Posted on Nov 3rd, 2023.

When it comes to pediatric speech disorders, understanding the differences between dysarthria vs. apraxia is crucial. 

These motor speech disorders can affect a child's ability to communicate effectively. 

In this article, we will explore the distinctions between dysarthria and apraxia, their causes, signs and symptoms, and effective treatment approaches.

Motor Speech Disorders in Children

Motor speech disorders are a group of conditions that affect the coordination and control of the muscles involved in speech production. These disorders can manifest in various ways, impacting a child's ability to communicate effectively.

These disorders encompass a range of conditions, including dysarthria and apraxia, each with its own distinct characteristics and underlying causes. These disorders can be caused by neurological, neuromuscular, or developmental factors, and they often present unique challenges in speech production.

In children, motor speech disorders can manifest as:

• Articulation Difficulties: Difficulty pronouncing sounds correctly, leading to imprecise articulation.
• Reduced Intelligibility: Speech that is challenging to understand due to distortions or substitutions of sounds.
• Speech Rhythm Issues: Altered speech rhythm, which can result in irregular pacing and fluency challenges.

Motor speech disorders can significantly impact a child's ability to express themselves and engage in effective communication. Early identification and intervention are crucial in addressing these challenges and supporting children in developing their speech and language skills.

In the next sections, we'll explore two prominent motor speech disorders in children: dysarthria and apraxia, each with its distinct characteristics and treatment approaches.

What is Dysarthria?

Dysarthria is a motor speech disorder characterized by muscle weakness or difficulty coordinating the muscles involved in speech. In children, dysarthria can result from various underlying causes, such as cerebral palsy, neurological conditions, or muscular dystrophy. It often leads to imprecise articulation, slurred speech, and reduced speech intelligibility.

Underlying Causes of Dysarthria in Children

• Neurological Conditions: Dysarthria often occurs as a result of neurological conditions that affect the brain's ability to control the muscles used in speech. Conditions such as cerebral palsy, brain injury, or neurodegenerative disorders can lead to dysarthria in children.
• Muscular Weakness: Some children may develop dysarthria due to muscular weakness or lack of coordination in the speech muscles. This weakness can be caused by conditions like muscular dystrophy or myasthenia gravis.
• Developmental Factors: In some cases, dysarthria may be related to developmental factors. Children may experience delays in the development of their speech motor skills, leading to dysarthria-like symptoms.

Signs and Symptoms of Dysarthria in Children

The signs and symptoms of dysarthria can vary widely among children, depending on the underlying cause and the severity of the condition. Common signs and symptoms include:

• Imprecise Articulation: Children with dysarthria often struggle to articulate sounds accurately, leading to slurred speech and unclear pronunciation.
• Reduced Vocal Volume: Dysarthria can result in a reduced ability to control vocal loudness, leading to speech that is too soft or too loud.
• Altered Speech Rate: Children with dysarthria may exhibit irregular speech rate and rhythm, making their speech sound choppy or fast.
• Resonance Issues: Some children with dysarthria may experience resonance problems, leading to a nasal or hoarse quality in their speech.
• Limited Speech Intelligibility: Reduced speech intelligibility is a common sign and symptom, making it challenging for others to understand the child's speech.

What is Apraxia?

Apraxia of speech, or childhood apraxia of speech (CAS), is a motor speech disorder characterized by difficulty planning and coordinating the precise movements required for speech. Unlike dysarthria, where the muscles themselves are weak or uncoordinated, children with apraxia struggle with the neurological planning of speech.

Underlying Causes of Apraxia in Children

• Neurological Basis: Apraxia of speech is primarily attributed to neurological issues that affect the brain's ability to send clear signals for speech production. These neurological factors can disrupt the precise planning and coordination needed for speech.
• Genetic Factors: While the exact cause of CAS is not always clear, some cases may have a genetic basis. It is not uncommon for children with a family history of speech and language disorders to develop apraxia.

