Childhood Apraxia of Speech

Bridget Hillsberg
May 10, 2020

Did you know that in order to speak, a message is sent from your brain to your mouth that tells your lips, tongue and jaw how to move? Seems simple enough, right? Well, unfortunately for children with Childhood Apraxia of Speech it is not that simple. At Speech Sisters, we are here to help. According to the American Speech and Hearing Association, Childhood Apraxia of Speech (CAS) is defined as “a motor speech disorder that makes it hard to speak.” CAS has nothing to do with muscle weakness or paralysis. Instead, the brain actually struggles to plan and coordinate the movements of the lips, jaw and tongue while talking.

So what does this look like in children? What are the signs of CAS?

  • Sounds are distorted (especially vowels). This happens because the articulators (tongue, lips, jaw) are not consistently moving in the same manner.
  • Multiple, inconsistent speech sound errors. A child may say a word correctly and then a minute later say it incorrectly.
  • Groping movements of the articulators (tongue, lips and jaw) in an attempt to try and make the correct sound.
  • Impaired prosody which is the inflection that is used when speaking.
  • Receptive language, or a child’s understanding, is far more advanced than their expressive language skills.

When do we see these signs?

Most symptoms of CAS are seen between 2 and 4 years old when most children are beginning to produce more and more speech sounds. It is important to note that CAS may look different from child to child and speech-language pathologists should not diagnose a child with CAS until they are at least 3 years of age. This is extremely important because up until that age some aspects of CAS can look similar to speech sound disorders in typically developing children under the age of 3 years.

Why? What is the cause of CAS?

There is no known cause of CAS but in some cases it can occur due to brain damage from a traumatic brain injury or it can be seen as part of a genetic disorder.  

What can be done to help a child with CAS?

It is very important that a child who is diagnosed with CAS receives speech therapy from a certified speech-language pathologist, as it is not a disorder that will improve in time or with development. Generally speaking, therapy for CAS requires intensive and individualized treatment that focuses on repetitive motor planning and production of sounds and words. There are multiple approaches that can be used in treatment, as there is no single approach to treat CAS. Most therapy techniques focus on motor programming through repetitions of sound sequences and words. Additionally, the use of visual and/or tactile cueing has proven to be helpful.

What is the outcome for a child with CAS?

Unfortunately, there is not an easy answer to this question because each child is so different. There are many factors that influence the prognosis of a child with CAS. These factors include family history, severity, overall health, attention/behavior skills, age of start of intervention, frequency of therapy, comorbidity, and parent involvement.

To end on a positive note, the majority of the time, children who do receive the appropriate treatment will learn to speak and/or improve their speaking skills.

To learn simple and effective strategies to help get your little one talking, check out our Talk on Track (newborn-14 months) and Time to Talk: Toddler Course (15-36 months). We’d love to equip you to experience the joy of your little one talking to you!


American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech.

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American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech.

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Mayo Clinic. (2019). Childhood apraxia of speech.

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Bridget Hillsberg
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