Verbal Dyspraxia, Verbal Apraxia,
Apraxia of Speech

See also: Cluttering

Our page on Dyspraxia explains that some people have a form of dyspraxia (developmental coordination disorder) called verbal dyspraxia. It is also known as verbal apraxia, apraxia of speech, development verbal dyspraxia and childhood apraxia of speech (CAS). Different terms seem to be prevalent in different countries, with the UK generally using ‘verbal dyspraxia’, and the US ‘apraxia of speech’ or ‘verbal apraxia’, although this is not fixed.

Just as dyspraxia causes problems of movement and coordination, people with verbal dyspraxia have trouble coordinating the movements required to speak. Verbal dyspraxia may occur by itself, or alongside the more general form of dyspraxia. This page provides more information about verbal dyspraxia, including symptoms, causes and treatment.

Understanding Verbal Dyspraxia

Verbal dyspraxia is a speech problem, where those affected find it difficult to coordinate the movements required to talk.

This may sound a bit like dysarthria—and indeed, it is similar in that it is a problem with how speech is produced, not with language or understanding. People with verbal dyspraxia generally have no problem understanding what is being said to them, or knowing what they want to say in reply. However, they cannot always manage to make the words come out as they wish.

Dyspraxia generally seems to be caused by a disruption in the messages between brain and muscles. This is also true of verbal dyspraxia.

In other words, both brain and muscles are apparently fine, but something is being disrupted between them.

There are two forms of verbal dyspraxia: acquired and developmental.

  • Acquired verbal dyspraxia occurs after a brain injury of some kind, for example, a stroke, a brain tumour or an infection.

  • Developmental verbal dyspraxia is present from birth. Its cause is not entirely clear, though it is sometimes associated with certain genetic or environmental factors, such as exposure to tobacco or alcohol.

Verbal dyspraxia is quite rare. Speech and language disorders affect around 60 children in every 1,000. However, verbal dyspraxia only seems to affect about one in every 1,000 children. That said, there are no very definitive figures on this, partly because getting a specific diagnosis is difficult, and partly because it often co-occurs with and is masked by other conditions.

Symptoms of Verbal Dyspraxia

The symptoms of verbal dyspraxia include:

  • Using the wrong sounds in words;

  • Using a very limited range of sounds, which may also develop more slowly than in other children;

  • No consistent patterns of ‘wrong sounds’, so that they may sometimes be unable to say a particular word but then at another time have no problem with it;

  • Being unable to say anything or make any coherent sound;

  • Being able to produce ‘automatic’ speech, for example, counting, nursery rhymes, or even swearing, but finding other speech hard;

  • Using odd rhythms or tonal changes in speech, so that the voice goes up and down in an unusual way. This can also make expressing emotions harder, because we often do that through changes in our voice or tone;

  • Finding longer or more complex words harder to say;

  • Moving the mouth or tongue as if searching for the right place to put them;

  • Getting stuck on a word or sound;

  • Muddling up speech sounds, so that speech sounds confused;

  • Using a lot of pauses or hesitations in speech; and

  • Speech taking a lot of effort, often looking like physical effort.

People with verbal dyspraxia may also have trouble coordinating the movements required to chew and swallow food or drink, or to blow out or suck in.

Like many other speech and language disorders, including stammering and cluttering, verbal dyspraxia may become worse when the person concerned is tired or under stress or pressure. It should also be clear that many of the symptoms show some overlaps with other speech and language conditions.

It is therefore important to seek professional help if you think you or your child may have verbal dyspraxia.



Treating Verbal Dyspraxia

Verbal dyspraxia can be treated using speech and language therapy.

It is a good idea to start speech therapy as early as possible, and it may need to continue for quite a long time. However, most people with verbal dyspraxia learn to speak relatively fluently, and only a few continue to need support into adulthood.

The speech therapist might focus on sound production, or they may work on finding other ways to communicate effectively. This might include learning to sign, or using communication aids such as those that are sometimes used by people with other conditions (for example, our page on dysarthria includes a case study of Professor Stephen Hawking, who used various speech aids over many years).

Communicating with People with Verbal Dyspraxia

It is important to remember that verbal dyspraxia is not a problem with either intelligence or understanding. However, it can still act as a barrier to effective communication. When communicating with someone with verbal dyspraxia, you may therefore wish to try some of these tips to improve communication:

  • Give them time to speak. As with someone who stammers, show that you’re interested in what they have to say by maintaining eye contact, and not being embarrassed if speaking takes them a while.

  • Look at them while they are talking. This will ensure that you pick up on their body language, including any gestures to communicate meaning.

  • Focus on the meaning of what is being said, not how it is being produced.

  • Choose a quiet environment, including turning off background noise like radios or television. It may also be helpful to sit or stand closer together, though this may not be everyone’s preference (and the section on proxemics in our page on body language explains more about this).

  • Ask questions that need shorter answers, including closed questions. It may also be helpful to use closed questions, reflecting and clarification as a way to check your understanding of their meaning.

  • If you are really struggling, ask questions to check your understanding, including to confirm the broad topic that they are talking about. It is always better to say that you have not understood than to pretend.

  • Try another method of communication. For example, it may be generally easier for someone with verbal dyspraxia to communicate in writing, or by email, rather than face-to-face or by telephone. This obviously will work better for adults and older children than very young children.

Help and Support


There is not a huge amount of information about verbal dyspraxia available, and very few specific charities or non-governmental organisations in this area.

However, you may find it helpful to visit the website of Apraxia Kids, the leading non-profit in this area, which runs an online community of over 60,000 parents and professionals.


A Final Thought

Like many other speech and language disorders, verbal dyspraxia can seem to create a substantial barrier to effective communication.

However, with good, consistent help and support, most children with verbal dyspraxia learn to communicate effectively. Those around them can also help them by adopting suitable communication strategies—because after all, communicating works both ways.


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