When someone struggles to talk, there can be a wide range of conditions causing the problem. Apraxia and dyspraxia are two motor speech disorders, neurological conditions that interrupt a person’s speech pattern or verbal communication. 

This article answers critical questions about the two conditions, including:

• What is the difference between apraxia and dyspraxia?
• What causes apraxia and dyspraxia?
• What are the different types of apraxia?
• What are the early signs and symptoms of apraxia and dyspraxia?
• How do apraxia and dyspraxia affect communication?
• How do apraxia and dyspraxia affect adults?
• How are apraxia and dyspraxia diagnosed?
• How are apraxia and dyspraxia treated? Where can I find a speech therapist near me who specializes in apraxia and dyspraxia?
• Where can I learn more about communication disorders like apraxia and dyspraxia?

What is the difference between apraxia and dyspraxia?

The four most common disorders that affect a person’s ability to speak are apraxia, dyspraxia, dysarthria, and aphasia. The neurological disorders apraxia and dyspraxia disrupt communication between the brain and the parts of our bodies related to speech:

• Apraxia is a neurological disorder where a person cannot coordinate and perform purposeful movements. The most common form of apraxia is apraxia of speech (AOS).
• Dyspraxia means there is only partial loss of the neurological abilities associated with apraxia. 

Where dyspraxia and apraxia impact neurological connections, dysarthria and aphasia affect coordination and comprehension:

• Dysarthria is muscular in nature. It occurs when a patient’s muscles do not coordinate to produce speech. 
• Aphasia describes a person’s inability to comprehend or use language.

All four speech motor disorders have similar symptoms, but they occur for different reasons. Some conditions, like apraxia and aphasia, can occur at the same time.

The difference between dyspraxia and apraxia is that dyspraxia refers to a partial loss of speech motor functions, while apraxia is the complete loss of those functions. To that end, dyspraxia can be considered a “milder” form of apraxia. 

What are the early signs and symptoms of apraxia and dyspraxia?

Early signs of apraxia and dyspraxia include: 

• Difficulty saying or imitating sounds.
• Saying something correctly the first time, then incorrectly the next time.
• Slowing down speech.
• Difficulty with automatic speech, things you say every day like “Hello” or “How are you?”
• Inability to make sounds at all. This occurs in severe cases of apraxia, not dyspraxia.

Other signs more common in apraxia than dyspraxia include:

• Difficulty carrying out facial movements like winking, licking your lips, or coughing.
• Moving your eyes.
• Responding to verbal commands.
• Completing activities with multiple movements involved, like getting dressed, making and eating food, or bathing.

What causes apraxia and dyspraxia?

Apraxia and dyspraxia come from a dysfunction of the brain’s cerebral hemispheres. When apraxia affects coordinated movements in children, it is called developmental coordination disorder (DCD). When it affects speech, it is called apraxia of speech (AOS).

There are two types of AOS:

• Childhood apraxia of speech (AOS) is also called developmental apraxia of speech. Developmental AOS begins very early in life and is often genetic. A person with developmental AOS may also have other developmental issues, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and epilepsy. 
• Acquired apraxia of speech (AOS) comes from brain injury in someone who has already learned to speak. Brain injuries may include stroke, traumatic brain injury, dementia, brain tumors, and brain diseases.

Dyspraxia carries the same types and distinctions as apraxia, but the symptoms are much milder.

What are the different types of apraxia?

There are two types of apraxia: ideational and ideomotor.

Ideational apraxia is an inability to perform specific motor tasks because the person no longer understands the overall concept of the act. This is often the result of extensive left hemisphere damage, dementia, or delirium.

Ideomotor apraxia, also known as voluntary-automatic dissociation, means the person has average strength and can often perform involuntary movements but cannot perform physical movements when asked.

