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

Be Enchanted by Trains That Glide Through Every Season @ Morton Arboretum

Combine equal parts white glue and shaving cream. Using a paintbrush or your hands, apply to paper and that’s it! Feel free to add food coloring to make your desired color or keep it white and pretend it’s snow! This activity is great for following directions, allowing children to touch and explore different textures, and makes a cute craft! 

You may hear your therapist emphasize the importance of “joint attention” during their sessions with your child. What does this mean and why is it important?

“Fun Crayons”
(a.k.a. short/broken crayons)

Broken crayons are actually a good thing! Coloring with broken crayons helps promote a mature pinch grasp of objects, and it promotes a more mature grasp of writing utensils. Use an easel or an inclined surface for your little artist to also encourage mature wrist movements when drawing and coloring.

There are many benefits of symbolic play to your child’s cognitive development. For example:

• Children learn many new skills through imitation. While engaging in symbolic play, they act out behaviors and scenarios they’ve observed in their daily life. While acting out these activities or behaviors, children develop their interests, or likes and dislikes. Given the opportunity to act out adult behaviors, a child may realize that they love tending to a baby but have less interest in driving a racecar (or vice versa!).

• They gain an understanding of relationships between people and build social skills. When children are young, they may hug, rock, and kiss a baby doll or stuffed animal, demonstrating their understanding of relationships and interactions between adults and babies. As children get older, their symbolic play becomes more in-depth and interactive. They assign roles to others, communicate, and take turns while role-playing. This type of play also encourages children to work out social issues and deal with different emotions while playing with children and adults around them.

• They problem solve. Acting out different scenarios allows children to be presented with a variety of issues or problems along the way. In a single symbolic play scenario, such as making dinner, a child could face multiple problems or complications:

  • The child may imitate a problem they’ve observed their parent solve, such as burning dinner.

  • They may have an issue finding the right surface or materials to make a “stove”.

  • They may have to solve a problem with a peer when both want to be the parent in this play scheme.

What can I provide to encourage symbolic play?

• Different sized boxes – a single box can be an airplane one minute and a barn the next.

• Adult clothing – what better way to feel like a grown up than wearing dad’s old dress shirt and tie?

• Stuffed animals or dolls – this allows children to imitate their own life and explore different feelings and thoughts.

What are some scenarios I can create in my home?

• Grocery Store: Instead of disposing of your trash, clean out milk jugs, jelly jars, cracker boxes, etc. and provide a few grocery bags. You can even expand the play scheme to create a shopping list or use construction paper to make money to pay for groceries.

• Post Office: Save your junk mail and your child can be a mailman! Those handy boxes mentioned above can be created into mailboxes. This also provides exposure to numbers and letters.

• Restaurant: Collect the take-out menus from your favorite restaurants and have a restaurant in your own home. Provide your child with some paper and a crayon and they can take your order (or the other way around!).

Kimberly Shlaes, MAT, DT