Blog
Childhood Apraxia of Speech: Early Signs, Causes, and How Speech Therapy Helps
Childhood apraxia of speech is a motor speech disorder that affects speech planning. The brain has trouble planning precise movements for clear speech. It is not caused by weak speech muscles. Children do not simply outgrow it, but speech therapy can improve communication.
Table of Contents
What Is Childhood Apraxia of Speech?
Parents often ask, “What is childhood apraxia of speech?” CAS is a neurological speech sound disorder. A child has trouble planning and timing the movements needed for speech.
CAS differs from muscle weakness. The lips, tongue, and jaw may have typical strength and tone. The problem involves planning accurate speech movements.
ASHA estimates CAS affects about 1 in 1,000 children ages 4 to 8. Its signs can overlap with other speech disorders.
Early Signs of Childhood Apraxia of Speech
The early signs of childhood apraxia of speech differ from child to child. These signs alone are not enough to diagnose CAS in babies and toddlers.
| Under 12 months | Fewer sounds, consonants, or syllable shapes |
| 12 to 24 months | Limited sound variety or slow growth in spoken words |
| 2 to 4 years | Inconsistent word attempts or trouble with longer words |
| 4 years and up | Unusual stress, slow speech, sound errors, or poor clarity |
Other signs include groping, where the mouth searches for a speech position. A child may also say the same word differently across attempts.
ASHA lists three common features: inconsistent errors, disrupted movement between sounds, and unusual word or phrase stress.
What Causes Apraxia of Speech in Children?
The cause of apraxia of speech in children is not always known. Some cases occur without a clear medical cause.
CAS may also occur after a neurological event or with another developmental condition. Early stroke, infection, trauma, and some genetic conditions have been linked with CAS.
Genetics is an active area of research. ASHA reports that more than 30 genes are linked with about one-third of CAS cases. These include FOXP2, CDK13, EBF3, and SETBP1.
How Is Childhood Apraxia of Speech Diagnosed?
A speech-language pathologist, or SLP, diagnoses CAS through clinical judgment and a detailed assessment. There is no single test that confirms it.
The SLP may check:
- Speech sounds in single words and longer phrases.
- Changes across repeated speech attempts
- Rhythm, stress, and speech rate
- Oral movements and muscle function
- Language and communication skills
- Hearing or the need for a hearing referral
Dynamic motor speech testing can show which cues help a child speak more clearly. It can also help separate CAS from other speech disorders.
A firm diagnosis can be difficult before age three. ASHA notes that younger children may receive a provisional label, such as suspected CAS. Treatment can still begin while the SLP tracks speech.
How Speech Therapy Helps Childhood Apraxia of Speech
Speech therapy helps children build more accurate speech movement plans through guided practice. Treatment should match the child’s age, speech needs, and language needs.
CAS therapy often includes:
- Frequent practice. Children repeat useful speech targets many times.
- Movement work. Therapy builds accurate movement between sounds and syllables.
- Sensory cues. The SLP may use visual, touch, and listening cues.
- Feedback. Cues change as the child becomes more independent.
- Communication support. AAC may help when speech alone is not enough.
These methods follow core motor learning principles used in CAS treatment.
Treatment intensity depends on the method and the child’s needs. The Royal College of Speech and Language Therapists’ 2024 position paper supports individual CAS therapy. It also reports stronger results with higher treatment intensity in many cases.
Parents can help with short practice tasks between visits. The SLP should guide these activities.
Common Therapy Approaches
| DTTC | Builds accurate speech through imitation and changing cues |
| ReST | Practices sound transitions, longer words, and stress |
| Nuffield Dyspraxia Programme | Builds speech from sounds and syllables toward connected speech |
| AAC | Gives another way to communicate while speech develops |
DTTC, ReST, and Nuffield use different ways to build speech motor skills. AAC can support communication when spoken speech is not enough. No single approach is best for every child.
New Trends in Apraxia Care
Research now gives more attention to genetics, early identification, and treatment planning. More gene changes linked with speech motor planning have been identified.
There is also more focus on children under three with possible CAS signs. An SLP may treat suspected CAS while collecting more speech samples.
AAC can also support children who cannot communicate well through speech alone. Pictures, signs, or speech-generating devices can support daily communication during therapy.
Can a child outgrow apraxia of speech?
Children do not simply outgrow CAS without support. ASHA and NIDCD state that speech-language therapy can improve communication. Outcomes vary based on each child’s needs and response.
Is apraxia the same as autism?
No. CAS affects the planning of speech movements. Autism affects social communication and behavior more broadly. However, a child can have both conditions.
At what age can childhood apraxia of speech be diagnosed?
CAS may be suspected in very young children. A firm diagnosis before age three can be difficult because speech samples are limited. An SLP may use a provisional diagnosis and begin treatment.
How long does speech therapy take?
There is no fixed timeline for CAS therapy. Some children need longer or more intensive care than others. The SLP should review progress and adjust treatment over time.
Can childhood apraxia affect reading and spelling?
It can. Some children with CAS also have language, sound awareness, reading, or spelling problems. The SLP can watch these skills and add literacy support when needed.
Early assessment can help families understand why speech feels difficult for their child. Precision Speech Therapy provides individualized, child-friendly pediatric speech therapy in Forney, Texas. Book your child’s evaluation today to find the speech therapy plan that best fits their communication needs.
Article written by:
Recent Posts
