Childhood Apraxia of Speech
A motor speech disorder where children struggle to plan and coordinate the movements needed for speech.
Childhood Apraxia of Speech (CAS) is a neurological motor speech disorder in which the brain has difficulty planning and programming the precise, coordinated movements of the jaw, lips, and tongue needed for intelligible speech. CAS is not caused by muscle weakness or paralysis; rather, the challenge lies in the motor planning and sequencing required to produce speech sounds, syllables, and words.
Children with CAS often show inconsistent speech errors, difficulty with longer or more complex words, inappropriate prosody (rhythm and stress patterns), and limited consonant and vowel repertoire. CAS can occur as an isolated condition or co-occur with other developmental, neurological, or genetic disorders. Accurate differential diagnosis is essential, as CAS requires a distinct treatment approach compared to other speech sound disorders.
Intervention for CAS emphasizes intensive, frequent practice of speech movement sequences using principles of motor learning. Evidence-based approaches such as Dynamic Temporal and Tactile Cueing (DTTC), the Kaufman Speech to Language Protocol, and PROMPT therapy have shown strong effectiveness. Consistent therapy with high repetitions of target sequences is key to progress.
Signs & Symptoms
- •Inconsistent errors on consonants and vowels across repeated productions
- •Difficulty sequencing sounds and syllables, especially in longer words
- •Groping or visible struggle when attempting to produce speech sounds
- •Abnormal stress, timing, or intonation patterns in speech
- •Limited babbling or sound repertoire in early development
- •Significant gap between understanding of language and ability to express it verbally
Treatment Approaches
- •Dynamic Temporal and Tactile Cueing (DTTC) for motor speech planning
- •Kaufman Speech to Language Protocol for systematic sound and syllable shaping
- •PROMPT therapy using tactile-kinesthetic cues to support motor planning
- •Intensive and frequent therapy sessions emphasizing repetitive practice
- •Multimodal communication support including sign language or AAC as needed
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