Childhood Apraxia of Speech (CAS)

A child with apraxia of speech knows what they want to say, but the words do not come out clearly correctly. Sometimes, the child has difficulties producing any words at all. The child might struggle to move their lips or tongue correctly, even though the muscles are not weak. The issue lies not in the child’s thoughts but in how the brain directs the mouth muscles to move.

Here are some common signs that a child may have CAS:

Early Signs

1. Minimal babbling or cooing as an infant.
2. Late appearance of first words, and they may be missing sounds.
3. Using only a few different consonant and vowel sounds as toddlers.

Speech Characteristics

1. Inconsistent errors on consonants and vowels in repeated productions of syllables or words. Children may say the same word a bit differently each time they say it.
2. Struggling to make movements needed for speech, especially when “put on the spot” to do so.
3. Visible searching or groping for the correct position of the mouth when attempting to produce sounds.
4. Difficulty imitating speech sounds, even if they can produce them spontaneously.
5. Distortions of vowel sounds, which is less common in other speech disorders.
6. Difficulty with Sequencing Sounds: Trouble putting sounds together in the correct order to form words.

Speech Patterns

1. Abnormal rhythm, stress, and intonation of speech (e.g., equal stress on all syllables, resulting in a monotone speech quality).
2. Limited vocabulary and fewer spoken words compared to peers.
3. More errors when attempting longer words or phrases compared to shorter ones.

Developmental Concerns

1. Overall delay in speech development and acquisition of language skills.
2. High levels of frustration due to difficulty communicating.
3. Performance may vary, with better results in some situations compared to same aged-peers.
4. Understanding language well but having significant difficulty expressing themselves.

Early identification and intervention by a speech-language pathologist are crucial for children showing these signs to improve their communication skills effectively.

Therapy for CAS includes working with children on the movement patterns needed to say different words and sentences. The SLP works closely with the family to choose word and sentence targets that are most meaningful to the child and family and will be the most helpful for them to more easily communicate with those around them.