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.

Learn MoreHow We Help

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.