These two types of apraxia are broken into multiple varieties. They include:

• Buccofacial apraxia, a type of ideomotor apraxia characterized by difficulties performing mouth movements. The person cannot blow out a candle, for example.
• Conceptual apraxia, when the person does not understand how to use an object. They may misuse items or have difficulty matching items and actions.
• Constructional apraxia, difficulty in drawing and building objects. 
• Limb-kinetic apraxia, or clumsy limb movement.
• Oculomotor apraxia, when a person is unable to perform eye movements on command.
• Orofacial apraxia, when someone has difficulty making skilled movements of the face, mouth, tongue, larynx, and pharynx.
• Verbal apraxia, which affects the articulation of words. 

For a complete list of apraxia and dyspraxia types, see Physiopedia.

How do apraxia and dyspraxia affect communication?

Apraxia and dyspraxia both affect the ability to speak, making it difficult to hold or follow a conversation. In addition, severe cases of apraxia and dyspraxia can affect certain fine motor skills, like holding a pencil, writing, or typing. 

Losing the ability to communicate can be extremely frightening, frustrating, and isolating for people with dyspraxia and apraxia. 

Many children with developmental apraxia or dyspraxia learn alternate methods of communication, like pointing, writing, drawing, or using assistive technology to produce speech. For adults, it can be challenging to re-learn these things or be suddenly forced to depend on them instead of speaking aloud.   

How do apraxia and dyspraxia affect adults?

Adults with apraxia may be unable to remember or perform the tasks they used to be able to do, even though they are still physically able to do those things. This may include anything from buttoning a shirt to holding a pen to saying hello. These changes in abilities can negatively affect a person’s social life and lead to mental health concerns, including depression.

Support groups, talk therapy, and creative methods of expression like art and music can help people with apraxia or dyspraxia cope with these changes.

How are apraxia and dyspraxia diagnosed?

There is no single test to diagnose apraxia. Instead, an apraxia or dyspraxia diagnosis comes after a series of tests performed by a speech-language pathologist (SLP).These tests typically include:

• Physical evaluations. Your doctor might ask you to brush your teeth, tie a shoelace, or use scissors to cut out a shape.
• Family evaluation. Your doctor will likely discuss your family medical history.
• Brain function tests. These neuropsychologic tests check how your brain’s problem-solving, memory, attention span, processing speed, and use of language.
• Imaging tests. Sometimes an MRI or CT scan is used to look for brain damage or other underlying conditions that can cause apraxia.

How are apraxia and dyspraxia treated?

There is no “one size fits all” treatment for apraxia or dyspraxia. Some forms of acquired apraxia go away on their own, or with treatment of the underlying cause. Meanwhile, children who develop apraxia of speech are very unlikely to improve without the efforts of a speech therapist.

Common treatments for apraxia and dyspraxia include:

• Physical, speech, or occupational therapy.
• Multisensory approaches, like practicing speech exercises while looking in the mirror.
• Rhythm, melody, or music exercises.

Some treatment methods aim to compensate for long-term apraxia and dyspraxia. These might include:

• Learning sign language.
• Using assistive technology like text-to-speech software or specialized communication apps. 
• Alternative communication, like drawing, writing, or using communication boards.

Where can I find a speech therapist near me who specializes in apraxia and dyspraxia?

If you or a loved one are having difficulty speaking, see a doctor right away. Often, apraxia and dyspraxia are linked to dangerous underlying conditions like brain damage or tumors. 

For children, ask your pediatrician or your child’s school for a referral to a speech-language pathologist. For adults, your family doctor or primary care provider (PCP) is a great place to start. You can also check with your medical insurance provider to see what kind of coverage you have for speech disorders, as well as recommendations for in-network providers.

In addition, Ability Central maintains a searchable database of nonprofits that can help with everything from diagnosis and treatment. These nonprofits can connect you with speech-language pathologists and speech therapists.

Where can I learn more about communication disorders like apraxia and dyspraxia?

To learn more about speech and motor disorders like apraxia and dyspraxia, see: 

• Cerebral Palsy: Symptoms and Early Signs
• Attention deficit/hyperactivity disorder symptoms (ADHD)
• Autism spectrum disorder
• Cerebral palsy
• Dysarthria
• Expressive language disorder
• Hearing loss
• Receptive language disorder
• Stroke
• Stuttering