What assessment strategy helps distinguish AOS from limb apraxia?

• A. Evaluate nonverbal oral movements exclusively
• B. Evaluate nonverbal oral movements and compare to speech tasks
• C. Focus only on limb movements
• D. Ignore nonverbal movements

Answer: (B)

Distinguishing AOS from limb apraxia comes down to seeing whether the motor planning problem is limited to speech or shows up in non-speech movements as well. The best approach is to evaluate nonverbal oral movements and compare how those movements perform to how speech is produced. In apraxia of speech, the challenge is in planning and sequencing the articulators for speech, so you often see distorted speech with groping, but non-speech oral movements can be relatively smooth and accurate. If nonverbal oral movements are good and speech is impaired, that pattern points to a speech-specific motor planning issue like AOS rather than a limb-based apraxia. If nonverbal oral movements themselves show apraxic errors or there are broader limb movement problems, that suggests a more general motor planning impairment or limb apraxia.