Which term describes a neurological speech sound disorder in which precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits?

• A. Dysarthria
• B. Aphasia
• C. Childhood Apraxia of Speech
• D. Phonological Disorder

Answer: (C)

This question is about distinguishing a motor planning/programming issue from other speech and language problems. The key idea is that the movements that produce speech are intended and sequenced correctly, but the planning or programming of those movements is impaired, even though the muscles themselves are capable and there isn’t a neuromuscular deficit.

The best term is Childhood Apraxia of Speech. It describes a neurological speech sound disorder where the brain struggles to plan and sequence the rapid, precise movements of the lips, tongue, and voice needed for clear speech. Because the muscles are not weak or damaged, there isn’t a neuromuscular deficit; instead, the difficulty lies in coordinating the motor plans for speech, leading to inconsistent errors, groping, and difficulties with rhythm and prosody as syllables and sequences become hard to program.

Dysarthria would involve neuromuscular weakness, slowness, or incoordination affecting all or most speech movements, so the problem is the muscles themselves rather than the planning. Aphasia is a language disorder that affects understanding and/or formulation of language, not the motor planning of speech sounds. A phonological disorder involves errors that reflect the internal sound system or rules, not a motor planning problem.