Childhood Apraxia of Speech (CAS) is a neurological speech sound disorder in which a child has difficulty planning and programming the precise movements needed for speech. The child may know what they want to say, but their brain has difficulty organizing the movements required to produce sounds, syllables, and words accurately and consistently.

CAS can affect speech intelligibility and may occur alongside language, literacy, motor, or other developmental difficulties.

What Are the Signs of Childhood Apraxia of Speech?

Children with CAS may show:

• Inconsistent speech sound errors

• Difficulty producing the same word consistently

• Difficulty moving smoothly between sounds and syllables

• Problems with longer or more complex words

• Difficulty sequencing sounds and syllables

• Vowel errors or distortions

• Consonant distortions

• Unusual or disrupted speech prosody

• Slow or effortful speech

• Visible searching or “groping” movements when trying to produce sounds

• Reduced speech intelligibility

Importantly, these features can also occur in other speech sound disorders. There is currently no single sign that can independently confirm CAS, which is why a comprehensive assessment by an experienced SLP is important.

CAS vs. Speech Delay

A child with a typical speech delay may have difficulty producing particular sounds but generally follows predictable developmental patterns.

In CAS, the primary difficulty involves motor planning and programming for speech . Errors may be inconsistent, speech may become more difficult as words get longer, and the child may struggle to coordinate the movements needed to transition between sounds.

A professional assessment is needed to differentiate CAS from phonological disorders, articulation disorders, dysarthria, and other motor speech disorders .

How Is Childhood Apraxia of Speech Diagnosed?

An SLP experienced in pediatric motor speech disorders may conduct a comprehensive assessment involving:

• Speech sound production

• Repeated productions of words and phrases

• Syllable and word sequencing

• Speech movement accuracy

• Vowels and consonants

• Prosody and stress

• Oral-motor and nonspeech motor skills when clinically relevant

• Receptive and expressive language

• Functional communication

• Speech intelligibility

Dynamic assessment can also help the SLP understand how a child responds to different cues and determine appropriate intervention strategies.

There is currently no single standardized test that can independently diagnose CAS . Clinical judgment and comprehensive motor-speech assessment are important.

How Can Speech Therapy Help Children With CAS?

Speech therapy for childhood apraxia of speech focuses on improving the child’s ability to plan and produce accurate speech movements.

Therapy may include:

Motor Speech Practice

Repeated practice of meaningful speech movements and word shapes to improve accuracy and consistency.

Movement-Based Speech Cues

Visual, verbal, tactile, and sensory cues may be used to help the child understand and produce speech movements.

Speech Sequencing

Activities may target smooth transitions between sounds, syllables, and words.

Increasing Speech Intelligibility

Therapy gradually works toward clearer and more functional speech across increasingly complex words and phrases.

Language Development

Children with CAS may also have expressive or receptive language difficulties, so language goals may be addressed alongside motor speech needs.

AAC and Total Communication

AAC—including gestures, signs, communication boards, or speech-generating devices—may be recommended when speech is not sufficient for functional communication.

AAC can provide the child with a reliable way to communicate while speech skills continue to develop.

Does Childhood Apraxia of Speech Go Away?

CAS is not simply something a child is expected to “grow out of.” However, children can make meaningful improvements in speech and communication with appropriate intervention.

Progress can vary depending on the child’s individual profile, severity, co-occurring difficulties, treatment approach, practice opportunities, and consistency of support.

Why Is Intensive Practice Important?

Because CAS involves motor planning and programming, therapy often requires frequent and carefully structured speech practice .

The appropriate therapy frequency and intensity should be individualized. SLPs monitor progress and adjust treatment goals and approaches according to the child’s response.

Home practice can also support carryover, particularly when families are given simple, achievable activities that fit naturally into daily routines.

Can CAS Affect Language and Literacy?

Yes. Some children with CAS may also experience:

• Expressive language difficulties

• Grammar and sentence formulation difficulties

• Phonological difficulties

• Reading difficulties

• Spelling difficulties

• Written-language difficulties

• Social communication challenges

Therefore, intervention should consider the child’s whole communication profile , rather than focusing only on speech sounds.

When Should You Consult a Speech-Language Pathologist?

Consider a speech and language evaluation if your child:

• Is difficult to understand

• Uses inconsistent sound productions

• Says the same word differently each time

• Struggles with longer words

• Has difficulty sequencing sounds or syllables

• Appears to struggle to move their mouth when speaking

• Has very limited speech

• Becomes frustrated when trying to communicate

• Has slow or effortful speech

• Has difficulty developing new words despite understanding language

Early and appropriate assessment can help identify the child’s specific communication needs and guide individualized intervention.

Childhood Apraxia of Speech Therapy at iSpeak Total Communication Clinics

At iSpeak Total Communication Clinics , therapy for children with suspected or diagnosed CAS focuses on motor planning, speech movement accuracy, intelligibility, functional communication, and language development .

Depending on the child’s needs, therapy may incorporate structured motor-speech practice, multisensory cueing, language activities, AAC, gestures, and home practice.

Our goal is not simply clearer speech—it is helping every child develop effective, confident, and functional communication .

Frequently Asked Questions

What is Childhood Apraxia of Speech?

CAS is a neurological speech sound disorder involving difficulty planning and programming the movements required for speech.

Is CAS the same as a speech delay?

No. CAS is a motor speech disorder and requires specialized assessment to differentiate it from other speech sound disorders.

Can a child with CAS learn to speak clearly?

Many children make significant improvements with appropriate, individualized speech therapy, although progress varies between individuals.

Is CAS caused by weak speech muscles?

CAS primarily involves difficulty with speech motor planning and programming rather than simply weak speech muscles.

Can AAC be used for children with CAS?

Yes. AAC can support functional communication when speech is difficult to understand or not consistently available.

Does CAS affect reading and writing?

Some children with CAS may also experience language, phonological, reading, spelling, or writing difficulties, so these areas may need to be monitored and supported.

References

American Speech-Language-Hearing Association (ASHA). Childhood Apraxia of Speech – Practice Portal.

ASHA Practce Portal – Childhood Apraxia of Speech

Recommended citation:

American Speech-Language-Hearing Association. (n.d.). Childhood apraxia of speech [Practice portal]. ASHA.

Copyright note: This article has been independently written for iSpeak Total Communication Clinics. It does not reproduce ASHA’s copyrighted text, tables, graphics, or proprietary content. ASHA is credited as the clinical reference and readers are directed to the original resource.

Disclaimer: This article is for general educational purposes and does not replace an individualized assessment, diagnosis, or treatment plan from a qualified speech-language pathologist or other healthcare professional.