What Is Childhood Apraxia Of Speech (CAS)?
Childhood apraxia of speech (CAS) is a motor speech disorder. A motor speech disorder is a problem in planning and actually making the movement. This is not due to muscle weakness or paralysis but rather involves the part of the brain that plans, coordinates and integrates movement. In this case, there is a problem with the child’s ability use his lips, tongue, and jaw to actually plan the movement necessary to produce speech that is clear and precise. This can be very frustrating for the child since he/she knows what they would like to say but the words are not coming out the way the child wants them to.
What Are The Types Of Apraxia?
Apraxia can be described as either developmental or acquired.
Developmental apraxia, used interchangeably with childhood apraxia of speech, is present at birth. Developmental apraxia affects a child’s ability to plan the movements necessary to form sounds, hence, speech production is impaired. Children with developmental apraxia demonstrate a significant difference between receptive (understanding) and expressive (verbal) language abilities. In many instances, the child’s understanding is better than verbal expression.
Acquired apraxia can occur at any time and at any age for a variety of reasons. Acquired apraxia is more common in adults but can also affect children and adolescents as well.
Childhood apraxia is usually not isolated, and frequently occurs concomitantly with other language and cognitive deficits. Therefore, the child will often demonstrate limited vocabulary, grammatical errors, difficulty with oral feeding and swallowing, problems with fine motor skills, and they may appear to be clumsy because they are unable to plan movements that are refined, integrated and coordinated.
What Are The Symptoms Of Childhood Apraxia Of Speech?
There are many symptoms that may be indicative of developmental apraxia, however, the child may exhibit only some of the signs associated with the disorder. In addition, there may be variability of symptoms among children as well. The following symptoms are provided by The American Speech-Language-Hearing Association:
In very young children:
• 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
In older children:
• 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
• 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 syllables or word
What Are The Causes Of Childhood Apraxia Of Speech?
The exact cause of childhood apraxia of speech is still unknown. However, because it is considered a motor speech disorder (not being able to successfully plan and produce the movement for speech production), scientists believe there is most likely a neurological basis for the disorder. In addition, since family members often report having language and cognitive difficulties, genetic and hereditary factors might also play a role in the disorder.
What Should You Do If You Suspect Your Child Of Having Apraxia?
The first thing you should do is to speak to your child’s pediatrician and ask for a referral to a licensed Speech Language Pathologist who has experience evaluating and treating children of all ages.
Prior to your child’s visit with the Speech Language Pathologist, schedule an appointment with a pediatric Audiologist for a complete hearing test in order to determine if hearing loss may be causing your child’s speech disorder. For example, frequent ear infections of the middle ear can cause delays in speech and language development. A more permanent hearing loss that affects the sense organ in your child’s inner ear can result in speech and language delays as well.
Next, schedule an appointment with the Speech Language Pathologist for a consultation and comprehensive evaluation of your child’s speech and language skills. The Speech Pathologist will evaluate your child’s oral-motor function, development of speech sounds, overall speech intelligibility, and language skills. Upon completion and interpretation of a comprehensive assessment, the Speech Pathologist will be able to confirm a diagnosis of Apraxia.