Signs and Symptoms of Apraxia in Children

Children with apraxia may exhibit a range of signs and symptoms that make their speech production challenging. The hallmark feature of apraxia is the inconsistency of speech errors, which can vary from one utterance to another. Common signs and symptoms include:

• Inconsistent Speech Errors: One of the defining characteristics of apraxia is the inconsistency of speech sound errors. A child with apraxia may produce the same word correctly in one instance but struggle to articulate it correctly in another.
• Difficulty with Speech Sound Sequencing: Children with apraxia often have difficulty sequencing speech sounds in the correct order. They may mix up sounds within words or syllables.
• Challenges with Speech Prosody: Apraxia can impact a child's ability to use appropriate speech prosody, including stress, intonation, and rhythm.
• Groping Movements: Some children with apraxia may exhibit groping movements as they attempt to produce specific sounds or words. These movements reflect the child's efforts to coordinate their speech muscles.
• Limited Speech Intelligibility: Due to the inconsistency and imprecision in speech production, children with apraxia often have reduced speech intelligibility, making it difficult for others to understand them.

Treatment Approaches for Dysarthria and Apraxia

Effective treatment for motor speech disorders such as dysarthria and apraxia in children requires a multidimensional approach that considers the unique characteristics of each disorder. Speech-language pathologists play a vital role in assessing, diagnosing, and implementing targeted interventions to help children improve their speech production abilities. Here, we'll explore the treatment approaches for both dysarthria and apraxia, emphasizing the differences in therapeutic strategies.

Treatment for Dysarthria in Children

• Speech Therapy: Speech therapy is the cornerstone of dysarthria treatment. The primary goal is to improve speech intelligibility by addressing muscle weakness or coordination issues. Speech-language pathologists (SLPs) work with children to strengthen their speech muscles and enhance control.
• AAC Devices: In cases where dysarthria significantly impacts speech clarity, augmentative and alternative communication (AAC) devices may be recommended. These devices, such as speech-generating apps or devices, help children communicate effectively when verbal speech is challenging.
• Oral Motor Exercises: SLPs may incorporate oral motor exercises to improve muscle strength and coordination. These exercises can target specific muscle groups involved in speech production.
• Breathing Techniques: Dysarthria can affect respiratory control during speech. SLPs may teach children breathing techniques to support better breath control for speech.
• Articulation Drills: Targeted articulation drills focus on improving specific speech sounds or sound patterns that are problematic for the child.

Treatment for Apraxia in Children

• Intensive Speech Therapy: Apraxia often requires intensive speech therapy. Children with apraxia benefit from frequent and consistent therapy sessions to practice and refine their speech motor planning.
• Cueing Strategies: SLPs use various cueing strategies to help children plan and execute speech sounds correctly. These cues may include visual, auditory, or tactile prompts to enhance motor planning.
• Phonological Awareness Activities: Apraxia can impact a child's phonological awareness, which is crucial for literacy development. Therapy may include activities that promote phonological skills.
• Parent/Caregiver Involvement: In many cases, parents and caregivers are actively involved in apraxia therapy. They learn strategies to support their child's speech development at home.
• Augmentative Communication: Similar to dysarthria, children with severe apraxia may benefit from AAC devices to facilitate communication when speech is challenging.

It's essential to recognize that therapy approaches may vary based on the severity of the motor speech disorder and the child's specific needs. Effective treatment often involves a combination of these approaches tailored to the individual child's requirements. Early intervention and consistent therapy sessions play a crucial role in helping children with dysarthria and apraxia make progress in their speech development.

Related: Orofacial Myofunctional Disorders (OMDs) in Children: Spotting the Signs for Early Intervention 

Conclusion

Speech-language pathologists (SLPs) play a vital role in addressing motor speech disorders such as dysarthria and apraxia in children. 

While both disorders present speech challenges, they differ in their underlying causes and characteristics. Dysarthria primarily involves muscle weakness or coordination issues, while apraxia centers on the neurological planning of speech movements. The treatment approaches also differ, with dysarthria focusing on muscle strengthening and coordination, and apraxia requiring intensive therapy to improve speech motor planning.

At Tryumph Speech Therapy, we specialize in providing speech therapy services for children, including those with dysarthria and apraxia. Our dedicated team of speech-language pathologists is committed to helping children unlock their full communication potential. If you believe your child may be facing challenges related to dysarthria or apraxia, don't hesitate to reach out to us. 

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Contact us at (512) 898-9858 or email us at [email protected]. Together, we can transform 'try' into TRYUMPH, empowering your child to communicate effectively and confidently.