Learning About Childhood Apraxia of Speech

What is childhood apraxia of speech (CAS)?

A child who has childhood apraxia of speech (CAS) can't speak well. They understand language. They know what they want to say. And the muscles of the mouth and throat have the strength and tone needed to speak. But their brain isn't able to plan the order and timing needed for the muscles to move together to create speech that others can understand.

CAS makes it hard for infants and toddlers to practice the sounds they hear when people talk to them. In older children, CAS can make it hard for other people to understand them. If your child has CAS, this may be frustrating for both of you.

Experts don't know what causes CAS. But with speech therapy, most children can learn to speak more clearly.

What happens when your child has CAS?

• Infants may not babble very much and may babble only a few sounds.
• Toddlers may:
  • Be able to say only a few words clearly.
  • Leave out parts of words or put parts of words in the wrong place.
  • Use gestures more than words.
• Older children may:
  • Be able to make single sounds, but not be able to put them together into longer words or phrases. For example, they might be able to say "ah" or "m" sounds, but not "mom" or "mama."
  • Sometimes say the wrong sound in a word, leave out some sounds, or make sounds in the wrong order. For example, they might say "uhkey ar" instead of "monkey bars" or "bubby dau" for "puppy dog."
  • Often pause or struggle to say something.

How is it diagnosed?

The doctor will do a physical exam and ask questions about your child's past health. The doctor will also ask if your child has reached speech and language milestones for their age.

If the doctor thinks that your child has a speech problem, they will refer your child to a speech-language pathologist (SLP). SLPs diagnose and treat speech and language problems. The SLP will listen to your child talk. They will also ask your child to say certain sounds, words, and sentences.

Tests may be suggested to:

• Look for other conditions. For example, your child may get a hearing test to rule out hearing loss.
• Find out what speech sounds your child can say.
• Find out if your child has problems putting sounds together to form words and sentences.
• Check how well your child is gaining speech, language, and motor skills.
• Make sure your child understands the speech of others and can follow directions.
• Find out if your child is having other problems, such as behavior issues. This may also include trouble with common skills, such as sucking, chewing, or swallowing.

How is CAS treated?

If your child has CAS, they will need regular speech therapy to learn how to speak more clearly. The speech-language pathologist may:

• Help your child learn to make different speech sounds and combinations of sounds. This can make speech easier for your child. It can also make their speech clearer.
• Help your child learn sign language or use devices to communicate if needed.

Treatment works best when problems are caught early. Your child's speech therapy team will help you decide on the best schedule for treatment.

A common schedule is for a child to get therapy once or twice a week and to practice every day at home. Often the SLP will suggest that it's best for the child to have several short practice sessions over the course of a day.

How can you care for your child at home?

• Talk, play, sing, or read together. These activities help your child's brain develop. Make reading a part of your child's daily routine.
• Don't imitate your child's unclear speech or constantly correct your child.
• Follow the speech-language pathologist's directions for activities that support the skills your child learns in therapy.