What is CAS or Childhood Apraxia of Speech?

By May 20, 2018 May 14th, 2023 Speech Pathology
Young girl doing a Speech Pathology assessment in speech therapy clinic in Bondi Junction and Mascot

What is Childhood Apraxia of Speech (CAS)?

Childhood Apraxia of Speech (CAS) is a ‘neurological motor speech disorder’. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words’ (source)

In other words, the child knows what they want to say. However, their brain has trouble making the muscles movements in their jaw, tongue and lips. As a result, the child can’t say words the way they want to say. Children with Childhood Apraxia of Speech understand what other people say to them, they know what they want to say, they often know exactly what sound they need to say in the word, but somewhere in their little brain the message misfires and the child can’t make the muscles in his mouth say the sounds correctly. As a consequence, CAS is very frustrating for children.

Childhood Apraxia of Speech is often called CAS. However, it can also be called developmental apraxia of speech (DAS), developmental articulatory dyspraxia (DAD) and developmental verbal apraxia (DVD).

How is it different from other speech problems?

Children who have a speech delay are developing their speech at a slower rate then what we expect. They are developing their speech sounds at a slower rate. They are also developing the underlying speech sound patterns at a slower rate too. We call these underlying speech sound patterns ‘phonological processes’.

On the contrary, children with CAS are developing speech that is not typical of the way children learn speech. Unlike children with a speech delay, children with CAS speech in an ‘atypical’ way.

The other significant difference is that CAS needs intensive Speech Pathology for a longer period of time.

What are the signs of CAS?

Children with CAS present with many speech errors, and these speech errors vary between children. Most people working in this area agree that children present with some, but not all, of the following.

  • The child has a limited range of sounds they say correctly.
  • The child struggles to say vowels correctly. Vowels sounds carry a lot of meaning in words. When you change the vowel sound you can change ‘hat’ to ‘hot’ to ‘ hit’ and to ‘hate’ very quickly.
  • The speech errors are inconsistent. This is a very strong characteristic of CAS. The child says the same word in three different ways. In a speech delay, most children makes the same type of mistake in their speech. Inconsistent errors, make it hard for others to understand what the child is saying.
  • There is a heavy reliance on one sound. The child uses this sound in many words.
  • The rate of speech, the intonation, the stress on different syllables and the rhythm of speech is disturbed. They sound like robots sometimes.
  • They make lots of mistakes on longer, more complex words.

Does it only affect speech?

CAS always affects speech. It doesn’t alway affect other areas of development. However, children with CAS sometimes have difficulty with:

  • Feeding
  • General co-ordination

What causes CAS?

At this stage we do not know what cause CAS. Current research suggests that there is a genetic component. Children with CAS have a higher incidence of a family history of speech and language problems.  Some children with CAS also have other developmental or medical conditions such as autism and epilepsy.

Childhood Apraxia of Speech is not caused by the parents!

How many children have CAS?

There is not a lot of research about the incidence of Childhood Apraxia of Speech. Some research suggests that 2-3 children in every 1000 have this speech disorder.

What does my child need if they have CAS?

Children with CAS need Speech Pathology intervention. The research shows that they need intensive intervention. Sessions should be at least twice a week. The program should be individualised for the child. The focus should be on learning the motor patterns for speech. Children with CAS need a lot of repetition of the speech movements that they learn.

Some children have such severe speech issues that they don’t use speech to communicate. These children use  augmentative and alternative communication which is called AAC. They use programs on iPads and other speech generating devices.

Children with CAS may be eligible for funding through the NDIS which can help families with the cost of seeing a Speech Pathologist at the required intensity.

What should I do if my child has CAS?

If your child has CAS then:

  • contact a Speech Pathologist who has experience with CAS
  • sessions need to be more frequent
  • find a speech pathologist who supports you to follow through at home. This increases the intensity of intervention.
  • Watch the video from the Mayo Clinic. It has a lot of really great information.

OneOnOne Children’s Therapy is a Speech Pathology clinic in Bondi Junction. Our Speech Pathologists are experienced in Childhood Apraxia of Speech and they have done extensive training in the area.  We are very happy to answer any of your questions about CAS. We can be contacted on (02) 80657837 or email us. Most of all, children with Childhood Apraxia of Speech can improve their communication skills!