Childhood Apraxia of Speech is a complex disorder that is often misdiagnosed. A definitive diagnosis of CAS is typically not made until a child has a repertoire of at least 100 words and/or following a diagnostic period of 3-6 months of therapy.

The American Speech Language and Hearing Association’s definition is as follows: “Childhood Apraxia of Speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements for speech are impaired. CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known or unknown origin, or as an idiopathic neurogenic speech sound disorder.”

Although there are not any formal guidelines for diagnosing CAS, (as it is a variable disorder and features change over time). The following features are considered to be hallmark characteristics of Childhood Apraxia of Speech and aid in the identification of a disruption in a child’s motor planning.

These hallmark characteristics include:

  1. Inconsistent speech sound errors on consonants and vowels, in repeated productions of syllables and words.
  2. Disrupted and/or lengthened co-articulatory transitions between sounds and syllables
  3. Impaired prosody (or rhythm of speech)
  4. Inconsistent errors in repetition of the same target, e.g., “bop” and “ba” for ‘pop’
  5. Omission of initial consonants, e.g., “at” for ‘hat’ (indicating difficulty initiating speech)
  6. Vowel distortion, e.g., “dug” for ‘dog’
  7. Groping, or struggle, while attempting to find the appropriate articulatory positioning (of lips, tongue and jaw) for certain sounds or words.
  8. A child’s ability to understand language (receptive language) is much greater than his/her ability to express language (expressive language)
  9. Inventing signs/gestures and using nonverbal means of communication to compensate for difficulty using words.
  10. Speech that is imitated (following a model) is much clearer (easier to understand) than spontaneous speech (speech produced independently), although imitating speech is difficult.

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