Childhood apraxia of speech - do you know the signs?

Do you know the signs of childhood apraxia of speech (CAS)? CAS, also known as verbal apraxia or dyspraxia, is a speech disorder in which a child has trouble saying what he or she wants to say correctly and consistently. It is a motor speech disorder, as the child's brain has difficulty coordinating the oral muscles used for speech; it is not due to weakness or paralysis of the speech muscles. Children with CAS have difficulty saying sounds, syllables, and words. The severity of apraxia of speech can range from mild to severe.

Although not all children have the same symptoms of CAS, here are some signs of CAS in young children:

- The child does not coo or babble as an infant

- Late onset of first words
- Missing sounds
- A small inventory of consonant and vowel sounds
- Problems combining sounds or long pauses between sounds
- Frequent deletion of difficult sounds or sound simplification
- Problems eating
- Expressive language problems like word order confusions and word recall

Here is an excerpt from an ASHA article on CAS:

"Research shows the children with CAS have more success when they receive frequent (3-5 times per week) and intensive treatment. Children seen alone for treatment tend to do better than children seen in groups. As the child improves, they may need treatment less often, and group therapy may be a better alternative.

The focus of intervention for CAS is on improving the planning, sequencing, and coordination of muscle movements for speech production. Isolated exercises designed to "strengthen" the oral muscles will not help with speech. CAS is a disorder of speech coordination, not strength.

To improve speech, the child must practice speech. However, getting feedback from a number of senses, such as tactile "touch" cues and visual cues (e.g., watching him/herself in the mirror) as well as auditory feedback, is often helpful. With this multi-sensory feedback, the child can more readily repeat syllables, words, sentences and longer utterances to improve muscle coordination and sequencing for speech ... Practice at home is very important. Families will often be given assignments to help the child progress and allow the child to use new strategies outside of the treatment room, and to assure optimal progress in therapy."

To learn more, read this ASHA article on CAS or talk to one of our speech-language pathologists.