What is Childhood Apraxia of Speech (CAS)?

Have you ever encountered a child and were not able to understand them? There are many reasons why it might be difficult for a child to be understood while talking such as a phonological disorder (e.g., when a child says "tat" for "cat" or "wing" for "ring" ) or an articulation disorder (e.g., when a child says " "sue" for "shoe" because they don't know how to make the "sh" sound). Another reason might be Childhood Apraxia of Speech.

What is Childhood Apraxia of Speech?

Apraxia Kids defines Childhood Apraxia of Speech (CAS) as "a motor speech disorder that makes it difficult for children to speak". Children with this diagnosis typically understand language and know what they want to say but the message from their brain to their mouth does not go through correctly. Oftentimes the cause of CAS is unknown. CAS is a neurological disorder, however not a medical diagnosis because there is no brain imaging or blood tests that are definitive. CAS is a label for a specific type of speech sound disorder.

What are potential signs of CAS?

When reading these signs it is important to remember that not all children with CAS have the same presentation.

The American Speech Language and Hearing Association identifies 3 main characteristics:

1) Inconsistent errors on productions of vowels and consonants

2) Difficulty with transitions between sounds or words

3) Disrupted prosody (intonation)

Additional signs include:

1) Limited babbling as a baby

2) Limited or distorted vowels

3) Spontaneous speech is better than volitional or "on command" speech

4) Speech is effortful and groping is present (e.g., a child moves their lips, tongue, jaw significantly to try to accurately say sounds or words).

How does speech therapy help with CAS?

SLPs are the most qualified providers to diagnose and treat CAS due to their extensive knowledge in speech sound production and treatment techniques. Therapy will look different for every child however, integration of the Principles of Motor Learning into therapy is most effective as they treat the underlying deficits in motor planning. The treating SLP will likely select a small set of target words that are important and meaningful to the child and their family to focus on in therapy until the child is highly successful and the child is ready for additional target words. For example, in traditional articulation therapy, a child might practice 10-20 target words in a session, in CAS therapy, a child might practice 1-5 words in a session to increase the repetition of accurate motor planning for each word. The treating SLP will provide strategies and support to the family on how to continue practicing the target words at home. What can I do to help my child? If you have concerns about your child's speech and language development at any time, discuss your concerns with your pediatrician. Based on your concerns they might refer you to a Speech-Language Pathologist (SLP) for an evaluation. Always provide praise when your child attempts to verbally communicate, even if the words were mispronounced. Communication is hard for these kids and we want to encourage them to be communication risk takers. Get on your child's level so they can watch your mouth when you talk. Research shows that children with CAS greatly benefit from watching your mouth to support them in accurately producing the sounds and words. All of the references below have wonderful, research based information about CAS if you would like to learn more. Contact a Speech Therapy clinic such as Little Peas and the therapists can help you best support your child's speech and language development! References: https://www.childapraxiatreatment.org/parents https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/#collapse_6 https://www.apraxia-kids.org/