Apraxia of Speech Exam Questions

Define apraxia of speech. 

"Neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech"

What are the 5 salient features of Apraxia of Speech?

1. Articulatory groping

2. Distorted substitutions

3. Automatic easier than volitional speech

4. Inconsistent articulatory errors

5. Increased errors with increased length and complexity

Define Articulatory groping

A physical behavior where a person tries to speak, but their mouth, lips, tongue, or jaw move excessively or pause as they struggle to find and set the correct position to make a sound.

Example: Observations

Define distorted substitutions

Occurs when a person tries to say a sound, but the output is not quite right or slightly altered, making it different from both the target sound and any standard substitute sound.

Example: “Puh-Tah-Kah”

Define automatic easier than volitional speech

Overlearned, habitual phrases like “hello” or “how are you” bypass the brain’s impaired conscious motor-planning pathways. They rely instead on subcortical neural circuits that store familiar, automatic motor sequences.

Volitional speech is voluntary speech like answering a direct question, naming an object, or making a statement in a deeper conversational context.

Ex: Cat vs. Catastrophic

Define inconsistent articulatory errors

A person says the same word differently each time they try.

Ex: The word is Umbrella: /sumbrella/, /unbress/, and /umgella/

Define increased errors with increase length and complexity

A person makes more mistakes as words get longer or sentences get harder to plan.

Ex: Cat vs. Catastrophic

List the eight confirmatory signs

1. Aphasia

2. Dysarthria

3. Nonverbal oral apraxia

4. Apraxia of swallowing

5. Limb apraxia

6. Hemiparesis

7. Hemiparalysis

8. Hemi-spasticity

Define Aphasia

Aphasia is a disorder that results from damage (usually from a stroke or TBI) to areas of the brain that are responsible for language. Aphasia impairs the expression and understanding of language, as well as reading and writing.

Define Dysarthria

Dysarthria is a motor speech disorder caused by brain or nerve damage that weakens or paralyzes the muscles of the mouth, face, and respiratory system. It results in slurred, slow, or hard-to-understand speech, though a person’s ability to understand language and know what to say remains intact.

Define nonverbal oral apraxia

Nonverbal oral apraxia is a motor planning disorder that makes it hard for a person to move their lips, tongue, cheeks, or jaw on purpose. There is no muscle weakness, but the brain struggles to plan and send the right steps for non-speech actions.

Define apraxia of swallowing

Apraxia of swallowing is a neurological motor-planning disorder. It impairs the brain’s ability to coordinate the voluntary mouth and tongue movements needed to start the oral phase of swallowing. This happens even though the muscles are not weak.

Define limb apraxia

Limp apraxia is a brain disorder that stops a person from doing skilled, purposeful body movements. This happens even though the person has normal muscle strength, normal feeling, and the desire to move. It usually comes from damage to the left side of the brain, often due to a stroke, head injury, or brain disease.

Define hemiparesis

Hemiparesis is muscle weakness or reduced control affecting just one side of the body. The person can still move the affected limbs, but they feel very weak or clumsy.

Define hemiparalysis

Hemiparalysis is the total or partial loss of muscle function and movement on one single, vertical half of the body (left or right side). It is caused by damage to the brain or spinal cord, most frequently due to a stroke, brain injury, or tumor.

Define hemi-spasticity

Hemi-spasticity is an abnormal, one-sided muscle stiffness and high muscle tone affecting the articulators (like the tongue, lips, or jaw) and vocal folds.

List the five most common causes of Apraxia of Speech

1. Stroke

2. Traumatic Brain Injury (TBI)

3. Tumor

4. Surgical Trauma (e.g. tumor resection)

5. Progressive Disease

What is the most common cause of Apraxia of Speech?

Stoke

What two locations have been implicated as the neuroanatomical correlates for apraxia of speech?

• The Left Insula

• Broca’s Area