Childhood apraxia of speech (CAS) is a motor speech condition that makes it challenging for children to speak clearly. A child diagnosed with CAS often has a good grasp of language and knows what they want to say, but they may struggle to consistently and accurately form words and coordinate the movements needed to speak. You might hear healthcare professionals also use the terms “developmental verbal dyspraxia” and “developmental apraxia of speech” interchangeably with CAS, but they all refer to the same condition.
To provide some insight into this complex condition, we spoke to several experts in the speech pathology field, including Laura Moorer, CCC-SLP, a speech-language pathologist and VP of programming for Apraxia Kids, and Edythe Strand, PhD, F-ASHA, CCC-SLP, an emeritus speech pathologist and developer of Dynamic Temporal and Tactile Cueing (DTTC), an approach for CAS treatment. Together we explore signs of CAS, how the condition is diagnosed, the impacts CAS has on children, and how we can treat CAS in thoughtful and meaningful ways.
Apraxia is a neurological condition that manifests as losing the ability to perform purposeful movements or tasks. It comes in many forms, including apraxia of speech (AOS) — also known as acquired apraxia of speech, verbal dyspraxia, or childhood apraxia of speech (CAS) when diagnosed in children. As the NIH explains, when children have CAS, “The brain knows what it wants to say, but cannot properly plan and sequence the required speech sound movements.” Moorer tells us that this can look different for every child — for some, it might be severe, such as a struggle to say even simple words or sounds. A child with mild apraxia might be able to voice some words and sounds but struggle with longer, more complex words. AOS isn’t due to paralysis or weakness in the muscles used to speak, like the tongue, jaw, or lips — that’s a different condition called dysarthria, which, confusingly, can appear alongside AOS.
Note that some healthcare professionals might prefer the term "verbal dyspraxia" instead of CAS because it's included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
According to the American Speech-Language-Hearing Association (ASHA), CAS affects about one to two out of every 1,000 children in the US, and it’s a condition that is present from birth. While little is known about the causes behind CAS, the National Institutes of Health (NIH) points to research that suggests genetic factors may contribute to the condition. (Around one-third of children with CAS have a genetic cause for their condition.) Data shows that children with AOS often have relatives with a history of some type of communication condition or a learning disability. The NIH also says that CAS appears to affect more boys than girls.
What makes CAS different from developmental delays in speech is that kids with delays have a path toward speech development that is just slower than typical. CAS, however, isn’t something a child will outgrow; they won’t be able to perform the basic motor functions necessary for speech by just being around other kids or paying enough attention in class.
When speaking is difficult, everyday communication becomes frustrating. A child might not be able to tell you about their day or ask a friend to play. The important thing to know is that kids with apraxia understand what’s being said to them, and they know what they want to say. The challenge is getting the words out.
Moorer explains how CAS can make it difficult for children to express themselves. Learn how apraxia affects not just speech, but literacy and social skills, and how it can impact a child’s life well into adulthood:
Moorer tells us that there are several different types of speech disorders where a child has difficulty talking. While CAS is motor-based — being able to program and plan the movements of the mouth to say the words — it’s different from other speech sound disabilities like those impacting articulation and phonology.
How does CAS present in children and what are the early signs? Considering that CAS varies in severity and can appear along with co-occurring diagnoses, it might not be that simple to determine. This can become even more difficult with multilingual children.
Moorer states that one of the biggest indicators of CAS is expression. “Childhood apraxia of speech will greatly impact their ability to express themselves, whether or not they have a co-occurring diagnosis, and so they will have difficulty just trying to get their mouth organized enough to and plan the motor movements that we need to have for speech. That will impact their ability to express themselves and be able to communicate with those around them — their family or at school.”
Here are some common symptoms of CAS. These characteristics help differentiate CAS from other speech sound disorders and are increasingly recognized in research and diagnosis.
You might be reading this as a parent of a child already diagnosed with CAS. However, if your child has not been diagnosed and is showing these signs and symptoms, it’s best to contact your healthcare provider, who can refer you to a speech-language pathologist. An SLP can ultimately make an official diagnosis. through dynamic, individualized assessments and elongated observations. A doctor could conduct genetic testing to determine any abnormalities that could be responsible for your child’s symptoms, but that cannot provide a definitive diagnosis of CAS.
Moorer says, “CAS is diagnosed by a speech-language pathologist, and they need to have appropriate training in order to be able to diagnose it. We don’t have a certain age that the child has to be, but the child has to be able to imitate some sounds and syllables in order for us to kind of see what’s going on with their mouth, to be able to diagnose it. If they’re not able to do that, we do have some characteristics that research has shown us that we can identify and suspect that maybe they have childhood apraxia of speech at an early age.”
