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.  As a result, even though the child knows what he wants to say, he cannot say it correctly at that particular time. Sometimes he cannot even begin. Either the wrong sound comes out, or many sounds are left out all together. At that particular time, the motor plan is not accessible. These errors are not under the child's voluntary control so he often cannot correct them, even when trying his hardest. This can be very frustrating for both the child and the parents.


The impact of dyspraxia is evident as described by The American Speech and Hearing Association:

A Very Young Child

  • Does not coo or babble as an infant
  • First words are late, and they may be missing sounds
  • Only a few different consonant and vowel sounds
  • Problems combining sounds; may show long pauses between sounds
  • Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
  • May have problems eating

An Older Child

  • Makes inconsistent sound errors that are not the result of immaturity
  • Can understand language much better than he or she can talk
  • Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
  • May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
  • Has more difficulty saying longer words or phrases clearly than shorter ones
  • Appears to have more difficulty when he or she is anxious
  • Is hard to understand, especially for an unfamiliar listener
  • Sounds choppy, monotonous, or stresses the wrong syllable or word

A child who has CAS will not simply "grow out of it". Without speech therapy, the child's communication skills may improve as he grows older, but his speech will still be filled with errors and be difficult to understand. Research shows that children with CAS have more success when they receive frequent (3-5 times per week) and intensive one-on-one treatment. It should start as soon as the disorder is identified and the child is old enough to participate in therapy (18-30 months). Therapy does not provide a "quick fix". Most apraxic children will be in therapy at least 2 years and sometimes significantly longer.

What can you do at home to help your apraxic child?
Probably the most helpful thing that you can do at home is make your child feel as good as possible about his speech and about himself. Accept whatever your child says and, if it is right, praise him. If it is wrong, do not say "No". The child will think that you are disagreeing with the content of his message rather than the way it was said. It is more positive to say, "Yes, that's right" then restate his message with the correct sounds.
You need to be supportive as possible. This will help create self esteem and a positive atmosphere in which you child can learn to enjoy communication.
As you start therapy try to practice for a few minutes each day. The more you practice, the faster that specific "motor plan" will become habitual. It is better to practice for a few minutes each day than to practice once or twice a week for longer periods of time. If you child is reluctant to practice, try using a reward system such as a sticker chart or earning small amounts of money towards a favorite toy.


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