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A 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 paralysis of speech musculature Decreased strength and coordination of speech musculature that leads to imprecise speech production, slurring and distortions No weakness, incoordination or paralysis of speech musculature
No difficulty with involuntary motor control for chewing, swallowing, etc. unless there is also an oral apraxia Difficulty with involuntary motor control for chewing, swallowing, etc. due to muscle weakness and incoordination No difficulty with involuntary motor control for chewing and swallowing
Inconsistencies in articulation performance–the same word may be produced several different ways Articulation may be noticeably “different” due to imprecision, but errors generally consistent Consistent errors that can usually be grouped into categories (fronting, stopping, etc.)
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 “schwaa” 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 length of word/phrase increases May be less precise in connected speech than in single words Errors are generally consistent as length of words/phrases increases
Well rehearsed, “automatic” speech is easiest to produce, “on demand” speech most difficult No difference in how easily speech is produced based on situation No difference in how easily speech is produced based on situation
Receptive language skills are usually significantly better than expressive skills Typically no significant discrepancy between receptive and expressive language skills Sometimes differences between receptive and expressive language skills
Rate, rhythm and stress of speech are disrupted, some groping for placement may be noted Rate, rhythm and stress are disrupted in ways specifically related to the type of dysarthria (spastic, flaccid, etc.) Typically no disruption of rate, rhythm or stress
Generally good control of pitch and loudness, may have limited inflectional range for speaking Monotone voice, difficulty controlling pitch and loudness Good control of pitch and loudness, not limited in inflectional range for speaking
Age-appropriate voice quality Voice quality may be hoarse, harsh, hypernasal, etc. depending on type of dysarthria Age-appropriate voice quality

Compiled by members of the Advisory Board of the Childhood Apraxia of Speech Association

© Apraxia-KIDS℠ – A program of The Childhood Apraxia of Speech Association (CASANA)
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