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The Complete Guide to Childhood Apraxia of Speech

Persistent impairments in speech skills in young children can be a sign of childhood apraxia of speech.
The Complete Guide to Childhood Apraxia of Speech
Updated: September 8, 2023
Medically reviewed by  Dr. Chelsea Hetherington, Ph.D.
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Childhood apraxia of speech can be a frightening thing to navigate as a parent. For most adults, moving our mouth muscles and exercising our vocal cords in order to articulate and communicate our needs comes easily for us – we don’t even think about it. But for young children, even if they know what they want to say, coordinating the many complex movements required to create speech and clear articulation can be challenging. In this article, we’ve compiled a parent’s guide to apraxia of speech in young children, including signs and symptoms to look out for and how this condition is treated.

What Is Childhood Apraxia of Speech?

While it’s common to struggle somewhat to understand what a young child or toddler is trying to say, sometimes persistent impairments in speech skills are actually a sign of a rare condition called childhood apraxia of speech, a.k.a. developmental apraxia. It’s important to know the signs of apraxia, as it’s a condition that will not go away on its own and requires treatment from a speech-language pathologist.

Apraxia of speech is a communication disorder that interferes with a child’s speech. Childhood apraxia of speech - also known as CAS - is typically present from birth and may have some genetic causes, which we will discuss later. Apraxia of speech can also occur in adults, typically after experiencing a stroke or a traumatic brain injury.

Most experts agree that CAS is a motor speech disorder rather than a cognitive disorder - that is, a child with CAS knows the correct words that they want to produce, but the signals they send from their brain to their facial muscles get jumbled up and produce unintelligible speech.

CAS is also referred to as pediatric apraxia. 

What Causes Childhood Apraxia of Speech?

Although researchers have learned a lot about CAS in the last several years, there still isn’t a clear consensus about what causes it. There may be a genetic component to childhood apraxia of speech that runs in families, or it might be a neurological condition where the signals in a child’s brain struggle to send speech movements to the mouth muscles.

Other experts believe that CAS might be related to other developmental conditions a child might have, such as autism, cerebral palsy, epilepsy, or galactosemia.

As mentioned above, experts believe that CAS might have a genetic component: researchers have found that children who have family members with a speech sound disorder, communication disorders, or a learning disability are more likely to have CAS. If one or more of those conditions runs in your family, you might want to be on the lookout for signs that your toddler might have childhood apraxia of speech.

Signs Your Child Might Have  Speech Problems


If you have concerns that your toddler might have apraxia of speech, here are some signs to look out for before the age of 3:

  • Lack of babbling
  • Sound errors such as pronouncing words differently each time they speak
  • Delays in saying their first word(s)
  • Difficulties eating
  • Only using a few different sounds
  • Struggling to put sounds together
  • Speech delays, such as long delays between words/syllables

As a child gets older, here are some additional signs to pay attention to:

  • Having a hard time producing words and speech sounds in the right order or struggling with sequencing
  • Inconsistent errors when pronouncing consonants and vowels
  • Seeming to understand language much better than producing it
  • Placing long breaks in between syllables or words
  • Difficulty with prosody, aka, the rhythm and intonation of speech that helps express meaning
  • Impairments in language development, such as loss of words that were previously mastered
  • Failure to meet language development milestones.

If you recognize one or more of these symptoms in your toddler, it might be a good idea to talk to your child’s pediatrician. CAS is a rare condition, but with early intervention and treatment from professionals such as a speech therapist, it is possible for your child to improve the quality of their speech.

Diagnosis of CAS 

As with many developmental disorders, early intervention is key with CAS. CAS is typically diagnosed by a pediatric speech-language pathologist or speech-language pathologist.

In order to make a diagnosis, an SLP will ask about any family history of learning disorders or communication disorders. They will also test your child’s speech by observing them and will be looking for:

  • Signs of weakened motor skills in the mouth muscles
  • Quality of vowel and consonant sounds
  • Production and ability of non-speech motor skills, like smiling and blowing bubbles
  • Variations in tone of speech
  • Intelligibility of speech such as the use of expressive language

How Is Childhood Apraxia of Speech Treated? 

CAS Treatment - Speech Therapy

CAS is typically treated through speech therapy with an SLP. Depending on the severity of a child’s condition, they might have sessions with their SLP as frequently as 5 times per week.

During speech therapy sessions, the SLP will provide tailored treatment and work with your child to improve the quality of their speech. Your child’s SLP might also recommend some exercises that you can do with your child at home in between speech therapy sessions.

Depending on the specific child, it may also be beneficial to explore alternate means of communication that don’t require speaking, such as sign language or an electronic communication device.

Is There a Cure for CAS?

Although there are many treatment options that can help improve your child’s speech, unfortunately, there is no cure for CAS. It’s important to get professional intervention from an expert, such as a speech-language pathologist, in order to improve a child’s speech and intelligibility.

Through consistent speech therapy, many children see vast improvements in their speech production. Long-term outcomes tend to vary a lot depending on the severity of the condition, consistency of treatment, and the individual child. Many children with CAS grow up to communicate effectively.

Additional Resources

If your child has been diagnosed with CAS, or if you suspect that they might have CAS, know that you’re not alone. Although this can be a frustrating condition to cope with, there are resources available that can help: 

Dr. Chelsea Hetherington, Ph.D.

About Chelsea

Chelsea is a developmental psychologist, writer, coach, and consultant. She works to bridge… Read more

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