Childhood Apraxia of Speech: Signs and Symptoms

By: Jennifer Tripoli M.S, CCC-SLP

You may have heard the term “apraxia” before but wondered, what exactly does this mean? According to the American Speech Language Hearing Association (ASHA),

“Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.”

Childhood Apraxia of Speech (CAS) is not a black and white diagnosis and can be difficult for speech language pathologists to diagnose especially in very young children (under the age of 2). Children with CAS may have coexisting conditions such as Down Syndrome, Cerebral Palsy, or some other neurological disease. Some children with CAS though do not have any other known neurological deficit.

Children with CAS may present the following key characteristics:

• Limited vowels produced, lack of differentiation between vowels, and/or vowel distortions
• Inconsistency or variability in productions
• Groping of oral structures or physical struggle to produce sounds
• More difficulty with multisyllabic words or more complex productions (longer phrases/sentences)
• Difficulty with imitation, better productions observed with spontaneous, learned, or automatic productions
• Choppy or monotone speech (equal stress patterns on multisyllabic words)
• Slow rate of speech
• Difficulty with non-speech oral movements such as sticking tongue out, pursing lips, etc. (oral apraxia)

Listed below are other common signs present in children with CAS, though are not exclusive to CAS:

• Decreased babbling or vocal play as an infant
• Lack of imitation skills in infancy
• Delayed speech production or expressive language skills
• Poor speech intelligibility (ability to be understood)
• Decreased sound inventory for his/her age
• Words used once and never used again

Children with CAS may not present with all of the above characteristics. There is currently no “rule” regarding how many characteristics a child must have to qualify for a CAS diagnosis.  If your child presents any of the above key characteristics, an evaluation by a speech language pathologist who specializes in CAS is recommended in order to differentially diagnosis your child.  Children with the above characteristics may present CAS or another speech sound disorder.

Visit Easter Seals DuPage & Fox Valley at EasterSealsDFVR.org to learn more about speech-language services and evaluation. And to learn more about CAS and access parent friendly resources, visit Apraxia Kids.