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Childhood Apraxia of Speech

What is Childhood Apraxia of Speech (CAS)?

Speech production is simple! You think of something to say, open your mouth and the words just come out, right? Wrong! There is so much planning and coordination that goes into speech production.

Do you ever feel like you know what you want to say, but because you’re rushing, or excited, or nervous, the words just don’t seem to come out right? This is similar to what a child with Childhood apraxia of speech (CAS) experiences all of the time. They know what they want to say, however the signal between their brain to their articulators, (lips, jaw, tongue, teeth), gets messed up and the message doesn’t come out the right way. Because the message from the brain to the articulators doesn’t come through correctly, the articulators don’t move in the way they are supposed to. It is important to note that CAS does not mean that there is weakness in the articulators.

According to the American Speech-language and Hearing Association a child with CAS will not learn speech sounds in a typical order and will (typically) not make progress without treatment.


Typically, the cause of CAS is unknown. However, in some cases, CAS can result from a genetic disorder or syndrome, stroke, or traumatic brain injury.

Signs and Symptoms

Not all children with CAS will show the same or all of the following signs/symptoms:

- Errors may be inconsistent – Although, the child may be asked to say a word 3 times in a row, it may sound different each time.

- Tends to put the stress on the wrong syllable or word.

- Distorts or changes sounds, especially vowels – This happens because the articulators are not consistently moving in the same manner.

- Can sometimes say shorter words with more clarity than longer ones.

- Receptive language (understanding) is more advanced than their expressive language.

Children with CAS may have other problems, including

- Difficulty with fine motor skills,

- delayed language; or

- problems with reading, spelling and writing.

When To Seek Help:

Typically, if your child is demonstrating any or all of the aforementioned signs/symptoms at or after age 3, it is advised to seek a consultation and evaluation from a licensed speech-language pathologist. Prior to age 3, some children may demonstrate similar characteristics of CAS, however these could be due to typically developing speech sound disorders.


Factors such as family history, severity, onset and frequency of intervention, comorbidity and parent intervention will all effect the child’s prognosis.

A child does not grow out of CAS and will require intensive and individualized therapy. However, children who do receive appropriate intervention, will typically show overall improvement in their speech.


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

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