SLPs play a key role in both the diagnosis and the treatment of CAS. They conduct the formal testing as well as sit down with your child frequently for speech therapy sessions. The SLP will assist with recommending IEP and 504 accommodations as well. Here are some ways SLPs work to diagnose a child with CAS:
Dr. Strand explains that for many years, it was hard to diagnose CAS because there’s no simple test, like a blood test, to confirm it. Even brain scans often don’t show the issues with motor planning that cause CAS. Instead, speech pathologists rely on specific speech patterns and behaviors to diagnose it, much like how autism is diagnosed based on certain traits. Over time, researchers and speech professionals have come to agree on the key signs of CAS that can help identify the condition. She explains more about this:
Note that getting a diagnosis for CAS can be tricky because it requires a specific type of therapy done multiple times a week — not just the typical once-a-week session. And sometimes, insurance companies pushback on covering that much speech therapy! Sometimes, schools will only give group speech (and often only 30 minutes a week), so parents may want to advocate for strong 1:1 speech support. Read up on funding in our guide to funding resources and in our article 4 Tips for Funding Your Child's Medical and Therapeutic Needs. And for advocating at school, check out our articles The 5 Most Important Things to Remember When Advocating in an IEP and 5 Tips to Help Parents Request Services in an IEP.
If you’re wondering whether there is an actual assessment for CAS that you can request your SLP do, the answer is yes, thanks to Dr. Strand. When she noticed a lack of validated ways to test for CAS, Dr. Strand used research, data collection, and analysis to develop the DEMSS (Dynamic Evaluation of Motor Speech Skill). Dr. Strand explains that during her time at the Mayo Clinic, she noticed that many children coming in who had little or no spoken language weren’t autistic or intellectually disabled but had some characteristics that she recognized as being associated with motor programming problems. So, she created a test to differentiate these children. Dr. Strand says that after years of determining DEMSS reliability and validity, “it did indeed separate these children to a good degree. So, that has now been one thing that people are using a lot to determine whether or not the child has primarily CAS or another speech sound disorder.”
Here’s a little more information on DEMSS. DEMSS is a dynamic assessment used to diagnose severe speech sound disorders in children ages 3 and older. It helps confirm or rule out a diagnosis of CAS and provides an estimate of the severity of your child’s speech disorder. The results also play a key role in developing treatment goals and deciding on the most effective methods of support and cues to use during therapy, ensuring that the treatment is tailored to your child’s specific needs.
SLPs administer DEMSS in a clinical setting, usually taking about 30 minutes or fewer. During the assessment, your child will be asked to say 60 different phrases, grouped by how they are made up of sounds. The SLP will say a word first, then ask your child to repeat it. If your child has trouble, the SLP will give extra help to make sure they can try again. The SLP scores the assessment based on how accurately your child can say the words, how well they make the vowel sounds, whether their speech is consistent, and how well they use the right rhythm and tone. After the assessment, the SLP will schedule a meeting with you to go over the results and talk about the next steps and recommendations.
What about assessment for children with other developmental disabilities?
Dr. Strand explains that for autistic children or children who struggle with joint attention and can’t imitate, then assessment can be more difficult. She says that they have been able to assess children using the DEMSS “as long as they can watch and they understand our very simple instructions modified with visual cues. And when we give them enough time, we can usually diagnose it if they’re speaking or will attempt repetition. I think the other thing important about assessment is people always ask me, ‘At what age can a child be diagnosed with CAS?’ And there’s no particular age. When a child can focus attention, watch your face, and attempt direct imitation, at least a few trials at a time, we can make the observations we need to make in order to say this child has characteristics of CAS.”
Moorer agrees, telling us, “It’s the same assessment that would need to be done with any child that we suspected, so they have to be able to imitate some of our sounds and words in order for us to see what’s going on. Having a co-occurring disability can complicate a diagnosis because they have to… be able to attend and try to imitate what we’re doing with our mouth — receptive language skills and that kind of thing. So sometimes it can be more difficult if there are co-occurring challenges going on.”
What if you’re hearing “your child doesn’t have enough language for us to assess?”
If you’ve been told your child doesn’t have enough language (or cognitive ability) for a proper assessment, you’re not alone — and it’s incredibly frustrating. It can feel like a never-ending loop: your child needs therapy to build language skills, but without a diagnosis, you can’t access that therapy. If you find yourself in this situation, know that you have the right to advocate for your child. Ask for a second opinion, or two, or seek out a specialist with experience in complex communication needs.
