To Lump or to Split? Possible Subtypes of Apraxia of Speech.
Marja-Liisa Mailend, Edwin Maas
PMID 33981126WHAT IT FOUND
The evidence does not settle whether apraxia of speech is a uniform motor planning problem.
Phonetic and prosodic subtypes have some support in progressive forms, but are not established for stroke-based apraxia of speech.
Key findings
01The strongest support for subtypes of apraxia of speech comes from progressive forms, where phonetic and prosodic presentations can be distinguished, though not all people fit a clear subtype.
02Whether the phonetic and prosodic classification holds for stroke-based apraxia of speech remains to be tested.
03Theory-driven studies suggest that people diagnosed with apraxia of speech may not all have the same speech motor planning impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review, so it does not test whether subtypes exist or whether subtype-guided treatment helps. The phonetic and prosodic subtype evidence comes mainly from progressive apraxia of speech, and its use in stroke-based apraxia of speech is uncertain. Not all people with apraxia of speech fit clearly into the proposed subtypes, and some reviewed samples had limited participant counts. Current diagnostic criteria may affect subtype detection, because normal speech rate and normal prosody are exclusionary criteria.
The easy way to misread this
Do not read the phonetic and prosodic distinction as an established way to choose therapy for patients with apraxia of speech. The review says this classification is most supported in progressive apraxia of speech and remains to be tested in stroke-based apraxia of speech.