Apraxia Practice Principles

Apraxia is a motor speech problem where the is a disruption between what the brain is telling the mouth to do and what actually happens.  Children with apraxia have trouble controlling their muscles to make speech sounds.  Often what the way they say sounds and words is not consistent.  When working with children with apraxia it is important to follow the principles of motor learning: 

  • Do as many repetitions of the sound you are working on as possible.

  • More frequent shorter sessions are better than longer ones.

  • Provide feedback to exactly what he needs to do with his tongue, lips, etc. to make the sound correctly.  Don’t say “I heard a W instead of an R”.  Say “Bite your back teeth together and pull your tongue back.”

  • Once he is able to make a sound fairly well (can do it in words at least ½ the time when focused), change practice so you: 

  •  Don’t provide feedback every time – let him know how he did only 50 to  70% of the time.  Try having him flip a coin or roll a dice as a way to decide if feedback will be given.

  • Wait 3 seconds before providing the feedback.This has him self-evaluate more and helps with carryover.

  • Work on multiple sounds at the same time.  Don’t work on one sound until it is “fixed”.  

  • Provide variability.  Practice saying words different ways – soft, loud, sarcastic, joyful, angry, etc. When practicing sentences place emphasis on different words in the sentence, make some questions, exclamations, etc.  

  • If possible don’t break sounds apart to make them easier to say.  If you are working on R don’t say “R…ed”.  Instead stretch it out and slow it down to make it easier “Rrrrrreeed”.

  • In addition to working on other practice words, work on a small list of “Core” words – words that you practice every day.  Watch for these words when you see him outside of therapy.  Send this list home.  See separate sheet for more information on Core Words.


I hope these ideas help.  For more information on Apraxia I would suggest visiting Apraxia Kids.  This is a wonderful site with therapy guides for parents as well as for speech therapists along with tons of great information to help with this difficult problem.