Conditions We Treat: Children

Childhood Apraxia of Speech

Specialized motor-speech treatment for children who have difficulty planning and coordinating the precise movements speech requires.

What Is Childhood Apraxia of Speech?

Childhood Apraxia of Speech (CAS) is a relatively uncommon motor speech condition, affecting roughly 1 to 2 out of every 1,000 children. It's not a problem with understanding language or knowing what to say — a child with CAS usually knows exactly what they want to say. The difficulty is in the brain-to-mouth connection: the messages that tell the mouth's muscles how to move to form words don't come through consistently, which makes speech sound effortful, inconsistent, or hard to understand.

A little girl frowns in concentration with her fingers at her lips as she tries to say a word while her mother watchesChildren with apraxia know what they want to say but struggle to plan the movements.

Signs by Age

CAS can look a little different depending on a child's age.

  • 18-24 months: delayed first words, and limited use of consonant and vowel sounds
  • 2-4 years: sound distortions, pauses between syllables, and speech that comes out differently each time it's attempted
  • Any age: awkward transitions between sounds, visible trial-and-error while searching for a sound, limited babbling as an infant, and sometimes feeding challenges
A toddler boy points at a toy truck while his mother crouches beside himEarly signs often show up as limited sounds and words.

Getting a Diagnosis

CAS can only be diagnosed by a certified speech-language pathologist, through a hands-on evaluation of a child's intonation, oral-motor skills, and sound production. Because CAS can look similar to other speech and language difficulties early on, this evaluation is an important first step before starting therapy.

A speech-language pathologist assesses a five-year-old boy at a deskA specialist evaluation confirms the diagnosis.

Our Approach to Treatment

Therapy for CAS is built around frequent, focused practice — we typically recommend around ten 30-minute sessions a week, or five sessions a week at minimum, since consistent repetition is what helps rebuild those brain-to-mouth pathways. Sessions use engaging, play-based activities to practice sound production and coordination, tailored to each child's specific pattern of errors.

We also start with a comprehensive hearing evaluation, since ruling out a hearing difference is an important part of getting the full picture, and we keep families closely involved with practice strategies and education so progress continues between sessions.

A therapist and a young boy both touch their chins in front of a mirror to practice forming a wordFrequent, hands-on practice is the heart of treatment.

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