What is Childhood Apraxia of Speech?

Childhood Apraxia of Speech (CAS) is a rare speech sound disorder that impacts the planning and programming of motor movements for speech. It requires a specific type of therapy that focuses on sequenced movements of speech.

Speech is a complicated motor movement. Just to say one sound “AH” you have to coordinate muscles to take a breath in and then push that air out but in a controlled way, not all at once. Your vocal cords have to close and then be blown open by the air from your lungs. You have to make sure your tongue, teeth, lips, jaw, and velum are in the correct positions so that you don’t accidentally have air coming through your nose or make a raspberry because your lips were closed. Just to say one sound! Let alone changing the shape of your mouth to say mom. That’s complicated!

All of this is typically done without a second thought. This is motor programming. Your body does what it needs to do without even thinking about it. So when motor programming is disrupted, something as “simple” as saying hey becomes incredibly difficult. This disruption is CAS. It is important to note, that this disruption is NOT due to muscle weakness.

Because CAS and motor planning is so different than a phonological processing disorder or an articulation disorder, it is important to receive an accurate diagnosis and evidence based treatment. But what are the signs of CAS? The Mayo Clinic, the American Speech-Language-Hearing Association, and researchers have agreed that the following are characteristics of CAS:

• Difficulty moving smoothly from one sound, syllable, or word to another

• Groping movements with the jaw, lips or tongue to make the correct movement for speech sounds

• Vowel distortions, such as attempting to use the correct vowel, but saying it incorrectly

• Using the wrong stress in a word, such as pronouncing "banana" as "BUH-nan-uh" instead of "buh-NAN-uh"

• Using equal emphasis on all syllables, such as saying "BUH-NAN-UH"

• Separation of syllables, such as putting a pause or gap between syllables

• Inconsistency, such as making different errors when trying to say the same word a second time

• Difficulty imitating simple words

• Inconsistent voicing errors, such as saying "down" instead of "town"

CAS is complicated and it’s important to implement evidence-based treatment to support motor learning. For more information about what CAS is check the Mayo Clinic’s website. Stay tuned for what to look for in terms of motor speech therapy planning.