To Lump or to Split? Possible Subtypes of Apraxia of Speech.

BACKGROUND: The speculation that apraxia of speech (AOS) is not a unitary diagnosis, but consists of different subtypes instead, has been around for decades. However, attempts to empirically substantiate such a notion remain few and far between. AIMS: The primary objective of this article is to consider the different bases for identifying subtypes of AOS, review existing evidence regarding subtypes under each classification basis, and provide discussion and implications for future research. MAIN CONTRIBUTION: AOS subtypes have been proposed on the basis of clinical symptomatology, theoretical constructs, and an analogy to limb apraxia. Different possible subtypes of AOS are reviewed, along with their empirical support and limitations. Empirical evidence, particularly in the context of a progressive disease, supports the idea that AOS diagnosis may capture different underlying impairments of speech motor planning. Future research to advance our understanding of AOS should carefully consider the basis for subtype classification, and include large sample sizes to differentiate individual variability from possible subtypes.
CONCLUSIONS: Several proposed AOS subtypes have found some support in the literature. Further research is needed to determine the validity, coherence and utility of possible AOS subtypes for theoretical and clinical purposes.