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Childhood Apraxia of Speech

Children with Childhood Apraxia of Speech (CAS) know what words they want to express, but they have difficulty with the motor planning and execution required in order to verbally express the message. The American Speech-Language-Hearing Association (ASHA) defines CAS as a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits.

Some characteristics of Chilldhood Apraxia of Speech include:

  • Inconsistent errors

  • Difficulty with transitions between sounds and sound sequencing

  • Inappropriate prosody and/or stress

  • Inaccurate voicing

  • Higher accuracy with shorter words compared to longer words.

  • Groping for sounds

  • Errors with tone, stress, voicing and rhythm

  • Vowel distortions

  • Consonant distortions

  • Reduced sound inventory

  • Few/simple syllable shapes

Please note: no single characteristic is sufficient for a diagnosis of Childhood Apraxia of Speech. A child with CAS may not present with ALL of the characteristics listed above. Also, a child without CAS may demonstrate some of these characteristics. Dynamic assessment of speech skills, as well as further language and play assessment, is required to rule out other factors. It is crucial to look at the child as a whole.

Since Childhood Apraxia of Speech is a motor speech disorder, treatment that involves principles of motor learning is recommended. The main focus of CAS therapy is on the movement and sequencing, not on the individual sounds. Frequent, high intensity practice of speech tasks is recommended to improve motor planning for speech.

Children with Apraxia may benefit from different levels of cueing, including tactile, visual, and auditory. Cueing may start as intensive, and fade over time to improve a child’s level of independence with these speech tasks.

Clinicians may choose to target functional, vocabulary targets to improve functional communication, versus a random set of words. This way, the child can communicate a variety of pragmatic functions using these functional words across contexts.

Some children with CAS may benefit from an augmentative communication system to express themselves along with verbal speech. See our posts about Augmentative and Alternative Communication to learn more.

Childhood Apraxia of Speech diagnosis and treatment may seem overwhelming. Our team of speech therapists at the Boston Ability Center are here to help and support your child’s growth. If you have questions regarding your child’s speech development, call us at 781-239-0100 and our SLPs would be happy to help!

Here are some helpful & recommended resources to learn more about CAS:



American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech [Position Statement]. Available from

Stoeckel, Ruth (2018, October 24). Building and expanding Your CAS toolkit [Webinar]. American Speech Language and Hearing Association.

Strand, Edythe. (2017). Appraising apraxia: when a speech-sound disorder is severe, how do you know it is childhood apraxia of speech? ASHA Leader Vol 22(3).

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