leads to paralysis of speech musculature
imprecise speech production,
slurring and distortions

No difficulty with involuntary Difficulty with involuntary motor No difficulty with involuntary motor
motor control for chewing, control for chewing, swallowing, control for chewing and swallowing
swallowing, etc. unless there is etc. due to muscle weakness and
also an oral apraxia incoordination

Inconsistencies in articulation Articulation may be noticeably Consistent errors that can usually be
performance--the same word may “different” due to imprecision, but grouped into categories (fronting,
be produced several different errors generally consistent stopping, etc.)
ways

Errors include substitutions,
omissions, additions and
repetitions, frequently includes
simplification of word forms.
Tendency for omissions in initial
position. Tendency to centralize
vowels to a “schwa”
Errors are generally distortions
Errors may include substitutions,
omissions, distortions, etc. Omissions
in final position more likely than initial
position. Vowel distortions not as
common.

Number of errors increases as May be less precise in connected Errors are generally consistent as
length of word/phrase increases speech than in single words length of words/phrases increases

Well rehearsed, “automatic” No difference in how easily speech No difference in how easily speech is
speech is easiest to produce, “on is produced based on situation produced based on situation
demand” speech most difficult

Receptive language skills are Typically no significant discrepancy Sometimes differences between
usually significantly better than between receptive and expressive receptive and expressive language
expressive skills language skills skills

Rate, rhythm and stress of speech Rate, rhythm and stress are disrupted Typically no disruption of rate, rhythm
are disrupted, some groping for in ways specifically related to the or stress
placement may be noted type of dysarthria (spastic, flaccid,
etc.)

Generally good control of pitch Monotone voice, difficulty Good control of pitch and loudness, not
and loudness, may have limited controlling pitch and loudness limited in inflectional range for
inflectional range for speaking speaking

Age-appropriate voice quality Voice quality may be hoarse, harsh, Age-appropriate voice quality
hypernasal, etc. depending on type
of dysarthria
•Compiled by Ruth Stoeckel, M.A., CCC-SLP and David Hammer, M.A., CCC-SLP
Copyright © March 2001, Childhood Apraxia of Speech Association of North America, Internet:
http://www.apraxia-kids.org

Childhood Apraxia of Speech- David W. Hammer, M.A., CCC-SLP