What is Childhood Apraxia of Speech (CAS)?

Imagine your brain as a conductor, and your mouth and tongue as the orchestra. In CAS, the conductor (the brain) has trouble sending clear instructions to the orchestra (the muscles used for speech). It's not that the muscles are weak; it's that the brain struggles to plan and coordinate the precise movements needed to produce sounds, syllables, and words. This leads to inconsistent speech errors and difficulty sequencing sounds.

Symptoms of Childhood Apraxia of Speech (CAS)

Children with childhood apraxia of speech (CAS) can exhibit a range of speech-related symptoms, which vary based on their age and the severity of their condition.

Early Signs (7–12 months):

• Reduced babbling or fewer vocal sounds compared to typical development.

Toddler Years (12–18 months):

• Delayed first words, often emerging later than expected.

• Limited use of consonants and vowels.

• Frequent omission of sounds in speech.

• Speech that is difficult to understand.

These symptoms often become noticeable between 18 months and 2 years. At this stage, CAS may be suspected, and ongoing monitoring is recommended to determine whether intervention is necessary.

Preschool Years (2–4 years):

As children begin to speak more, additional signs of CAS may include:

• Distorted vowel and consonant sounds.

• Unusual pauses between syllables or words.

• Voicing errors, such as "pie" sounding like "bye."

How is CAS Diagnosed?

If you suspect your child has CAS, a comprehensive assessment by a qualified Speech Pathologist is crucial. This typically involves:

• Oral-Motor Examination: Checking the strength and coordination of the lips, tongue, and jaw.

• Speech Sound Inventory: Identifying the sounds your child can and can't produce.

• Assessment of Prosody: Evaluating the rhythm, intonation, and stress patterns in their speech.

• Non-Speech Oral Motor Tasks: Assessing abilities like blowing, sucking, and tongue movements.

What Treatment Options Are Available?

CAS requires intensive, individualised therapy. Here's what that might look like:

• Regular and Repetitive Practice: Consistent practice is key to building motor planning skills.

• Multisensory Feedback: Using visual, auditory, and tactile cues to help your child understand and produce sounds.

• Phonetic Placement: Teaching the correct positioning of the lips, tongue, and jaw for specific sounds.

• Syllable Drill: Breaking down words into syllables and practicing each part.

• Functional Communication Training: Incorporating sign language or AAC devices to support communication while working on speech.

Outcomes and Prognosis

Every child's journey with CAS is unique. While some children achieve significant improvements with early intervention, others may face ongoing challenges. The key is consistent, dedicated therapy and a supportive environment. If you have concerns about your child's speech, don't hesitate to seek professional help.