What Is Childhood Apraxia of Speech?
Childhood Apraxia of Speech (CAS) is a rare motor speech disorder that makes it difficult for children to coordinate the movements needed for talking. It’s not about weak muscles, it’s about the brain having trouble planning and sending the right messages to the lips, tongue, and jaw.
To speak clearly, the brain needs to:
- Create a motor plan for what it wants to say
- Send that plan to the muscles used in speech
- Carry out the movements to produce each sound and word
For children with CAS, this planning process doesn’t happen smoothly. Even when they know exactly what they want to say, their brain struggles to coordinate the precise movements needed to get the words out.
This can make speech effortful, inconsistent, and hard to understand, not because the child isn’t trying, but because their brain and mouth aren’t working together as automatically as they should.
CAS can range from mild to severe. Some children may show just a few speech difficulties, while others need more intensive and ongoing support. The good news? With early diagnosis and the right speech therapy, most children with Childhood Apraxia of Speech can make strong, meaningful progress over time.
What Are the Signs of Childhood Apraxia of Speech?
Some early signs of CAS can be seen in babies and toddlers, while other features become clearer as children start using more speech.
In younger children, signs might include:
- Delayed speech: Talking might start later than expected (though there’s a wide range of normal).
- Limited babbling: Less cooing or sound play as a baby.
- Feeding difficulties: Challenges with sucking, chewing, or swallowing.
- Gestures over words: More pointing or vowel sounds instead of clear speech.
- Limited sound range: Fewer consonants or difficulty copying words.
- Unclear vowels: Vowel sounds may be distorted or inconsistent.
As children get older, you might notice:
- Inconsistent speech: Same word sounds different each time.
- Difficulty with long words: Shorter words are often easier to say.
- Effortful speech: Pauses or visible struggle to get words out.
- ‘Robotic’ tone: Speech may sound flat or choppy.
- Communication frustration: Some children become anxious, frustrated, or avoid speaking.
- Literacy challenges: Extra support may be needed for reading, writing, and spelling.
What Causes Childhood Apraxia of Speech?
In most cases, the cause of CAS isn’t fully understood, but here’s what we do know:
- CAS is a neurological speech disorder, meaning it’s related to how the brain works, not how the muscles work.
- It’s considered a motor planning disorder, because it affects how the brain plans and organises the movements needed for speech. Children know what they want to say, but their brain has trouble sending the right messages to their lips, tongue, and jaw to get the words out clearly.
- Research is ongoing into possible neurological and genetic links
What it’s not caused by
Muscle weakness or paralysis
The speech muscles themselves work as they should. The difficulty lies in how the brain coordinates and sequences those movements for speech.
Language ability
Most children with CAS know exactly what they want to say, the challenge is getting the words out clearly. That said, some children with CAS may also experience co-occurring language delays or disorders.
Other factors
CAS is not caused by hearing loss, intellectual disability, parenting style or environment. These factors may impact communication more broadly but are not the underlying cause of CAS.
How Will Working on Childhood Apraxia of Speech Help My Child?
Speech is central to how children connect, express their needs, and feel confident in the world. Speech therapy for CAS helps children:
- Learn how to plan and produce speech sounds more clearly and consistently
- Build words, sentences, and longer messages with greater ease
- Communicate more confidently with family, friends, and educators
- Reduce frustration and feel more understood
- Take part more fully in everyday life – at home, school, and beyond
Because CAS is a motor-based difficulty, therapy often involves frequent, structured sessions with lots of repetition. Your speech pathologist will also work closely with you to support practice at home and collaborate with teachers or other professionals to support your child across all environments.
Childhood Apraxia of Speech: Facts vs Myths
Myth:
“It’s just a speech delay, why is my child finding this so hard?.”
Fact:
CAS isn’t a typical delay, it’s a specific difficulty with how the brain plans and coordinates the movements needed for speech. That’s why it feels harder, and why your child needs specific, targeted therapy to develop clear, confident speech.
Myth:
“Can’t we wait? Maybe they will grow out of it.”
Fact:
While some speech delays can resolve on their own, CAS usually doesn’t. Early support gives children the best chance to build clear, confident speech, and helps prevent frustration from building up over time.
Myth:
“But they’ve said that word clearly before, maybe they’re just not trying hard enough.”
Fact:
Inconsistency is a key feature of CAS. A child might say a word clearly one day and struggle with it the next. It’s not a matter of effort or motivation, it’s related to how their brain works.
Myth:
“They’ll always have trouble talking.”
Fact:
With the right therapy and support, many children with CAS make significant progress. While it may take time and consistency, clear and confident communication is often possible.
Frequently Asked Questions
How is CAS diagnosed?
Diagnosis involves a detailed assessment by a qualified speech pathologist. We look at how your child moves their lips, tongue, and jaw, and how they plan and produce sounds, especially as words get longer or more complex. We check for signs like inconsistent speech, unusual stress or rhythm, how they respond to support and how clearly they can repeat or imitate words. We also assess areas like language to rule out other concerns. This helps us understand if CAS is present and what kind of therapy will help.
Is there a cure?
There’s no “quick fix”, but children with CAS can learn to speak more clearly and confidently with ongoing support. The earlier we start, the better the outcomes tend to be.
How is CAS treated?
Speech therapy for Childhood Apraxia of Speech (CAS) focuses on helping your child plan and produce the movements needed for clear speech. Because CAS is a motor speech disorder, treatment is different from other types of speech sound disorders. Therapy uses evidence-based techniques that focus on motor learning principles, along with consistent repetition and cues (like visual or tactile prompts) to help your child speak more clearly and confidently. The best treatment for CAS depends on your child’s age, current skills, and the severity of their speech difficulties, and therapy may change over time as their communication improves.
Our therapy services focus on
Your speech pathologist can help guide you with strategies that suit your child’s needs and fit easily into your daily life.
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