Apraxia of Speech or a Phonological Disorder?

Childhood Apraxia of Speech (CAS) is a motor speech disorder that is not due to muscle weakness. The brain has difficulty planning the movements that need to be executed by the mouth structures to result in speech. This results in difficulty with making voluntary speech sounds and sequencing or stringing them together in the correct order to make words. The child knows what he/she wants to say, but his/her brain has problems with coordinating the muscle movements necessary to produce those words.

Characteristics of CAS include:

Early Development

·         slow and late development of speech skills

·         limited early sound development; most vocal communication is in vowels only

·         limited ability to imitate speech

·         frustration with communication skills

·         use of grunting and pointing as a main mode of communication beyond 18 months of age

·         words used a few times and then never heard again

     Speech Characteristics

·         unintelligible speech

·         difficulty positioning the mouth structures for speech sound production (“groping”)

·         inconsistency of speech productions

·         difficulty speaking “on demand”

·         unusual and atypical error patterns

Phonological Disorders:

A phonological disorder is difficulty with the patterns for combining sounds clearly into speech. Find a description of phonological processes here.

Important Differences

1.    Language Skills

Although their receptive language or understanding is generally intact, children with apraxia usually have delayed expressive language skills. Children with phonological disorders may have expressive language skills closer to or within the normal range. While their speech is mostly unintelligible, they use lots of words and try to combine them into phrases and sentences.

2.    Copying Abilities

Children with apraxia usually have severe difficulties imitating speech sounds or mouth movements, while children with phonological disorders can copy movements, sounds or words, although their words might not be produced accurately.

3.    Consistency of Errors

Children with phonological disorders are generally consistent with their errors and exhibit patterns of errors, while children with apraxia are very inconsistent. They could say a word correctly once and then incorrectly a short while after.

4.    Vowel Sounds

Both children with phonological disorders and apraxia have difficulties with consonant sounds, but children with apraxia also substitute or sometimes omit vowel sounds too.

5.    Groping

Children with apraxia often look like they are searching for the correct way to position their mouths to form speech sounds.

It is important to contact a speech- and language therapist if you are at all concerned about your child’s speech development and –intelligibility.

For more information check out the following links:

The Source for Childhood Apraxia of Speech (LinguiSystems)

http://www.asha.org/public/speech/disorders/childhoodapraxia.htm

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Childhood_apraxia_of_speech

http://www.pammarshalla.com/blog/2011/08/differentiating-between-apraxia-and-severe-phonological-deficit/

http://teachmetotalk.com/2008/03/16/is-it-apraxia-or-a-phonological-processing-disorder-sorting-out-the-differences-in-toddlers-preschoolers-2/

http://testyyettrying.blogspot.com/2011/04/what-is-childhood-apraxia-of-speech-and.html

http://www.webmd.com/brain/apraxia-symptoms-causes-tests-treatments

Post by Elmien Truter

What are Phonological Processes?

What are Phonological Processes?

Phonological processes are the patterns of sound errors that typically developing young children use to simplify adult speech as they are learning to talk. All children use these processes while their speech and language are developing.

Young children do not yet have the ability to coordinate all the mouth structures such as the lips and tongue for clear speech, so they simplify complex words in predictable ways until they develop the coordination needed for clear articulation.

As children get older, their speech matures and they stop using these patterns to simplify words, which results in more understandable, adult-like speech. As every child is unique, each child will develop their phonology skills differently, but there are ages when it is expected that a child should stop using different phonological processes.

Below is a table describing the different phonological processes and the age by which they should likely disappear:

Substitution Processes

Phonological Process	Description	Examples	Gone by Approximately
Fronting	A sound produced in the back of the mouth, e.g. /k/ or /sh/, is replaced by a sound produced in the front of the mouth, e.g. /t/ or /s/.	car → tar sheep → seep	3:6 yrs
Backing	A sound produced in the front of the mouth, e.g. /t/ or /d/, is replaced by a sound produced in the back of the mouth, e.g. /k/ or /g/.	tap → cap duck → guck	Usually seen in more severe phonological delays.
Stopping	A fricative sound (e.g. /f/, /s/ or /sh/) or affricate sound (e.g. /ch/ or /j/) is replaced by a plosive/stop sound (e.g. /p/, /t/, /d/).	fish → pish sun → tun shoe → too thin → tin	3 yrs = /f/, /s/ 3:6 yrs = /v/, /z/ 4:6 yrs = ‘sh’, ‘ch’, ‘j’ 5 yrs = ‘th’
Deaffrication	An affricate (e.g. ‘ch’ or ‘j’), is replaced with a fricative or stop sound (e.g. ‘sh’ or ‘d’).	chips →  ships jump → dump	4 years
Gliding	Liquid sounds (/l/, /r/) are replaced by glide sounds (/y/, /w/).	leg → yeg ring → wing	5 yrs

Syllable Structure Processes

Phonological Process	Description	Examples	Gone by Approximately
Final consonant deletion	The final consonant in a word is deleted.	soap → sew dog → dah	3:3 yrs
Weak syllable deletion	The unstressed syllable in a word is deleted.	telephone →tephone banana → nana	4 yrs
Cluster reduction	A consonant cluster (two consonants next to one another) is reduced to a single consonant.	spoon → poon truck → tuck	4 yrs

Assimilation Processes

Phonological Process	Description	Examples	Gone by Approximately
Pre-vocalic voicing	An voiceless sound at the beginning of a word, e.g. /p/ or /k/, is replaced by a voiced sound, e.g. /b/ or /g/.	pig → big key → gey	3 yrs
Word final devoicing	A final voiced sound, e.g. /d/ or /g/, is replaced by a voiceless sound, e.g. /t/ or /k/.	bed → bet bag → bak	3 yrs
Consonant harmony	A sound starts to sound like another sound in the word.	bus → bub cat → tat	3:9 yrs

Click here to download the PDF version of this table.

A phonological delay is when a child continues to use these processes beyond the age when most typically developing children have stopped using them.

It is important to consider contacting a speech- and language therapist for an evaluation if you are concerned regarding your child’s speech intelligibility and/or suspect a phonological delay.

Information for this post was gathered from these sources:

1. http://mommyspeechtherapy.com/?p=2158
2. http://www.playingwithwords365.com/2011/09/phonological-processes-and-phonological-delay/
3. http://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=30:table2&catid=11:admin&Itemid=117
4. http://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=31:table3&catid=11:admin&Itemid=117

Post Submitted by Elmien Truter