Childhood Apraxia of Speech (CAS)

What is Childhood Apraxia of Speech?

Childhood apraxia of speech (CAS), or verbal dyspraxia, is a developmental delay where a child may have trouble making proper speech sounds. CAS doesn’t occur because of muscle weakness mouth, but because children have a difficult time coordinating movements of their jaw, lips, and tongue.

Sometimes there is no discernible cause of CAS, however, neurodevelopmental disorders and neurological impairments can cause it to occur. For instance, CAS can be a symptom of metabolic, mitochondrial, or genetic disorders such as epilepsy, galactosemia, a rare metabolic disorder, or autism. If a child has a neurological impairment from trauma or a serious illness in the womb or after birth, they can also develop CAS.

What are the Symptoms of Childhood Apraxia of Speech?

CAS can be difficult to diagnose in children younger than two since speech samples are limited. CAS also isn’t as prevalent as other speech disorders and may have overlapping symptoms.

Symptoms include

  • difficulty transitioning from different syllables or words
  • mixing up words that rhyme
  • a smaller vocabulary for their age group
  • stressing the wrong syllable or omitting it altogether
  • fumbling movements of the mouth to try to make the right sounds
  • saying words incorrectly even after they hear it a second time

Childhood Apraxia of Speech Causes

Childhood Apraxia of Speech (CAS) is a motor speech disorder, which means that messages sent from the brain to the mouth in order to manipulate speech do not travel correctly. The result is that the mouth cannot produce speech normally.

In some instances, CAS is caused by genetic disorders or syndromes which the child was born with.

This could include:

  • Autism
  • Galactosemia
  • Some forms of epilepsy
  • Chromosome deletions, duplications or translocations

In other cases of CAS, it is a neurological impairment caused by illness, injury or abnormal fetal development which is to blame. Stroke is one such example of an illness which could cause damage to parts of the brain which control speech.

In many instances of CAS, the root cause of the condition is not known. This is known as “idiopathic” speech disorder. In these cases, diagnostic tests such as MRI scans have shown no clear neurological abnormalities, the child does not have a known genetic disorder or syndrome, and there is no history of illness or injury.

How is Childhood Apraxia of Speech Treated?

Since children with CAS need to improve their fine and gross motor skills, it is recommended that they see a speech-language pathologist or a an occupational therapist. Sensory cuing””or using tactile and visual references””can help children learn proper movements, as well as rhythmic approaches, such as learning melodies and intonation.

Even though there is no cure for CAS, the frequency of therapy can decrease greatly once the child is able to speak more clearly and fluently.

Childhood Apraxia of Speech Prevention

There is no scientific evidence to suggest that CAS can be prevented. Instead, parents of children with the condition should focus on treating it as early as possible in order to help improve their speech.

Practicing speech is vital for children with CAS, and often a professional speech therapist will be required to help deliver intensive speech practice. Speech therapists will also recommend speech practice at home with parents to maintain the momentum of their therapy sessions.

To prevent children from feeling isolated by CAS, it’s important that they find alternative methods to communicate while their speech improves through treatment. Sign language and portable computers that can produce speech may be particularly helpful.

However, it’s important that these communication aids are gradually replaced by speech as the child’s speaking ability improves. In very extreme cases of CAS, speech therapy may not improve speech significantly enough that the child can communicate and in these instances sign language and other alternative communication systems may be used in the long term.

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Last Reviewed:
September 18, 2016
Last Updated:
December 01, 2017