What's the Difference Between Apraxia and a Phonological Disorder?

Diagnosing speech disorders in children can be incredibly difficult. One reason why is that kids don’t develop uniformly, and some children’s speech development may lag behind others. They may just need time instead of a therapist.

Another reason is that there are many different types of speech disorders. Each one requires different methods of correcting.

A recent 2015 study found that about 1 in 12 children has a disorder related to voice, speech, language or swallowing. The disorders among these children vary. Two of the biggest disorders are CAS, or Childhood Apraxia of Speech, and phonological disorders.

To get the right help for your child, you’ll need to determine which disorder your child has. Below we’ll break down both types of disorders and explain their differences. You can also schedule a free introductory call to get matched with a speech language therapist on our team that specializes in childhood apraxia of speech and speech disorders. 

What is Childhood Apraxia of Speech?

Childhood Apraxia of Speech is an entirely neurological disorder. It prevents your child from making accurate movements with their mouth or throat when speaking.

With Childhood Apraxia of Speech, your child’s brain struggles to make plans for speech when your child wants to talk. Your child’s speech muscles aren’t necessarily weak. They simply can’t cooperate properly because the brain can’t coordinate the movements.

This isn’t to say it’s impossible for your child to speak. They just have to make a concerted effort to tell their brain how to organize the movements of their mouth, jaw, and tongue to produce accurate sounds. With speech therapy, this process can become easier.

Symptoms of Childhood Apraxia of Speech

The symptoms of CAS can vary and are difficult to spot. CAS can often be connected to the delayed onset of first words, or the ability to only pronounce a few consonant or vowel sounds. These symptoms are noticed between 18 months and two years of age.

Other symptoms include speech characteristics, generally referred to as markers, that accompany CAS. These markers include:

• Trouble moving from one sound or syllable to another
• Incorrect pronunciation of vowels
• Placing a pause or gap between syllables
• Placing equal emphasis on syllables of words
• An inconsistency of errors; like making different mistakes when pronouncing the same word several times
• Abnormal movement of the mouth or jaw when trying to speak

Causes of Childhood Apraxia of Speech

There are many possible causes of CAS, but in many cases, the cause cannot be determined.

Since it is a neurological disorder, CAS can come as the result of traumatic brain injuries, such as strokes, infections, and concussions.

CAS is also widely considered to be genetically inherited. It occurs more frequently in children that also have galactosemia, a disorder that prevents children from properly metabolizing the sugar galactose.

What Is a Phonological Disorder?

A phonological disorder is a disorder in which a child has trouble grasping the speech rules of a given language as well as the sounds the differentiate words.

Simply put, your child may not be able to recognize the pattern of sounds that accompany certain letters or combinations of letters that other kids can usually intuit.

For example, your child may pronounce the ‘s’ sound in “bus” correctly but will pronounce the ‘s’ sound in “sock” like “shock” or vice versa.

This type of disorder is often broader in scope than something like CAS. It often requires more intensive coaching by a speech therapist.

Symptoms of Phonological Disorders

A phonological disorder can be especially tricky to spot. This is because kids are supposed to say words wrong. It is completely normal for your child to pronounce drop the ‘r’ at the end of “car,” for example.

But if your child continues to make these mistakes later in life, he or she may have this disorder.

If you suspect your child may have these speech problems, you should consult a speech-language pathologist (SLP). If untreated, it can lead to reading, spelling, and other difficulties later in life.

Causes of Phonological Disorders

Like with CAS, the causes of these disorders are largely unknown or hard to pinpoint. But, phonological disorders are linked to other developmental disorders like autism and genetic disorders like Down Syndrome.

Brain damage from concussions or infections, as well as hearing loss, can also contribute to these disorders.

The Differences Between CAS and Phonological Disorders

Both CAS and phonological disorders fall under a greater umbrella known as Speech-Sound Disorders. Within this group are two smaller subgroups. These are articulation disorders and phonemic disorders.

With an articulation disorder, your child has no problem understanding what sounds need to be made when he looks at his words, he simply doesn’t have the muscle-mind connection to effectively produce the correct sounds.

CAS, then, falls under this category. In speech therapy, this disorder is treated simply by practicing the production of the correct sounds until it becomes second nature.

The second category, phonemic disorders, can be used interchangeably with phonological disorders. They are synonyms that refer to your child’s difficult understanding the sound system of a given language.

With your a phonological or phonemic disorder, your child has no difficulty making a variety of sounds. They just cannot yet discern when to make what sound.

For some children, the disconnection between the word and the sound comes as a result of your child’s inability to hear the distinctions between phonemes, or syllables, in his own speech. This is known as the “fis phenomenon,” where your child can hear someone say “fish” correctly, but say “fis” instead, unable to recognize that they’ve made an error.

Speech challenges such as childhood apraxia of speech and phonological disorders are serious, and if a thorough speech therapy plan is not followed, they can become worse and even effect academic success. Schedule a free introductory call with Great Speech today, and we’ll make sure your child or teen makes consistent progress towards their goal of clearer speech.

The Bottom Line

Simply put, childhood apraxia of speech is a type of articulation disorder that makes your child say words incorrectly as a result of poor motor function. Phonemic disorders, on the other hand, are an entire branch of speech disorders that relate to your child’s inability to understand where and when to make certain sounds when speaking a language.

If you think your child has either disorder and needs to see a speech-language pathologist, consider scheduling an introductory call to see if our virtual program could be a good fit for your child. Whatever your needs are, Great Speech will be with you every step of the way. Click here to schedule a free introductory call to get matched with a specialized online speech pathologist on our team, and begin your journey to better communication!