What is Childhood Apraxia of Speech?

By AASLMay 6, 2021

Childhood Apraxia of Speech (CAS) is a motor speech disorder that initially becomes apparent when a child is learning how to talk.  Children with CAS have difficulty planning, coordinating, and producing the movements necessary to produce speech that is considered intelligible, that is, easily understood by those around them including both familiar (i.e. family) and unfamiliar (i.e. someone new)  listeners.  In order for speech to occur, the brain sends messages to your mouth, which tells the muscles of the tongue, lips, jaw, and palate how and when to move in the right ways.  This difficulty occurs despite not having weak muscles of the mouth.   Furthermore, children with CAS know what they want to say, however, the problem occurs in how the brain sends the signals for the muscles of the mouth to move.  Children with CAS do not learn speech sounds in the typical developmental sequence that other children learn and often require skilled therapy in order to make progress for their speech to improve.  

Signs and Symptoms
Children with CAS may show some or all of the signs listed below.  As with all children, not all children with CAS are the same and they develop differently!  If you have concerns you should talk to your doctor and seek getting an evaluation from a speech-language pathologist.  The most common signs and symptoms of CAS include: 

  • Unable to say words the same way every time resulting in inconsistent and unpredictable errors (i.e. dog> do, dod, gog)
  • Distorts or changes sounds in words across vowels and consonants  
  • Can say shorter words more clearly than longer words
  • Individual words are easier to understand than connected speech 
  • Groping aka “silent posturing” of the mouth when trying to get words out 
  • Disturbances in the prosody of speech (i.e. speaking rate, melody, intonation, voicing, pausing) across sounds and syllables in words
  • Puts stress on the wrong syllable or word

Children with CAS may have other difficulties, including:

  • Fine motor skills, having poor coordination, and low tone
  • Delayed language or a gap between what they understand (receptive language) and what they are able to communicate (expressive language ) 
  • Problems with reading, spelling, and writing

What Key Factors Should Speech Therapy Include? 

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