– an independent problem of auditory processing deficits
– general awareness of speech problems
– problems in volitional or spontaneous sequencing of movements required for speech with relatively unaffected automatic speech
– compensatory strategy of reduced rate in some but not all patients
– significant articulatory problems, diagnostic of AOS, such as frequent sound substitutions
– more pronounced difficulty with consonants than vowels; more severe problems with affricates and fricatives and consonant clusters; more frequent errors on infrequently occurring sounds
– anticipatory substitutions, e.g. lelo for yellow
– metathic errors (e.g. tefalone for telephone)
– increased frequency of errors on longer words
– trial and error groping and struggling, associated with speech attempts
– greater difficulty on word-initial sounds in some cases
– easier automatic productions than volitional/purposive productions
– attempts at self-correction, not always successful
– errors in prosody, such as slow speech rate, silent pauses between words, and impaired intonation


– lack of interest in human voices and a better response to environmental noises; a fascination with mechanical noises
– slow acquisition of speech sound production and language in general
– disinterest in interaction with others
– use of language in a meaningless, stereotypic manner including echolalia
– perseveration on certain words or phrases
– faster learning of concrete than abstract words, including more ready learning of words that refer to objects as opposed to emotions
– lack of generalization of word meanings
– lack of understanding of the relationships between words
– pronoun reversal (use of you for I and I for you; referring to self as she, him, or her)
– use of short, simple sentences; occasional use of incorrect word order
– omission of grammatic features such as plural inflections, conjunctions
– pragmatic problems such as lack of eye contact and lack of topic maintenance; reduced initiation or lack of assertiveness

(from An Advanced Review of Speech-Language Pathology, Celeste 
Roseberry-McKibben and M.N. Hedge; ProEd; 2000.)