Neurodevelopmental and Behavioral Pediatrics

Childhood Apraxia of Speech

Description

Childhood Apraxia of Speech (CAS) is a motor speech disorder characterized by difficulty with motor planning for speech production. Children with CAS may have difficulty saying sounds and words because their brain has difficulty planning and coordinating the movements of the lips, tongue, jaw, and other articulators. A child with CAS usually knows what they want to say, but they struggle to say it due to difficulty with planning and coordinating the speech movements. Muscle weakness or paralysis is not a characteristic of CAS.  Some children with CAS have little or no functional speech, whereas other children are verbal but have problems with intelligibility.  

Diagnosis

If you suspect CAS, your child should be evaluated by a speech-language pathologist with specialized knowledge and experience. The SLP will assess your child’s oral-motor skills, speech sound development, and other speech characteristics such as the melody or prosody of speech (e.g., timing and stress).  The SLP will look for signs of motor weakness, which is not a sign of CAS but can help in making or ruling out the diagnosis. They will pay particular attention to how your child coordinates and sequences speech sounds in speech and non-speech activities (e.g., blowing bubbles). For very young children or children with very limited verbal speech, it may be difficult to determine if they have CAS. The SLP may also evaluate your child’s language skills as part of the evaluation to determine if they can understand more than they are able to produce. A child who is suspected of having CAS should also have an audiological evaluation to rule out hearing problems. 

Associated Developmental & Learning Issues

Childhood Apraxia of Speech can result problems getting wants and needs met.  This may make the child and family frustrated.  CAS can also make it hard for children to be independent,  make friends and play with other children. Children with CAS are at risk for problems with reading and writing.   

Treatments

Children with CAS tend to do better with intense, frequent,  individual speech therapy. Treatment focus is on planning, sequencing, and coordinating for the production of speech. Multi-sensory feedback has been found be helpful, including visual, tactile (touch), and auditory cues. The SLP also may recommend other ways to help your child communicate, such as gestures, picture boards, or computerized communication devices (augmentative and alternative communication).  

How Many People Have Apraxia

Currently, there is little data available on the prevalence of Childhood Apraxia of Speech. 

Causes

We usually do not know the exact cause of Childhood Apraxia of Speech.

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