Childhood Apraxia of Speech – What you need to know…

More and more people are becoming increasingly aware of Childhood Apraxia of Speech (CAS). However, it is important for parents to know about the disorder, so that they can look for any red flags.  Children who experience CAS gave a difficult time saying sounds, syllables, and words. This is NOT because of a muscle weakness, but rather because their brain has difficulties planning for the production of their speech. Think about how many muscles and nerves are involved in speech; what the lips, jaw, and  tongue do to produce even a single sound. In summation, the child knows what he/she wants to say, however his/her brain has a hard time coordinating and planning the muscle movements needed to execute the words.

In order to diagnose CAS the child must first go to an audiologist to rule out any hearing loss. Then, a Speech-Language Pathologist who has knowledge and experience with oral-motor abilities, prosody/melody of speech, and sound acquisition can diagnose CAS. Or, a neurologist can as well.


with knowledge and experience with CAS conducts an evaluation. This will assess the child’s oral-motor abilities, melody of speech, and speech sound development. The SLP can diagnose CAS and rule out other speech disorders, unless only a limited speech sample can be obtained making a firm diagnosis challenging.

Below is a list created by the American Speech and Hearing Association (ASHA) on some signs and symptoms of CAS. 

“Not all children with CAS are the same. All of the signs and symptoms listed below may not be present in every child. It is important to have your child evaluated by a speech-language pathologist (SLP) who has knowledge of CAS to rule out other causes of speech problems. General things to look for include the following:

A Very Young Child

  • Does not coo or babble as an infant
  • First words are late, and they may be missing sounds
  • Only a few different consonant and vowel sounds
  • Problems combining sounds; may show long pauses between sounds
  • Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
  • May have problems eating

An Older Child

  • Makes inconsistent sound errors that are not the result of immaturity
  • Can understand language much better than he or she can talk
  • Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
  • May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
  • Has more difficulty saying longer words or phrases clearly than shorter ones
  • Appears to have more difficulty when he or she is anxious
  • Is hard to understand, especially for an unfamiliar listener
  • Sounds choppy, monotonous, or stresses the wrong syllable or word

Potential Other Problems

  • Delayed language development
  • Other expressive language problems like word order confusions and word recall
  • Difficulties with fine motor movement/coordination
  • Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like toothbrushing or crunchy foods, may not be able to identify an object in their mouth through touch)
  • Children with CAS or other speech problems may have problems when learning to read, spell, and write”




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