Childhood Apraxia of Speech

Childhood apraxia of speech (CAS) is a motor speech disorder where children have difficulty planning, coordinating, producing, and sequencing speech sounds. CAS interferes with the child’s ability to say sounds and to combine them into syllables, words, phrases, and conversations. Also known as Developmental Apraxia of Speech (DAS), Apraxia of Speech (AOS), Verbal Apraxia, and Verbal Dyspraxia, apraxia affects a child’s ability to say what they want clearly and consistently. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words. Its root cause is a neurological motor planning difficulty (sequencing), not a muscle impairment. In CAS, children do not follow typical patterns and will not make progress without treatment. There is no cure, but with appropriate, intensive intervention, significant progress can be made.

Symptoms of CAS may include:

• speech is difficult to understand, especially by those unfamiliar with the child
• lack of babbling as an infant and/or late to begin using sounds and words
• limited repertoire of sounds
• vowel errors (saying “ha” for “hi” or a for “you”)
• Unpredictable and inconsistent speech sound errors: a child might say a word one way one time and another way another time
• Increased speech production  errors as sentence length increases (for example, pronouncing  "mama" properly as a single word utterance, but having difficulty pronouncing it when part of a two-word phrase (“Mamas shoe”)
• Being able to produce a word in a learned and often repeated context (for example, while reading a familiar book) but not in a  novel context
• Difficulty producing new words and phrases as compared to words and phrases that have been practiced many times
• Stronger understanding of language than ability to use language
• Difficulty imitating speech
• difficulty imitating oral motor movements (for example, difficulty imitating you sticking out your tongue). This is called oral apraxia.
• Groping or otherwise physically struggling when trying to produce a speech sound or word

Note that not all children with CAS will exhibit all of these symptoms and that a diagnosis of CAS can only be made by a qualified professional. Treatment for CAS should be customized to meet the individual needs of the child, but most often, frequent and intensive 1:1 sessions with a Speech-Language Pathologist and/or supportive personnel is recommended to make progress. Approaches used to treat children with CAS may involve a combination of techniques such as PROMPT, Speech EZ for Apraxia, Kaufman Speech to Language Protocol, Multisensory Treatment for Apraxia (David Hammer), and Dynamic temporal and tactile cuing (DTTC).