• What is childhood apraxia of speech?

    Childhood apraxia of speech (CAS) is a motor speech disorder. Children with apraxia have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.

    What are some signs or symptoms of childhood apraxia of speech?

    Not all children with apraxia are the same. All of the signs and symptoms listed below may not be present in every child.  General things to look for include the following:

    • Makes inconsistent sound errors that are not the result of immaturity
    • Can understand language much better than he or she can talk
    • Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech 
    • May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
    • Has more difficulty saying longer words or phrases clearly than shorter ones
    • Appears to have more difficulty when he or she is anxious
    • Is hard to understand, especially for an unfamiliar listener
    • Sounds choppy, monotonous, or stresses the wrong syllable or word 

    Potential Other Problems

    • Weakness of the lips, jaw, and/or tongue
    • Delayed language development
    • Other expressive language problems like word order confusions and word recall 
    • Difficulties with fine motor movement/coordination
    • Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like toothbrushing or crunchy foods, may not be able to identify an object in their mouth through touch)
    • Children with apraxia or other speech problems may have problems when learning to read, spell, and write

    What treatments are available for children with apraxia of speech?

    The focus of intervention for the child diagnosed with apraxia is on improving the planning, sequencing, and coordination of muscle movements for speech. Isolated exercises designed to "strengthen" the oral muscles will not help without a combined focus on speech production. Apraxia is a disorder of speech coordination, not strength.

    To improve speech, the child must practice speech. However, getting feedback from a number of senses, such as tactile "touch" cues and visual cues (e.g., watching him/herself in the mirror) as well as auditory feedback, is often helpful. With this multi-sensory feedback, the child can more readily repeat syllables, words, sentences and longer utterances to improve muscle coordination and sequencing for speech.

    Practice at home is very important. Families will often be given assignments to help the child progress and allow the child to use new strategies outside of the treatment room, and to assure optimal progress in therapy.

    One of the most important things for the family to remember is that treatment of apraxia of speech takes time and commitment. Children with apraxia need a supportive environment that helps them feel successful with communication.

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