For speech production, your child’s brain has to learn how to make plans that tell his/ her speech muscles how to move the lips, jaw and tongue in ways that result in accurate sounds, syllables, words, phrases, and sentences. Your child’s brain also plans these movements so that he/she speaks with a normal rate and rhythm.

In Childhood Apraxia of Speech, the brain struggles to develop plans for coordinated speech movements. Consequently, children with CAS do not learn the precise movements for speech production. In CAS, the speech muscles are not weak; rather they do not perform normally because the brain has difficulty planning and sequencing the necessary speech movements.

Signs of Childhood Apraxia of Speech

Three Most Common Characteristics

Inconsistent speech sound errors
Difficulty moving from one speech sound to another or from one syllable to another
Abnormal rhythm, rate, stress and intonation during speech

Other Characteristics That May Be Seen

First words are late and may be missing sounds
Inconsistent sound errors
Difficulty producing many speech sounds
Use of only vowel sounds, grunts, or single syllable to communicate
Use of only a few speech sounds during speech
More errors on longer words or phrases than with single sounds or syllables
Struggles when trying to find the correct mouth position to produce a sound
Difficulty starting a sound
Normal receptive language (understanding) skills but limited expressive language skills
Difficulty imitating mouth movements
Difficult to be understood, especially to the unfamiliar listener
Behavioral issues related to the frustration in not being understood by family members, teachers and peers

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Content goes hereTop Three Characteristics of Childhood Apraxia of Speech The top three characteristics of Childhood Apraxia of Speech, as reported by the American Speech-Language-Hearing Association (ASHA) Technical Report on Childhood Apraxia of Speech, that can help the SLP make a differential diagnosis are: • Inconsistent errors with consonants and vowels on repeated productions of syllables and words (your child says the same word in different ways when asked to repeat it several times. This might be more apparent in new words or longer more complex words.) • Difficulty moving from sound to sound or syllable to syllable, resulting in lengthened pauses between sounds and/or syllables • Inappropriate stress on syllables or words (such as all syllables are said with equal stress on each one causing the “melody” of speech to sound odd) Other possible signs of apraxia of speech are: • Increased mistakes in longer or more difficult and complex syllables and words. • Reduced vowel inventory (the number and assortment of vowel sounds that your child can produce), or errors when producing vowels, and • Possible “groping” behaviors in which your child appears to struggle to achieve the correct oral posture to start or produce the syllable or word. (Not all children exhibit this at all times or situations. If your child does not demonstrate groping of their speech musculature, that alone is not enough to rule out apraxia of speech.)