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Understanding Childhood Apraxia of Speech

Updated: Jul 6


Childhood Apraxia of Speech, also known as CAS , is a neurological motor planning disorder that affects a child's ability to speak. Depending on the severity, a child with CAS may find it difficult to produce speech sounds or be understood when speaking in full sentences. The motor planning involvement makes it difficult for children to produce individual speech sounds, sequence those sounds into syllables, combine syllables into words, produce words for sentences, and then combine sentences for conversations. A child with CAS often experiences lots of frustration, and if their ability to speak is significantly impaired, may require alternative methods for communicating. Some alternative forms of communication are sign language or gestures, Picture Exchange Communication System (PECS), communication boards and Augmentative and Alternative Communication devices (AAC). Early identification along with early treatment are key in improving outcomes for children with CAS.


Some indicators of Childhood Apraxia of Speech:


1. difficulty coordinating the motor movements of the mouth, jaw, lips and tongue to produce speech sounds

2. limited speech sound repertoire

3. limited babbling or vocalizations during infancy and early childhood

4. difficulty being understood

5. inconsistent speech errors

6. vowel distortions

7. impaired prosody

8. difficulty maintaining intelligible speech as the length of words or sentences increase

9. difficulty blowing out candles or blowing bubbles

10. deleting sounds and producing incorrect speech sounds when speaking


With CAS, a child knows what to say but has a difficult time coordinating and planning the motor processes to say it. Because of this, CAS requires a motor planning approach to therapy. Some of the the techniques for motor planning therapy include the following:


  1. Providing multi-sensory and articulatory placement cues, which includes tactile, visual and auditory input or feedback for proper articulatory placement and motor production.

  2. Using word approximation targets during therapy can help as a means to shape speech productions. This involves the progression of phonemes to syllables to words to phrases and sentences. (i.e. ma --> mama --> mommy; wa --> wawa --> wada --> water, for word level productions)

  3. Targeting prosody is important and it involves working on the child's rate, pitch and volume of speech.

  4. Adhering to a structured hierarchy of speech sound targets and syllable shapes is important (i.e. vc, cv, cvc, vcvc, cvcv, etc)

If you suspect your child has Childhood Apraxia of Speech, reach out to a speech language pathologist for a consult or evaluation. Seeking speech therapy as soon as possible is very important when treating CAS. Each state has early intervention programs for babies and toddlers, and school districts and private practices help serve children ages 3 and up.


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