Childhood Apraxia of Speech – The Basics

by Hannah Blackwell, M.A., CCC-SLP
Duncan Lake Speech Therapy, LLC

What is Childhood Apraxia of Speech?

Childhood Apraxia of Speech (CAS) is a neurological speech sound disorder impacting the precision and consistency of motor movements necessary for speech production in children. CAS impairs in the planning of speech motor movements due to neurological causes, rather than deficits in the muscles themselves. The deficits in planning muscle movements necessary for speech results in speech sound and prosody errors, impacting their ability to appropriately communicate their wants/needs/thoughts as well as others’ ability to understand them.

What causes Childhood Apraxia of Speech?

CAS can be congenital (present at birth) or acquired (developing later in childhood). It can occur as its own neurogenic disorder, meaning there are no other observable conditions, or in conjunction with other disorders and neurological events including autism, syndromes, or trauma. It is important to note that CAS is not developmental in nature and is not something a child can “grow out” of; its effects most often persist past developmental stages.


What are the signs/symptoms of Childhood Apraxia of Speech?

It is currently very difficult to differentiate CAS from other speech sound disorders due to the absence of thoroughly researched, validated diagnostic criteria. The American Speech-Language-Hearing Association (ASHA) lists certain characteristics which suggest the presence of CAS. A few of these are:

  • Inconsistent errors on consonants and vowels
  • Lengthened pauses between sounds and syllables
  • Inappropriate prosody (rhythm, stress, intonation)
  • Articulatory groping (the mouth is searching for appropriate positions for speech production)
  • Distorted consonants
  • More difficulty producing longer or more complex words
  • Adding “uh” between consonants in words or at the end of words 
  • Voicing and vowel errors

The characteristics of CAS, in conjunction with formal testing of language and speech sounds as well as informal testing of motor movements, can provide evidence for diagnosis of CAS.

How do you treat Childhood Apraxia of Speech?

Speech-language pathologists often focus treatment for CAS on improving communication skills by targeting speech sound production and intelligibility as well as use of other modes of communication such as Augmentative and Alternative Communication (AAC) or sign language. There are various ways to approach treating CAS. The motor programming approach uses repetition of speech motor movements by targeting similar word structures. This helps the child more consistently produce sounds and sequences of sounds accurately in natural contexts. Other approaches may target specific speech sounds or intonation patterns. No matter the approach, though, CAS requires intensive and individualized speech therapy treatment.

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