There are basically two different types of apraxia. One is "limb apraxia" which affects the arms and legs and the other is "oral apraxia" which affects the verbalizations one makes. Being a speech/language pathologist, I know a lot more about the oral type, but often times, limb apraxia symptoms are somewhat similar. Both types affect one's ability to plan out a motor task, such as walking, talking, throwing, aiming, etc. My article will focus more on the oral type.
Apraxia of speech is not very difficult to diagnose. Often times it stands out like a sore thumb. It involves difficulty in getting the muscles of the mouth and face to do what you want them to, when you want them to. I can give an example to make it easier to understand: A young child is referred for speech therapy because she is not talking and she is four. She says the same two words or phrases over and over again fluently but everything else she says is totally unintelligible. These pat phrases are the only way she can communicate a real word at all. The therapist plays all kinds of games with her to see if she can imitate different oral movements and speech sounds such as sticking out her tongue, puffing out her cheeks, biting her lower lip in an attempt to make an /f/ sound, producing different sounds in the environment we hear like a fire truck siren, sounds in the alphabet, etc. When she tries to converse, certain sounds are easier for her than others. Usually these are the earlier developing ones like /b/, /p/, /m/. Imitating is easier for her than producing spontaneous utterances. As a matter of fact, she can usually pronounce the sound (environmental or speech) by itself fairly well, but the minute the therapist adds other sounds or makes a full word, the child becomes totally difficult to understand again. Adding some visual work with a mirror when speaking helps a little, as do physical cues such as touching the lower lip for the /f/ sound but as soon as the mirror or physical cue is taken away so go the correct postures of the tongue and lips for the sound. She is back at square one it seems unless her parents and caregivers practice using the cues that helped her during therapy. Then on her way out the door from the session, she uses one of her automatic, pat, over-learned phrases clear as a bell. She says the same few words over and over again like they are all new and different words that tell her parents all about what she did in therapy.
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