<p>There appear to be more than your two basic problems: see <a href="http://en.wikipedia.org/wiki/Apraxia_of_speech#Characteristics" rel="nofollow">Wikipedia's list of characteristics</a>. Subjective difficulty in producing speech appears to be one particularly plausible reason to self-initiate treatment.</p>

<ol>
<li>I don't see any indication of a lack of concern for how speech is received by others.</li>
<li><p><a href="http://en.wikipedia.org/wiki/Apraxia_of_speech#Progressive_apraxia_of_speech" rel="nofollow">Some forms seem to be progressive</a>, but <a href="http://en.wikipedia.org/wiki/Apraxia_of_speech#Acute_apraxia_of_speech" rel="nofollow">not all are</a>:</p>

<blockquote>
  <p>Recent research has established the existence of primary progressive apraxia of speech caused by neuroanatomic motor atrophy.<sup>[19][<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338923/" rel="nofollow">20</a>]</sup></p>
</blockquote>

<p>By comparison, stroke can introduce acute apraxia of speech that can (rarely) improve over time.</p></li>
<li>I wouldn't say "unacceptable", but <em>undesirable</em> seems true enough in general. Plenty of variation in rate of speech is normal and acceptable, but extremely slow speech can be grating. Tonal variation is expected in most languages with which I'm at all familiar, but again, most people probably understand that some people will be more or less monotone. Again, extreme monotonicity will tend to violate expectations and raise complaints, because variations in pitch and emphasis carry useful semantic information in normal speech. Personally, I've been criticized for speaking in monotone at many times in my life, but never for having too wildly fluctuating intonation, even though I've tried to exaggerate this quality somewhat compensatorily. Yet as with all anecdotes, your mileage may vary.</li>
</ol>

<hr>

<p><sup><strong>References</strong><br>
19. Josephs, K. A., &amp; Duffy, J. R. (2008). Apraxia of speech and nonfluent aphasia: A new clinical marker for corticobasal degeneration and progressive supranuclear palsy. <em>Current Opinion in Neurology, 21</em>(6), 688–692.<br>
20. Josephs, K. A., Duffy, J. R., Strand, E. A., Machulda, M. M., Senjem, M. L., Master, A. V., Lowe, V. J., Jack, C. R. Jr., &amp; Whitwell, J. L. (2012). Characterizing a neurodegenerative syndrome: Primary progressive apraxia of speech. <em>Brain, 135</em>(5), 1522–1536. Retrieved from <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338923/" rel="nofollow">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338923/</a>.</sup></p>

CC BY-SA 3.0
2014-04-28T21:06:44.630Z
I noticed wiki does not mention one possible cause. Sometimes one immediately knows the important words: nouns / verbs / adjectives / adverbs. But he needs time to sequence and add the lesser important words. His speaking quickly creates a spaghetti salad of words. The guy will stop and redo the whole sentence very slooowly.
shinmai_psb
CC BY-SA 3.0
2014-04-28T21:11:32.963Z
It mentions several possible causes. Are you only interested in speech apraxia of a particular origin?
Nick Stauner
CC BY-SA 3.0
2014-04-28T21:31:59.053Z
sure... areas of interest: (1) the occipital lobe, (2) major concussion (left forehead hit concrete at 15-mph; no helmet;). How might one, the other, or a combination of both effect facial muscles / pronunciation / word ordering while speaking. Those topics interest me. thanks.
shinmai_psb
CC BY-SA 3.0
2014-04-28T21:43:28.623Z
Sounds like you might want to ask a new question or two. Some of those details could be [edited](http://cogsci.stackexchange.com/posts/6332/edit) into this question, but it might be better to separate other aspects you want to focus on and give them their own question.
Nick Stauner
CC BY-SA 3.0
2014-04-28T23:20:39.977Z
Well, like I said, what difference is slow / monotonous speech? But, I've always been curious about why the concussion started all this trouble. As the clavicle, which broke, surely absorbed most of the impact, I'm sure the concussion was at not 15-mph but still should've been wearing bike helmet.
shinmai_psb
CC BY-SA 3.0
2014-04-28T20:09:39.933Z
2014-04-28T20:16:09.573Z
2014-04-28T20:16:09.573Z
Nick Stauner
<p>People with Apraxia of speech have two basic problems: monotone pronunciation and slow speech.  </p>

<p>(<strong>1</strong>) Might someone with Apraxia of speech who does not seek treatment have psychological problems? They just don't care about not talking with people who don't want to wait and listen to their thoughts. Is that arrogance? low self-esteem? severely anti-social?</p>

<p>(<strong>2</strong>) Is Apraxia of speech degenerative? Without treatment, speaking will become more, and more, difficult?</p>

<p>(<strong>3</strong>) Is it socially unacceptable to speak slowly with a monotone pronunciation?</p>

<social-psychology><linguistics><neurology>
Why would someone seek treatment for Apraxia of speech?
shinmai_psb
# Why would someone seek treatment for Apraxia of speech?

