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Childhood Apraxia of Speech (CAS) is a motor speech disorder.

Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. 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.

CAS may be referred to as “developmental apraxia,” but it is not a disorder that children simply “outgrow.” For many developmental speech disorders, children learn sounds in a typical order, just at a slower pace. 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. The incidence is on the rise for CAS but still generally low in comparison to other speech disorders.

If any concerns are present, 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. Research shows the children with CAS have more success when they receive frequent (3-5 times per week) and intensive treatment. Children seen alone for treatment tend to do better than children seen in groups. As the child improves, they may need treatment less often, and group therapy may be a better alternative. The focus of intervention for CAS is on improving the planning, sequencing, and coordination of muscle movements for speech production.

Some things to looks for:

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