Fluent apraxia?

The purpose of this blog is to reflect on aphasia, aphasia therapy and the brain. I hope that this blog will stimulate conversation about aphasia - especially among people who experience aphasia on a daily basis. Whether you are a survivor, a co-communicator, or a professional, you have important insights to share with others!

A "Fluent apraxia"?

Recently I met two people with aphasia who did not fit into the usual traditional categories of aphasia They both had good comprehension. Their speech was worse when they were saying a longer word, or a word they didn't use very often. They were very aware of their errors. So far it sounds like apraxia.

However, they had fluent speech with many phonemic paraphasias. In other words, the nonsense words sounded similar to the real word they were trying to say. Repetition was just as affected as spontaneous speech. One person found that if she spoke slowly, her speech was better. These symptoms sound like fluent aphasia.

Theoretically, I wonder if this problem is on the border of speech and language, at the level of phonemic sequencing. There is a theory that we first decide what we want to say, then we sequence the phonemes (sounds) that we need to produce to express the sentence, and then send instructions to the muscles to produce the sounds. Apraxia means there is a problem with sending the instructions to the muscles. Is there a name for the problem that only involves sequencing the phonemes?