Apraxia vs. Phonological Disorder: How can I tell the difference?

“Help! My child has a lot to say, but only his father and I can understand him. What’s wrong with his speech?”

“My three-year old understands everything we say, but she rarely makes any sounds at all! What’s going on?”

Pediatric speech-language pathologists spend a lot of time working with families who have these same questions. The answer to these questions is likely that your child has a phonological disorder or a motor speech disorder. But, what’s the difference between the two? Read on.

Phonology is the sound system of a language. Oftentimes, as a kiddo’s speech is beginning to develop, they will use a series of phonological processes to simplify word production. These kiddos may consistently substitute one sound for another, they might make all the sounds in their words the same, or they might delete certain sounds and/or syllables in a word. These speech sound substitutions are tricky because they can often result in significantly decreased intelligibility. For example, a child with a phonological disorder might consistently substitute his “t” sound for a “k” sound. So, “cat” becomes “cack.”

Unlike phonological-based disorders, childhood apraxia of speech is a motor speech disorder. This means that a child is having difficulties transmitting a speech signal from their brain to their mouths. A child who is diagnosed with apraxia of speech may produce frequent vowel distortions, speech sound distortions, and inconsistent productions of the same speech sound. Speech production for these children can additionally be characterized at perseverative and effortful.

Diagnoses of either a phonological disorder or a motor speech disorder should only be made by a speech-language pathologist. If you have concerns regarding your child’s speech sound development, please contact PlayWorks Therapy, Inc. for a comprehensive speech-language evaluation.

Julie Euyoque MA CCC-SLP
Speech-Language Pathologist