This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Is Down Syndrome Apraxia?
By Pam Marshalla
Q: Everyone seems to say that kids with Down Syndrome have apraxia. Is this right? Shouldn’t it be dysarthria?
Any client with a speech problem and neuromuscular disorder has dysarthria. Period. That is the very definition of dysarthria.
Dysarthria is a non-linguistic, neuromuscular disorder of expressive speech, characterized by impaired capacity to execute speech movements.
Dysarthria defines a group of motor speech disorders that includes clients with muscle tone disturbance–– Low tone, high tone, mixed tone, fluctuating tone;
It includes client with cerebral palsy, Down syndrome, cerebellar disorders, muscular dystrophy, Parkinson’s disease, multiple sclerosis, fetal alcohol syndrome, etc.
Many therapists and researchers in our field label Down syndrome as apraxia but this is not correct. Down syndrome is Dysarthria and Mental Retardation. (I know that MR is a politically incorrect phrase, but we need this term.)
Please see the other Q&A’s specific to Down syndrome in this blog for speech recommendations.
Good Textbooks on Dysarthria
- Darley, F. L., & Aronson, A. E., & Brown, J. R. (1975). Motor Speech Disorders
. Philadelphia: W. B. Saunders.
- Duffy, J. R. (1995). Motor Speech Disorders: Substrates, Differential Diagnosis, and Management
. St. Louis: Mosby.
- Yorkson, K. M., & Beukelman, D. R., & Strand, E. A., & Bell, K. R. (1999). Management of Motor Speech Disorders in Children and Adults
. Austin: Pro-Ed.
Is it possible that a Downs Syndrome child has BOTH dysarthria and apraxia? I work with a 15 year old Downs Syndrome girl and although she does demonstrate characteristics of dysarthria, I believe she also demonstrates difficulty with the motor planning and execution of sounds and sound sequences, which I thought was the hallmark of apraxia.
Yes, I think most therapists would say it is both.
I’m a bit appalled that you say “Down syndrome is” dysarthria and Mental Retardation.” I can’t believe a well respected SLP would say this. I am a fellow SLP and mother of a child with Down syndrome and this is unacceptable. Please change your terminology this is offensive.
I agree, the term ‘mental retardation’ is deeply offensive and inappropriate. I would be shocked to hear anyone use it, and particularly a speech and language therapist. I am also shocked by the author’s comment that she ‘does not care’. Disgraceful and shameful!
the author says, ‘we need the terminology ‘mental retardation?” maybe pam marshalla needs to go back to school. i wont return to this site again.
Goodness gracious, friends. This is a professional site and she is using professional terminology. Retardation simply means delayed. I have a son with Down syndrome (not Downs) and his learning is delayed. The term was not used derogatorily. She has some of the best information on helping your clients and your children with Down syndrome. It will be a loss for you and for them if you are offended unnecessarily.