Childhood Apraxia of Speech (CAS)
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.
If you suspect CAS, your child should be evaluated by a speech-language pathologist
(SLP) 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 (for example, 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 (for
example, 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 can produce. A child who is suspected of having CAS
should also have an audiological evaluation to rule out hearing problems.
Associated Developmental and Learning Issues
CAS 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, or play with other children. Children with CAS are at risk for problems
with reading and writing.
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 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 CAS?
Currently, there is little data available on the prevalence of CAS.
We usually do not know the exact cause of CAS.
We do not treat children with CAS as their main diagnosis; however, we do treat children who have developmental disabilities as well as CAS.
You can find resources for CAS in our Resource Directory!