Childhood Apraxia of Speech

Childhood Apraxia of Speech (CAS) is a neurological childhood speech sound disorder characterized by impairments in the precision and consistency of speech movements in the absence of underlying neuromuscular deficits. Children with CAS have difficulty learning and executing complex sequenced movements necessary for intelligible speech.

CAS is not as common as other speech sound disorders. About 1 in 1000 children are suspected to have childhood apraxia of speech.

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Signs & Symptoms

Inconsistent errors in both consonants and vowels in repeated productions of syllables or words. For example, a child may say “puppy dog” three times and make all three productions differently.
Lengthened and disrupted coarticulatory transitions between sounds and syllables
Inappropriate prosody, especially with stress

Other Possible Symptoms

Groping of articulators
Consonant distortions
Inaccurate movements in transitioning from one sound to the next
Increased errors in longer, more complex utterances
Insertion of a schwa (“uh”) between consonants or at the end of words
Slow rate of speech
Pauses between sounds, syllables, or words that affect smooth speech
Errors with voiced and unvoiced sounds
Vowel errors

Co-Occurring Language, Literacy, and Sensory-Motor Problems

Delayed language development
Expressive language problems (word confusion and grammatical errors)
Difficulty learning how to read, spell and write
Social communication problems
Gross and fine motor difficulties
Motor clumsiness
Oral or limb apraxia
Feeding difficulties

Causes & Risk Factors

Most children with CAS fall into a category of idiopathic speech disorder, meaning there is no known reason for the speech impairment
Children with neurodevelopmental disorders such as autism, epilepsy, Fragile X, and Galactosemia have a higher incidence of CAS.
Neurological impairments such as infection, illness, or injury before, during or after birth can be a cause of CAS, although a brain injury is more likely to cause dysarthria (a motor-based impairment) rather than CAS.

How We Can Help

Speech-language pathologists screen, assess, diagnose, and treat individuals with speech sound disorders. Our role also includes:

Providing prevention information to those at risk for CAS
Recognizing that children with CAS are at an increased risk for later language and literacy problems and providing appropriate early intervention.
Conducting comprehensive and DYNAMIC assessments for differentially diagnosing CAS and for determining severity and prognosis.
Referring and collaborating with other professionals to rule out other conditions, determine underlying causes and provide multidisciplinary services.
Developing appropriate treatment plans and implementing evidence-based treatment approaches for functional outcomes.