(Asked by: username_0 on 2014-04-28)

People with Apraxia of speech have two basic problems: monotone pronunciation and slow speech.

(**1**) Might someone with Apraxia of speech who does not seek treatment have psychological problems? They just don't care about not talking with people who don't want to wait and listen to their thoughts. Is that arrogance? low self-esteem? severely anti-social?

(**2**) Is Apraxia of speech degenerative? Without treatment, speaking will become more, and more, difficult?

(**3**) Is it socially unacceptable to speak slowly with a monotone pronunciation?

**Tags:** social-psychology, linguistics, neurology


---

## 1 answers

### Answer by username_1 on 2014-04-28. Score: 2 | Accepted answer

There appear to be more than your two basic problems: see [Wikipedia's list of characteristics](http://en.wikipedia.org/wiki/Apraxia_of_speech#Characteristics). Subjective difficulty in producing speech appears to be one particularly plausible reason to self-initiate treatment.

1. I don't see any indication of a lack of concern for how speech is received by others.
2. [Some forms seem to be progressive](http://en.wikipedia.org/wiki/Apraxia_of_speech#Progressive_apraxia_of_speech), but [not all are](http://en.wikipedia.org/wiki/Apraxia_of_speech#Acute_apraxia_of_speech):

   > Recent research has established the existence of primary progressive apraxia of speech caused by neuroanatomic motor atrophy.[19][[20](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338923/)]

   By comparison, stroke can introduce acute apraxia of speech that can (rarely) improve over time.
3. I wouldn't say "unacceptable", but *undesirable* seems true enough in general. Plenty of variation in rate of speech is normal and acceptable, but extremely slow speech can be grating. Tonal variation is expected in most languages with which I'm at all familiar, but again, most people probably understand that some people will be more or less monotone. Again, extreme monotonicity will tend to violate expectations and raise complaints, because variations in pitch and emphasis carry useful semantic information in normal speech. Personally, I've been criticized for speaking in monotone at many times in my life, but never for having too wildly fluctuating intonation, even though I've tried to exaggerate this quality somewhat compensatorily. Yet as with all anecdotes, your mileage may vary.

---

**References**  
19. Josephs, K. A., & Duffy, J. R. (2008). Apraxia of speech and nonfluent aphasia: A new clinical marker for corticobasal degeneration and progressive supranuclear palsy. *Current Opinion in Neurology, 21*(6), 688–692.  
20. Josephs, K. A., Duffy, J. R., Strand, E. A., Machulda, M. M., Senjem, M. L., Master, A. V., Lowe, V. J., Jack, C. R. Jr., & Whitwell, J. L. (2012). Characterizing a neurodegenerative syndrome: Primary progressive apraxia of speech. *Brain, 135*(5), 1522–1536. Retrieved from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338923/>.

> **Comments:**
> **username_0**: I noticed wiki does not mention one possible cause. Sometimes one immediately knows the important words: nouns / verbs / adjectives / adverbs. But he needs time to sequence and add the lesser important words. His speaking quickly creates a spaghetti salad of words. The guy will stop and redo the whole sentence very slooowly.  
> **username_1**: It mentions several possible causes. Are you only interested in speech apraxia of a particular origin?  
> **username_0**: sure... areas of interest: (1) the occipital lobe, (2) major concussion (left forehead hit concrete at 15-mph; no helmet;). How might one, the other, or a combination of both effect facial muscles / pronunciation / word ordering while speaking. Those topics interest me. thanks.  
> **username_1**: Sounds like you might want to ask a new question or two. Some of those details could be [edited](http://cogsci.stackexchange.com/posts/6332/edit) into this question, but it might be better to separate other aspects you want to focus on and give them their own question.  
> **username_0**: Well, like I said, what difference is slow / monotonous speech? But, I've always been curious about why the concussion started all this trouble. As the clavicle, which broke, surely absorbed most of the impact, I'm sure the concussion was at not 15-mph but still should've been wearing bike helmet.  

---

