Childhood apraxia of speech (CAS) is a motor-planning disorder that can make clear speech difficult. A child with apraxia may know exactly what they want to say, but their brain has trouble telling the muscles in their mouth how to move to produce the correct sounds.
Although childhood apraxia of speech has specific characteristics, some symptoms resemble those of other speech and language disorders. This overlap can make CAS difficult to diagnose.
This article explains how childhood apraxia of speech is diagnosed, how speech therapy can help, and how to find a speech therapist with relevant experience. With the right type and frequency of therapy, many children with apraxia can learn to speak well and communicate clearly and confidently.
How is childhood apraxia of speech diagnosed?
A speech-language pathologist, also called a speech therapist, diagnoses CAS after an evaluation. An evaluation for childhood apraxia of speech includes several parts.
First, the speech therapist will interact with your child to better understand their speech and language skills. When appropriate, the therapist may encourage your child to talk about their interests. This helps the therapist identify which sounds your child can and cannot say.
The evaluation will also include an oral-motor exam. The speech therapist will assess your child’s lips, tongue, jaw, and palate to make sure each structure looks typical and has typical strength. If the therapist notices weakness or a structural difference, such as a tongue-tie, it could be contributing to your child’s speech difficulties rather than apraxia.
The speech therapist will give your child an articulation test to evaluate how they produce consonants and vowels. The test may be administered more than once so the therapist can compare your child’s performance across testing attempts. Inconsistent errors are one of the hallmark characteristics of apraxia of speech. For example, a child might pronounce “butterfly” one way the first time and a different way the next. Asking for multiple attempts can help the speech therapist identify these inconsistent productions.
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What are the main symptoms of childhood apraxia?
Apraxia can look different from one person to another. Other key characteristics or symptoms of childhood apraxia of speech include:
- Difficulty combining sounds, syllables, or words
- Unusual or inappropriate stress on words during speech
- Inconsistent speech errors
- Errors when producing vowels
- Groping movements of the mouth while trying to produce a word
As part of the evaluation, the speech therapist will ask you to complete a packet of questions about your child’s medical and developmental history. This information is important for making a diagnosis.
After the evaluation, the speech therapist will review and analyze everything they collected before making a diagnosis. This process includes ruling out other speech and language disorders to determine whether CAS is present.
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Speech therapy for childhood apraxia of speech
There are currently no definitive studies on the long-term outcomes of children with apraxia. However, we do know that consistent, one-on-one speech therapy, supported by the child’s caregiver, offers the best opportunity for improvement. A child is unlikely to “grow out” of apraxia without intervention.
If your child is diagnosed with apraxia of speech, the speech therapist will develop a treatment plan with specific goals related to sound production. Therapy will emphasize frequent practice and repetition of these sounds. The therapist will also monitor and track your child’s accuracy percentage for each goal.
Speech therapists use different techniques to help children produce sounds and words more clearly. These techniques may include prompts such as:
- Visually demonstrating how to form each sound with the mouth. For example, the speech therapist may say words at the same time as the child.
- Using tactile cues, such as touching the child’s lips to remind them to close their lips when producing the /m/ sound
- Asking the child to listen to a sound production and decide whether it was correct or incorrect
Learn more about how Astrel evaluates and treats childhood apraxia of speech in our treatment guide.
Just as apraxia symptoms differ from child to child, so does progress. A treatment technique that helps one child may not help another, and each person progresses at their own pace.
Some children with very severe CAS may need alternative ways to communicate and share their thoughts. These options can include:
- Sign language
- A notebook containing pictures or written words
- An alternative or augmentative communication device, such as a communication board or a portable tablet that writes and produces speech
These assistive tools may not be necessary long-term. However, using them while working with your speech therapist can help promote verbal skills and reduce the frustration your child may be feeling.
How to find a speech therapist for childhood apraxia of speech
There are several ways to find a speech therapist who treats childhood apraxia of speech. Start by asking friends or acquaintances who have firsthand experience with speech therapy. Recommendations from people you know can be helpful.
You can also contact your child’s pediatrician, who likely has a list of speech therapists they recommend.
Before choosing a therapist, call their office and ask about their background in treating childhood apraxia of speech. CAS falls within every speech therapist’s scope of practice, but some therapists have more experience with it than others. Look for online reviews of the speech therapist as well.
Apraxia Kids provides an online registry of speech therapists throughout the United States and Canada who have experience treating children with apraxia of speech. You can search by location to look for a therapist near you.
Also consider the practical details of your child’s therapy sessions. How far will you need to travel? Do the available appointment times fit your schedule? Many families find online speech therapy more convenient. Many academic studies have found that online speech therapy is just as impactful and effective as in-person therapy.
Once you find a speech therapist, write down any questions you want to ask. You can call before your child’s evaluation or bring your questions to the appointment. Speech therapists understand that this can be an uncertain and anxious time for families. Your therapist will answer your questions and explain the plan for your child’s treatment.
If you have concerns about your child’s communication, do not wait to begin the process of getting them into speech therapy. The sooner therapy starts, the sooner your child can begin making progress.