Maybe you’re familiar with the term “childhood apraxia of speech” or not. Your child may have recently received this diagnosis, or you have a suspecting child on your caseload. Either way, there’s always more to learn about this rare speech disorder!
Read on to learn more about what childhood apraxia of speech is, the likelihood of it to occur, telltale signs, and what to expect in an evaluation and therapy in this beginner’s guide to all things childhood apraxia of speech.
What is Childhood Apraxia of Speech?
Childhood apraxia of speech (also referred to as CAS) is a neurological motor speech disorder that makes it challenging for a child to speak. Usually, a child with CAS has a good understanding of language and knows what they want to say.
The difficulty of this speech disorder comes from the ability to plan and execute the sequence of movements needed to produce clear speech. There is no muscle weakness associated with CAS.
The cause of CAS is usually unknown. Occasionally, damage to the brain can cause this speech sound disorder such as stroke or traumatic brain injury.
Likelihood of Occurrence
Although CAS is gaining attention in the speech world, it is a rare speech disorder.*
It is estimated that 1 to 2 children in every 1,000 are diagnosed with CAS.
Boys are more likely to have CAS than girls, and any child with CAS is more likely to have comorbid delays (see specifics below).
*note for SLPs– you’re likely NOT to have several kids with this diagnosis unless you specialize in CAS.
Telltale Signs of CAS
The following signs may be indicators that your child or a child you serve has CAS:
- Inconsistent sound errors
- Says shorter words easier than longer words
- Often puts stress on the wrong syllable or word
- Difficulty forming smooth transitions between syllables, words, or sentences
- Slower speech rate than normal
- Facial features appear to be “groping” when speaking or attempting to do so
Co-occurring Characteristics
Children with CAS are more likely to also have difficulties with gross and fine motor skills and reading, writing, and/or spelling abilities.
What to Expect: Evaluation and Therapy
CAS Evaluation
Although childhood apraxia of speech is a neurological disorder, this diagnosis cannot be determined from a neurological examination. A trained SLP is the only professional who should complete a CAS evaluation.
Parts of the Evaluation
A formal CAS evaluation includes the following components, in no specific order:
- Receptive and expressive language skills
- Oral-motor skills
- Intonation (the melody of a child’s voice)
- Motor speech abilities
Other Evaluation Considerations
For any child with speech concerns, it is recommended to have one’s hearing evaluated by an audiologist. This will help rule out a potential hearing loss, which can also attribute to difficulty learning to speak.
CAS Therapy
The goal of therapy is to help a child produce more clear and spontaneous speech. The approach includes teaching a child how to sequence movements needed for speech and to use them correctly at the right time.
Frequent repetition should be a driving force of speech therapy for childhood apraxia of speech. A trained SLP can also advise parents on how to properly use repetition during at-home practice as well.
Due to the repetitive nature of CAS therapy, it is usually recommended that a child with this diagnosis received speech therapy more frequently than a child with another type of communication delay. Often, the recommendation for CAS therapy is 3-5 times per week.
Cues
Touch, visual, and listening cues are all helpful when working with a child with childhood apraxia of speech.
Games
Games are a great way to keep children involved and excited during a very repetitive therapy session.
Some Favorite Games:
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Other Ways to Communicate
Depending on the severity of a child’s CAS, it may be beneficial to introduce AAC (augmentative and alternative communication) to your child. AAC may be used temporarily or in differing long-term capacities.
Examples of AAC:
- Signs
- Picture visuals
- Tablets with software to speak for the individual
Expectations for Progress
The exact expectations for long-term progress depend on each child’s unique situation. The severity of their CAS, comorbid disorders, and frequency of therapy are all factors in this equation.
Overall, most children with CAS achieve verbal speech at optimal levels.
More Resources
The following resources include detailed, research-based information to guide you further in understanding how to better advocate for your child with a new diagnosis of childhood apraxia of speech or how to best treat this rare disorder as an SLP:
Don’t forget– you’re exactly who your child (or student) needs! Be confident that you’re the right person to help them make steps toward lifelong success!
SLPs, check out these handouts on Speech Sound Disorders including apraxia!
References
American Speech-Language-Hearing Association (n.d.). Childhood Apraxia of Speech (Practice Portal). www.asha.org/Practice-Portal/Clinical-Topics/Childhood-Apraxia-of-Speech/
Apraxia Kids. (2022, August 9). https://www.apraxia-kids.org/
You may also be interested in reading:
The Difference between Speech and Language (IG)
Applying for Disability Benefits for a Child with CAS
