Childhood Apraxia of Speech (CAS) is a motor planning disorder that interferes with a child’s ability to plan and execute the precise sounds needed for speech. Children with CAS find it difficult to produce specific sounds on demand, and find even more difficulty in stringing sounds together into words. They may be able to use various sounds when babbling but cannot produce a specific sound when asked to do so. It is often frustrating for the child, as they know what they want to say but struggle to produce the sounds and words needed to communicate their message.
How do I know if my child has CAS?
Initially, CAS may present as a language delay in young children if they are not yet talking by 15-18 months of age (most children say their first word around 12 months of age). It is difficult to diagnose CAS when the child is not yet talking, so initial speech therapy may focus on verbal imitation of age-appropriate sounds. Children with a speech or language delay can successfully imitate the prompted sound with guided support. Children with CAS, however, will struggle to imitate sounds when prompted because their brain does not send the right coded message to their mouth. Without this message (i.e. the motor plan), they will not know how to use their tongue, lips, and/or teeth to make the correct sound.
Common characteristics of CAS:
Reduced babbling during early language development (6-12 months of age)
Inconsistency of speech sound productions
More errors or changes in errors when producing the same sound or word multiple times
Difficulty imitating sounds and sound patterns when prompted
Incoordination and/or groping of the mouth when attempting to speak
Significant gap between receptive language skills (understanding of language) and expressive language skills (production of sounds/words); receptive language skills tend to be age-appropriate in children with CAS
Slow progress in therapy, or a plateau in progress
If you think your child may have CAS, refer to a speech therapist for a speech and language evaluation. The speech therapist will work with you and your child to determine the appropriate diagnosis and to establish therapy goals that will support your child’s communication skills.
Autumn Smith, MS, CCC-SLP