What is Apraxia of Speech

Childhood apraxia of speech or CAS is a disorder that interferes with the messages that travel from the brain in order for the mouth to move and form words. A child may be able to speak a word one time and unable to say the same word later. When parents notice that their youngster exhibits speech problems, they should have the child evaluated and properly diagnosed.

Symptoms of Apraxia

CAS is commonly referred to as developmental apraxia or verbal dyspraxia. However, the problem is not something children outgrow. Ongoing therapy is required in order for a youngster to improve. Symptoms of CAS differ from one child to the next. Children under the age of three typically:

  • Do not babble or coo during infancy
  • Form words later than most children
  • Makes a few different verbal sounds
  • Exhibits difficulty putting consonant and vowel sounds together
  • Pause between sounds


Children over the age of three:

  • Pronounce words differently from one time to the next
  • Comprehend the speech of others
  • Exhibits difficulty mimicking words spoken by others
  • Move the jaw, lips and tongue before uttering a sound
  • Longer words are more difficult to pronounce compared to short words
  • Exhibits greater difficulty speaking when nervous or upset
  • Often cannot be understood when speaking
  • Have choppy speech and commonly accent the wrong syllable
  • Demonstrate an unusual sensitivity in their mouths
  • May have no sensitivity and cannot differentiate between hot and cold food

CAS Causes

A number of factors may contribute to the development of the disorder. However, there is also the possibility that an underlying cause cannot be determined. Apraxia may develop secondary to an infection, a stroke or an injury. Youngsters having galactosemia or other metabolic conditions or syndromes may be at a higher risk of developing the speech problem.

Some children are genetically predisposed. Anomalies in the FOXP2 gene cause an increased risk for developing CAS or other language and speech disorders. Researchers theorize that the FOXP2 gene plays a role in the development of the pathways between nerves and the brain.

Additional Considerations

Children having CAS may have additional problems that affect communication ability. The problems are not related to the disorder but may accompany the diagnosis. Symptoms of other complications include:

  • Difficulty understanding speech, a smaller vocabulary and problems using correct grammar
  • Having an inability to learn how to spell, read and write
  • Displays problems with fine motor skills, gross motor skills or physical coordination
  • Complains of not liking fabric textures or the mouthfeel of certain foods
  • Has difficulty eating and swallowing

Testing for CAS

Parents having a concern about their youngster should speak with their physician. A physical examination may determine possible medical problems. Hearing tests indicate whether speech problems are due to hearing loss. A speech pathologist determines a child’s ability to understand or form speech. They also test to assess if a child effectively relays their thoughts and feelings to others. During the assessment, the pathologist also assesses a child’s motor skills when trying to speak, the melody of their speech and how the youngster forms different sounds.

Childhood Apraxia of Speech Treatment

Children typically work with a speech therapist three to five times a week. As the child improves, sessions become less frequent. Initially, the child works one-on-one with the therapist. When they are better able to form consonant and vowel sounds along with words, youngsters may then progress to working in a group. In this way, they learn communications skills by forming sentences and talking with other children.

Treatment revolves around helping the child learn to use their mouths to make sounds, words and sentences. Part of therapy includes performing exercises to train the muscles and oral components used to create speech. At home, the child is encouraged to practice the exercises and speaking in order to improve. Touch and visual cues often help children know when they are forming sounds correctly. They might put a finger to their lips to ensure that the lips are functioning properly. They might also watch themselves in a mirror to monitor mouth movement. Some youngsters benefit from hearing the sounds they make by listening to a recording of their speech.

Alternative Communication Methods

The disorder may be so severe in some children that they resist speaking at all. In this case, a child may be interested in learning sign language, using picture boards or a mobile device that can speak for them. Parents may be reluctant to introduce alternative communication techniques for fear that the child will never learn to speak. However, the methods help children effectively express themselves and encourage learning speech along the way. As a youngster becomes more capable of speaking they depend less on other methods.

Support is Vital

From the time a child is diagnosed and undergoes treatment, they require ongoing support from their family. Family members help boost learning by working with their children during practice sessions and providing encouragement.


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