What is Childhood Apraxia of Speech?

Childhood Apraxia of Speech (CAS) is described as a speech condition that impairs a child’s ability to plan the motor movements of the lips, tongue and jaw, which are the parts of the mouth that are used to produce clear and intelligible speech. With intensive and appropriately targeted intervention children with this condition can learn the techniques needed to produce correct production of sounds.

There appears to be several characteristics that are consistently seen in children who have CAS:

  1. Difficulty with making and being consistent in the production of articulatory gestures
  2. Difficulty with speech sound characteristics (e.g.: vowel distortions)
  3. Impairment in syllable production
  4. Prosodic errors (rhythm – the different emphasis that is placed in words) in:
  • Pitch
  • Rhythm
  • Loudness
  • Pause
  • Stress

The onset of CAS is assumed to be early in speech sound development, and there are age related differences in children who have CAS.

CAS can be identified once therapy has commenced and children start presenting with these irregular speech patterns. Conversely, children who have initially been presented as having CAS may go on to being diagnosed with a phonological disorder.

The targeted therapy may include repetition of real and nonsense polysyllabic words.  These children may still go on having difficulty producing new and complex words that they have not come across.

Some research shows that children who have a speech-motor problem may have difficulty with spelling, reading and writing. Children who struggle to pronounce words and the sounds in words may have difficulty segmenting words into their syllables. Research puts forward that, due to their poor articulation of sounds,  children that have CAS may have difficulty with discriminating between sounds.

Therefore, it is essential that a Speech Pathologist teaches these children phonological awareness skills as well as other pre-reading and spelling skills as part of therapy. This would include focussing on teaching:

  1. Rhyme
  2. Syllabification
  3. Compound words (e.g. basket / ball)
  4. Onset and rime
  5. Listening for and identifying initial, middle and final sounds

Barbara A. Lewis Lisa A. Freebairn Amy J. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS • Vol. 35 • 122–140 • April 2004. School–Age Follow -Up of children With Childhood apraxia of Speech.