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Childhood Apraxia of Speech

What is it?

Childhood Apraxia of Speech (CAS) is a speech sound disorder, which affects a child’s ability to create and execute a motor plan to create speech sounds. CAS is characterized by inconsistency and imprecision in speech when there is an absence of muscular deficits (there is nothing structurally affecting speech sound production). Essentially, the brain is creating a message (the child knows what they want to say) but might send too many or not enough signals to the articulators (e.g., lips, tongue, jaw) to accurately produce the motor movements for speech. What effect does this disorder have on a child’s communication?

CAS presents differently in each child; however, there are distinguishing characteristics to support a diagnosis. Below are some common characteristics/signs that a child may have CAS:

  • Difficulty consistently producing the motor movements for a sound or word

  • Inconsistent production of vowel sounds (may affect prosody/intonation)

  • Automatic speech is easier than elicited speech (automatic = picking up the phone and saying “Hello” / elicited = answering a question and formulating a response in the moment, i.e. “What did you do at school today?”)

  • A child may be frustrated when trying to communicate and may demonstrate “groping” (movements of the mouth as if they are trying to say something but cannot get their mouth to produce the message the brain is sending)

  • Increased difficulty articulating as an utterance gets longer

What do assessment and treatment look like?

The DEMMS is an assessment tool used to evaluate the presence of CAS. A diagnosis can be helpful toe ensure a child's treatment approach is tailored to their specific needs.

  • Goals of treatment for CAS include improving the motor movements for speech, improving consistency of sound production and providing compensatory strategies or alternative communication methods if necessary

  • Repetition and consistency of practice are essential in treating CAS, so treatment is often intensive, occurring multiple times a week, depending on the severity of the diagnosis.


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