Apraxia of Speech in Children (CAS)
A Guide for Parents
What is Childhood Apraxia of Speech?
Childhood apraxia of speech (CAS) is a neurological disorder that affects a child’s ability to speak. Children with CAS have difficulty coordinating the complex movements of their lips, tongue, and jaw, which makes it difficult for them to produce clear and understandable speech.
Even though children with CAS have a good understanding of language and know what they want to say, they may struggle to say it. They may make errors in the order of sounds, or they may leave out sounds altogether. They may also have difficulty saying long or complex words.
CAS is not a speech delay or a learning disability. It is a motor speech disorder that requires specialized treatment from a speech-language pathologist. With early intervention, children with CAS can learn to improve their speech and communication skills.
What Causes Apraxia of Speech?
The exact cause of apraxia of speech is still unknown. However, it is believed to be a neurological condition, meaning it is related to how the brain functions. Some children may develop apraxia of speech due to genetic factors or as a result of certain neurological conditions, such as cerebral palsy or genetic disorders like Down syndrome.
Signs and Symptoms of Apraxia of Speech:
Apraxia of speech can manifest differently in each child.
Some common signs and symptoms to watch for include:
- Inconsistent speech: Your child’s ability to produce sounds, syllables, or words may vary from one attempt to another. They may say a word correctly one day but struggle to say it the next.
- Difficulty with complex words: Your child may find it challenging to pronounce longer or more complex words. They might simplify or omit certain sounds or syllables.
- Ineffortful groping: You might notice your child making unusual facial or oral movements when attempting to speak. This can include groping or struggling to find the right position for their articulators.
- Slow rate of speech: Children with apraxia of speech often speak at a slower rate compared to their peers. They may pause frequently, searching for the correct sounds or words.
- Language development delay: Apraxia of speech can also impact a child’s overall language development. Your child might have difficulty combining words into sentences or expressing themselves effectively.
The American Speech-Language-Hearing Association (ASHA) published the following 10 early signs and symptoms of childhood apraxia of speech (source):
- Limited babbling, or variation within babbling
- Limited phonetic diversity
- Inconsistent errors
- Increased errors or difficulty with longer or more complex syllable and word shapes
- Omissions, particularly in word initial syllable shapes
- Vowel errors/distortions
- Excessive, equal stress
- Loss of previously produced words
- More difficulty with volitional versus automatic speech responses
- Predominant use of simple syllable shapes
What is the Difference Between CAS and a Speech Delay?
Children with a developmental delay in speech will follow the same general path of speech development as other children, but they will do so at a slower pace. Children with apraxia of speech, on the other hand, are on a different path altogether. They have difficulty planning and executing the complex movements required for speech, which can lead to inconsistent errors and difficulty making smooth transitions between sounds and syllables. This can make it difficult for them to produce clear and understandable speech.
Supporting Your Child
- Early intervention: If you suspect that your child may have apraxia of speech, seek an evaluation from a speech-language pathologist (SLP). Early diagnosis and intervention can greatly improve outcomes. You can schedule a free consult with a speech-language pathologist here.
- Speech therapy: Working with an experienced SLP is crucial. The SLP will design a customized therapy plan to help your child improve their speech production skills and overall communication abilities.
- Practice at home: Consistency is key! Your child’s SLP will likely provide you with exercises and strategies to practice at home. Regular practice in a supportive environment can reinforce the progress made during therapy sessions.
- Encourage non-verbal communication: While your child works on their speech skills, encourage alternative forms of communication, such as gestures, sign language, or visual aids. This can help reduce frustration and enhance overall communication.
- Create a positive environment: Patience, understanding, and positive reinforcement are essential. Celebrate your child’s efforts and successes, even if they are small steps forward. Building their confidence and self-esteem is crucial for their progress.
Will My Child Ever Speak Normally?
The journey of a child with childhood apraxia of speech (CAS) through therapy is influenced by many factors, such as the severity of the disorder, the presence of other disorders (such as autism), and the frequency of therapy. However, professional articles and experienced speech-language pathologists (SLPs) report that most children with CAS can achieve optimal verbal communication to some degree with the right help.