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

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