What is Childhood Apraxia of Speech (CAS)?

By: Madison Gwizdalski MS, CCC-SLP 

May is Apraxia Awareness Month and we would like to use it to bring awareness of childhood apraxia of speech to families, including what resources there are if your child gets this diagnosis!

Here are some common questions and misconceptions that hear regarding Childhood Apraxia of Speech (CAS):

What is Childhood Apraxia of Speech (CAS)?

Childhood apraxia of speech (CAS) is a motor speech disorder that makes it hard for children to speak. Children with a diagnosis of apraxia of speech may possess strong language comprehension and know what they want to say. Their difficulties lie in learning and/or carrying out the motor movements involved in speaking.

What are the core challenges of someone who has CAS?

Challenges can include learning to talk due to difficulty with speech motor planning and programming; producing coarticulatory movements between sounds, syllables, and words to produce intelligible speech; and developing appropriate prosody.  Children with CAS can often communicate their wants/needs effectively, though not always verbally (they. May often rely on gestures).

What are some early signs of CAS?

Some early signs of CAS include:

  • Limited babbling, or variation within babbling
  • Limited phonetic diversity
  • Inconsistent errors
  • Increased errors or difficulty with longer or more complex syllable and word shapes, such as multisyllabic words
  • Omissions of sounds, particularly at the beginning of words
  • Vowel errors/distortions
  • Excessive, equal stress that impacts prosody of speech
  • Loss of previously produced words
  • More difficulty with volitional versus automatic speech responses
  • Predominant use of simple syllable shapes
  • Difficult imitating words

Some non-speech signs that may also be present include:

  • Impaired volitional oral movements (oral apraxia), such as “smiling”, “kissing”, and “puckering”
  • Delays with fine/gross motor skills
  • Feeding difficulties that include choking and/or poor manipulation of food
  • General awkwardness or clumsiness

Why does this happen?

Most often, the cause of CAS is unknown. However, sometimes CAS can be attributed to differences in the brain and or damage to the brain as a result of stroke, TBI, genetic disorders, or metabolic conditions.

Do children outgrow this diagnosis?

Children may progress but do not outgrow this diagnosis. With early intervention and treatment, children can demonstrate significant improvements and may achieve age-appropriate speech skills.

What steps can I take if I suspect my child has this?

If you are concerned that your child is presenting with signs of CAS, you can contact a trained Speech Language Pathologist to conduct a thorough evaluation.

What does speech therapy look like for this diagnosis?

Studies have shown us that children with CAS benefit from frequent speech therapy sessions (3-5 per week) to show improvements in their intelligibility. Since CAS is a motor planning disorder, and different from other speech sound disorders, it requires specialized interventions. Without using these approaches in therapy, a child with CAS will not make as much progress. Your therapist will need to incorporate:

  • Frequent and extensive practice
  • Multi-sensory cueing tailored to the child. This could include visual cues (pictures, videos), verbal cues, metaphors, tactile cues (touch). These cues are reduced as the child progresses so that they become increasingly independent
  • Emphasis on movement versus correctness of sounds
  • Feedback tailored to the child
  • Incorporation of prosody targets into speech therapy sessions to help child improve fluency, rhythm, stress, and intonation.


Uplift Therapy Center can help you if you suspect that your child may have CAS. Contact us today if you would like to speak with a licensed Speech Language Pathologist, or set up and evaluation.


More Posts

Autism Spectrum Disorder and Speech Therapy

By: Pranali Shah, MS, CF-SLP Introduction Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that affects communication, behavior, and social interaction. It is called


By: Nicole Crisan, PT, DPT Floor play time is an integral part of development and is one of the first ways a baby learns to

Send Us A Message