Difficulties Associated With Childhood Apraxia Of Speech

Childhood apraxia of speech (CAS) has numerous associated difficulties that make it among the more challenging speech disorders handled by speech language pathologists. But there’s also hope for children with CAS and it starts with early diagnosis and intervention.


Difficulty in Diagnosis


The first difficulty encountered by parents of children with CAS is in getting a definitive diagnosis, a difficulty also encountered by speech therapists and other medical professionals. This is due to the absence of a definitive test and/or checklist for childhood apraxia, among other reasons.


In young children, there are many disorders that can be mistaken for CAS mainly because of their similarities in signs and symptoms. CAS, for example, is often mistaken for dysarthria (i.e., poor muscle tone of the mouth) or autism, and it’s an erroneous diagnosis that will affect early intervention measures.


In fact, apraxia experts caution against an official CAS diagnosis before a child reaches three years of age. By age three, other causes for speech delays would have been ruled out and a CAS diagnosis will likely be more accurate.


Apraxia experts, nonetheless, look for red flags in young children including little to no babbling; difficulty in saying a word the same way with each try; loss of previously used words; feeding issues; absence of phonetic diversity; and limited intonation.


Even without a CAS diagnosis, however, parents should still have their child treated for speech difficulties. Speech therapy customized to the specific needs of the child is highly recommended.


Difficulty in Speech Development


Children with CAS have numerous challenges in their speech and language skills obviously.  While many of these issues seem cute and charming, especially in older babies still learning to talk, these aren’t so considering that speech is an integral part of communication. When left untreated, it can affect the child’s social, mental and emotional development in the future.


While each child with CAS has a specific set of symptoms including their onset, severity and duration, the disorder is typically associated with delayed onset of the first words; the decreased ability to form consonant and/or vowel sounds; and just a few spoken words. These symptoms usually appear between 18 and 24 months although, again, these may be attributed to other causes.


The symptoms change, too, as an affected child grows older. Between 2 and 4 years old, a child with suspected CAS can exhibit symptoms like distortions in forming sounds for vowels and consonants; errors in voicing (e.g., “bye” sounds like “pie” or vice versa); and separation of the syllables within a word or between words.


But it isn’t just speech difficulties that children with CAS have to deal with. Many of them also have physical symptoms, such as difficulty in getting their lips, tongues and jaws to their correct positions.


Once a definitive diagnosis has been made, fortunately, children with CAS have high chances of improving their speech and language skills.




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