Childhood Apraxia of Speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis, it’s because the brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech.

Although not all the signs listed below will be present in every child, the following are some things to look for:

A very young child

  • Does not coo or babble when an infant
  • First words are late, and they may be missing sounds
  • Uses only a few different consonant and vowel sounds
  • Has problems combining sounds; may show long pauses between sounds
  • Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
  • May have problems eating


An older child

  • Makes inconsistent sound errors that are not the result of immaturity
  • Can understand language much better than he/she can talk
  • Has difficulty imitating speech, but imitated speech is clearer than spontaneous speech
  • Appears to struggle when attempting to produce sounds or to coordinate the lips, tongue, and jaw movement
  • Has difficulty saying longer words or phrases clearly
  • Appears to have more difficulty when he/she is anxious
  • Is hard to understand, especially for an unfamiliar listener
  • Sounds choppy, monotonous, or stresses the wrong syllable or word


How is CAS diagnosed?

Start by having an audiologist perform a hearing evaluation to rule out hearing loss as a possible cause of your child’s speech difficulties.

Then consult a certified Speech-Language Pathologist (SLP) with experience in CAS. They will conduct an evaluation to assess your child’s oral-motor abilities, melody of speech, and speech-sound development. The SLP will be able to diagnose CAS and rule out other speech disorders.

What treatments are available?

In order to rule out other causes of speech problems, it is important to have your child evaluated by a Speech-Language Pathologist (SLP) who has knowledge of CAS.

Children with CAS have better success when they receive frequent (3-5 times per week), intensive treatment. As your child improves, they may need treatment less often, and can then join group therapy.

Speech practice is essential, and sensory feedback, such as tactile “touch” cues and visual cues (watching him/herself in the mirror, for example) as well as auditory feedback, is also helpful.

If the apraxia makes speaking very difficult, some children may be taught to use sign language or an augmentative and alternative communication system.

Your family will be given assignments to help your child practice at home. Bear in mind that treatment of apraxia of speech takes time and commitment. A supportive environment will go a long way to help your child feel that they are achieving success in their communication.

If your child has CAS and you would like further guidance, please contact one of our Sunshine team members.