Apraxia of speech exercises for adults

What apraxia of speech is

Acquired apraxia of speech is a difficulty planning and sequencing the movements needed to speak. It most often follows a stroke in the left side of the brain. The muscles themselves are not weak; the problem is in getting the right movements in the right order.

Signs include:

• Slow, effortful speech, with pauses between syllables
• Groping: visible searching movements of the lips and tongue before a sound
• Inconsistent errors, so the same word comes out differently on different tries
• Automatic phrases (“I don’t know”) coming out more easily than chosen words

It often occurs together with aphasia, which affects language, and sometimes with dysarthria, which is weakness or poor coordination of the speech muscles. A speech-language pathologist can tell which is which, and that matters, because the right practice is different for each.

How to practice at home

A 2015 systematic review of treatment research found the strongest support for approaches that work directly on the movements of speech, built on principles of motor learning: many repetitions, a slow rate, and a model to watch and copy. These steps follow those principles. If the person sees a speech-language pathologist, ask which steps and words to focus on.

1. 1. Start with automatic speech

   Counting from one to ten, the days of the week, the months, or a familiar song or prayer. These sequences are stored differently from new sentences and often come out more easily, which makes them a good warm-up and an early success.

2. 2. Watch, listen, and say it together

   Sit face to face. The helper says a word slowly and clearly while the person watches the mouth. Then they say it together, then the person says it alone. This "watch me, listen, say it with me" approach is called integral stimulation, and it is one of the core techniques for apraxia of speech.

3. 3. Keep the rate slow

   Slow, deliberate speech gives the brain time to plan each movement. Tapping a finger for each syllable can help keep the pace steady.

4. 4. Practice a small set many times

   Choose five to ten useful words and practice them many times each session rather than many different words once. When they come out reliably, add new ones.

5. 5. Build from sounds to words to phrases

   If particular sounds are hard, a speech-language pathologist may work on them directly, an approach called sound production treatment. At home, move from single words to two-word phrases ("good morning", "thank you") and then to short sentences.

6. 6. Practice personal scripts

   A script is a few sentences the person needs in daily life: name, address, phone number, a coffee order, "I had a stroke, please be patient." Practicing the same script every day until it comes out smoothly is useful in real situations.

Tips for helpers

• Keep sessions short: ten to fifteen minutes, once or twice a day. Speech practice is physically tiring.
• Stop a word after a few failed tries. Go back to a word that works, then try again later. Repeated failures practice the wrong movements.
• Do not finish words too quickly. Give time for the person to plan, but offer the model again if they are stuck.
• Celebrate smooth attempts, not just correct ones. Easier, steadier speech is real progress.

A word about speech recognition

Apps that listen and score spoken answers are often unreliable for apraxia of speech. Because errors are inconsistent, a recognizer may reject an attempt that a listener would accept, and that can be discouraging. Practice that relies on watching, listening, and repeating does not have this problem. Our guide to speech recognition in aphasia therapy explains where recognition works and where it does not.

Where Parrot Software fits

Parrot Software is mainly built for aphasia, but a few of its 94 programs are useful for apraxia of speech practice:

• Melodic Intonation, which uses rhythm and melody to support phrases
• Mastering Personal Information, for practicing name, address, and other personal facts
• Say a Sentence, for practicing short sentences
• Record Words, for naming pictures aloud, listening back to the recording, and comparing it with the correct pronunciation
• Help with Speech Recognition, a short practice lesson for getting used to speaking to the microphone

Software does not replace a model to watch face to face, and a speech-language pathologist should guide treatment for apraxia of speech. The first week of Parrot Software is free, with no credit card, which is enough time to see whether these programs suit a particular person.

Common questions

What is the difference between apraxia of speech, aphasia and dysarthria?

Aphasia is a language problem: finding, understanding, and putting words together. Apraxia of speech is a problem planning and sequencing the movements for speech, even though the person knows exactly what they want to say. Dysarthria is weakness or poor coordination of the speech muscles themselves. After a stroke, a person can have one, two, or all three.

What exercises help apraxia of speech in adults?

The approaches with the most research support focus on practicing the movements of speech: watching and listening to a model, saying the word with the helper, then alone, with many repetitions at a slow rate. Practice often starts with automatic speech such as counting or the days of the week, then moves to words, phrases, and short personal scripts.

How many repetitions are enough?

Many. Motor learning depends on a large number of correct attempts, so practice sessions for apraxia of speech usually include dozens of repetitions of a small set of words or phrases. Short daily sessions work better than occasional long ones.

Does speech recognition software work for apraxia of speech?

Often not well. Apraxia of speech produces inconsistent errors, so the same word may come out differently each time, and speech recognizers handle that poorly. Expect correct attempts to be rejected sometimes. Practice that relies on listening, watching, and repeating does not depend on a recognizer at all.

Can apraxia of speech improve?

Yes. Acquired apraxia of speech after a stroke often improves, especially with regular, structured practice guided by a speech-language pathologist. How much it improves varies from person to person.