Excerpted from "Aphasia v. Apraxia," Stroke Connection Magazine September/October 2003 (Science update August 2009)
Communication disorders that can appear following stroke or other brain injury include aphasia, apraxia of speech and oral apraxia. At times, it may be difficult to identify which of these conditions a survivor is dealing with, particularly since it is possible for all three to be present at the same time.
Aphasia is impairment in the ability to use or comprehend words.
It may cause difficulty:
- Understanding words.
- Finding the word to express a thought.
- Understanding grammatical sentences.
- Reading or writing words or sentences.
Therapy approaches for aphasia:
| Restoring language ability | Understanding spoken language Example: Word/picture matching |
| Stimulating word finding Example: Identify features of a target word to cue its name (i.e., size or shape) | |
| Learning compensating communication methods | Using writing or gestures |
| Training conversation partners so they may adjust the way they communicate with persons with aphasia |
Apraxia of speech (verbal apraxia) is difficulty initiating and executing voluntary movement patterns necessary to produce speech when there is no paralysis or weakness of speech muscles.
It may cause difficulty:
- Producing the desired speech sound.
- Using the correct rhythm and rate of speaking.
Therapy approaches:
| Teaching sound production | Repeating words |
| Instruction on placement of oral structures | |
| Teaching rhythm and rate | Using a metronome or finger-snapping to keep time |
| Prolonging duration of sentences | |
| Providing an alternative or augmentative communication system that requires little or no speaking | Low-tech system – Paper and pencil |
| High-tech system – Computer program that produces voice output at keystroke |
Oral apraxia, also referred to as nonverbal oral apraxia, is difficulty voluntarily moving the muscles of the lips, throat, soft palate and tongue for purposes other than speech, such as smiling or whistling. It may be difficult to carry out commands such as blowing a kiss, opening the mouth or puffing the cheeks. Because oral apraxia doesn’t affect speech or swallowing, it may not be treated by a speech-language pathologist.
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