What is Childhood Apraxia of Speech?
WHAT IS CHILDHOOD APRAXIA OF SPEECH?
Childhood apraxia of speech, or CAS, is defined by the American Speech-Language-Hearing Association (ASHA) as “a neurological childhood (pediatric) 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)”, and in other words “a motor speech disorder that makes it hard to speak. It can take a lot of work to learn to say sounds and words better”. CAS is a rare speech disorder that affects a child’s ability to plan and execute the movements of the mouth, jaw, and tongue for speech production. Unlike some other speech sound disorders, there is no muscle weakness involved, but rather there is a problem with planning the motor movements – a problem with the signal from the brain to the muscles.
CAS is not developmental in nature, i.e., children don’t “grow out” of apraxia over time. Rather, they require frequent, intensive treatment to train their speech muscles to move in the correct ways and at the correct times to produce intelligible speech. With the proper treatment and dedicated work, many children with CAS can have great success.
EARLY SIGNS OF CAS
There are three major patterns that a child might exhibit in the presence of CAS, including:
Inconsistent articulatory errors on vowels and consonants. This is especially noticeable if a child attempts to say a word or phrase multiple times in succession and produces it differently each time. Children with apraxia know what they want to say but have difficulty initiating and coordinating the movements of their mouth, tongue, and jaw.
Difficulty with transitions between sounds, syllables, and words. When we move from one sound or syllable to the next, we can usually anticipate the sounds that are coming, allowing our brain to signal those muscles to get ready for the necessary movements. In the case of CAS, there is difficulty with that signal, which causes our muscles to be delayed in their movements or to move in the wrong ways.
Irregular intonation patterns. Frequently, children with CAS speak with a monotone quality or place stress on syllables and/or words that wouldn’t typically be stressed.
Children with CAS may also exhibit language delays, difficulty with reading and writing, and social communication deficits. Additionally, children with apraxia may present with other gross and fine motor difficulties and may seem to be “clumsier” overall.
SEEKING TREATMENT
If parents suspect their child has childhood apraxia of speech, it is recommended that they seek the opinion of a speech-language pathologist. An SLP can evaluate your child’s speech in depth. They will assess the child’s oral motor abilities, intonation, and sound production in words and phrases of varying lengths and complexity. It is also important to speak with your child’s pediatrician to rule out other medical problems, such as hearing loss, which may impact speech production.
RESOURCES FOR FAMILIES
Treatment for CAS takes time and family involvement is crucial for consistency and long-term success. Below are a couple resources that families may find beneficial and encouraging:
Home - Apraxia Kids (apraxia-kids.org)
Parents – Child Apraxia Treatment
Sources:
American Speech-Language-Hearing Association. (n.d.). Childhood apraxia of speech. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/Childhood-Apraxia-of-Speech/
American Speech-Language-Hearing Association. (n.d.-a). Childhood apraxia of speech. American Speech-Language-Hearing Association. https://www.asha.org/Practice-Portal/Clinical-Topics/Childhood-Apraxia-of-Speech/#collapse_4