Childhood Apraxia of Speech (CAS) is a complex speech disorder that can significantly impact a child’s ability to communicate. As a parent, understanding what CAS is, its potential causes, symptoms, and treatment options can help you navigate this journey and support your child’s development.

What Is Childhood Apraxia of Speech?
The American Speech-Language-Hearing Association (ASHA) defines CAS as “a neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g., abnormal reflexes, abnormal tone).”
In simpler terms, children with CAS have difficulty coordinating the movements of their lips, tongue, and other speech mechanisms to produce sounds, even though the muscles themselves are not weak. This can make speech challenging and inconsistent.
What Causes CAS?
CAS can occur for a variety of reasons, although in many cases, the exact cause is unknown. Potential causes include:
Idiopathic Neurogenic Speech Sound Disorder: This means there are no observable neurological abnormalities causing the issue.
Neurobehavioral Disorders or Conditions: CAS may occur as a primary or secondary symptom of conditions such as:
Autism Spectrum Disorder
Epilepsy
Genetic syndromes like Fragile X Syndrome, Rett Syndrome, and Prader-Willi Syndrome.
Neurological Events: CAS can also result from specific neurological events such as traumatic brain injury (TBI), stroke, or brain tumor resections.
The core challenge in CAS is difficulty planning and sequencing the movements required to produce speech sounds. This can affect the rhythm, timing, and clarity of speech.
Signs and Symptoms of CAS
While every child with CAS may present differently, some common signs include:
Inconsistent Speech Production: For instance, a child may say the word “hi” differently each time they attempt it.
Reduced Intelligibility in Longer Sentences: Speech becomes harder to understand in longer phrases or utterances.
Excessive Drooling: Drooling beyond the age of two may be a concern.
Inappropriate Prosody: Difficulty with the natural rhythm, tone, and emphasis in speech.
Articulatory “Groping”: Visible struggle to position the mouth correctly for speech sounds.
Slow Speech Rate: Speech may appear slower than typical.
Consonant/Vowel Distortions: These distortions often worsen as sentences get longer.
Feeding or Oral Motor Challenges: Some children with CAS may also struggle with feeding due to oral motor difficulties.
It’s important to note that there are no current validated diagnostic features that definitively differentiate CAS from other pediatric speech sound disorders. If you notice these signs in your child, a Speech-Language Pathologist (SLP) can provide more information and guidance.
How Is CAS Treated?
Treatment for CAS is highly individualized and typically involves multiple approaches to address the unique needs of each child. These may include:
Motor Programming Approaches: Focused on improving the planning, sequencing, and execution of speech movements.
Language Approaches: Targeting overall language development alongside speech skills.
Combination Approaches: Using both motor and language techniques for a comprehensive intervention.
Prosodic/Rhythmic Approaches: Emphasizing the natural rhythm and melody of speech to improve clarity and fluency.
Next Steps for Parents
If you suspect your child may have CAS, the first step is to consult a qualified Speech-Language Pathologist. They can provide a thorough evaluation and create a tailored treatment plan to help your child develop clearer and more consistent speech. Early intervention is key, so don’t hesitate to seek support if you have concerns.
At Mighty Kids Therapy, we’re here to support you and your child every step of the way. Contact us to learn more about our services and how we can help your child reach their communication goals.
source: asha.org
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