One parent told us, “In our case, we had four SLPs tell us ‘off the record’ that he had apraxia, but none could get the DEMSS to show it because he didn't have enough spoken language. We finally found one SLP who was willing to write up that his speech had ‘characteristics of apraxia’ that would require ‘multiple sessions of speech therapy a week,’ and that was enough for our insurance to authorize two visits a week — though really, for apraxia they want you to have four or five a week. But despite all my advocating, that was the best we could get. And still, it was better than nothing.”
What about multilingual children?
Since CAS impacts language, for children who are multilingual, this is another important factor in diagnosis. According to ASHA, when diagnosing CAS in multilingual children, each language must be considered so that an SLP can distinguish differences from other conditions. ASHA states that for children who speak multiple languages, “CAS will influence production across all languages” and that “errors may be manifested differently in each language.” This also means that multilingual children with CAS might appear to favor one language or have a proficiency in one over another due to its ease of production and word structure. In situations like this, it could be helpful to seek out an SLP who is multilingual.
What does it mean if your child has a co-occurring condition alongside CAS? Put simply, it’s just another consideration that plays a factor in diagnosis and treatment. Dr. Strand explains that many children with CAS, but certainly not all children, have co-occurring conditions. This study found that co-occurring conditions “may be the norm rather than a rare occurrence for children with CAS.” They stated that the most prevalent co-occurring conditions are expressive and receptive language disabilities, intellectual disabilities, and nonspeech apraxia.
CAS and genetic disorders
Dr. Strand explains that there are conditions that have been determined to have a higher risk of CAS (relative to others), and they include galactosemia and velocardiofacial syndrome (VCFS). Down syndrome is another one.
CAS and developmental coordination disorder (DCD)
Children with CAS often have co-occurring nonspeech sensory and motor challenges, such as gross and fine motor delays, feeding difficulties, and challenges in orosensory perception (hyper- or hyposensitivity in the oral area). As Dr. Strand explains, there are different terms for challenges with fine motor, such as global apraxia or developmental coordination disorder (DCD).
Apraxia Kids explains that CAS and DCD “are both motor disorders that can be explained by impaired planning and execution of voluntary movements. DCD is defined as poor motor proficiency in children. These motor impairments interfere with a wide variety of behaviors and skills, including academic achievement, daily living skills (such as dressing, tying shoelaces, and brushing teeth), and the ability to engage in sport and other motor activities.” Dr. Strand adds, ”These are children that have a lot of difficulty programming movement gestures for simple activities, especially the fine motor activities. But I’ve had children with CAS who also have awkward gaits, but they’re not ataxic due to cerebellar problems. Awkward gaits, awkward runs, some of them even needed PT to learn how to ride a bike. Not all children with CAS have this for sure, but there are a good number that do, and they usually will benefit from both OT and PT intervention.”
CAS and autism
It’s important to note that there’s a common misconception that most children with autism also have CAS. Data from this study found that only 34% of the children they surveyed were also on the autism spectrum. Dr. Strand tells us, “All children with autism do not have CAS. Not even the majority of children,” and explains that some children diagnosed with both autism and CAS might not actually have either condition. This is because early signs of CAS — such as difficulty with motor planning for speech — can be hard to assess when a child lacks foundational communication skills like joint attention (the ability to share focus with another person), has echolalia (repeating words without meaning), or just struggles to point to a preferred item. In these cases, the first priority is building core communication skills such as encouraging joint attention (e.g., using engaging activities to prompt shared focus), supporting basic decision-making (e.g., offering visual choices and modeling responses), or introducing alternative communication methods.
CAS and dysarthria
Dysarthria “is a speech disorder caused by muscle problems. It can make it hard to talk. People may have trouble understanding what you say.” According to the NIH, dysarthria is easier to identify than CAS, but it can be difficult to differentiate the two conditions due to a child’s limited speech sound system, and in rare cases it can co-occur with CAS. ASHA explains that, “Differentiating CAS from some types of dysarthria presents a significant challenge because these disorders can share several speech, prosody, and voice features.” Some examples they list are imprecise consonant sounds, inconsistent pitch or loudness, inappropriate or aberrant stress patterns, and vowel distortions.
How do co-occurring conditions affect diagnosis?
One of the main ways a co-occurring condition will come into play with CAS is during the diagnosis process. Dr. Strand explains that the diagnosis process will still be specific to your child and their capabilities. Some autistic children, for example, who have joint attention and can imitate are able to participate in something like the DEMSS and in treatment focused on motor programming. However, she explains, “The way it’s compounded is that some of the other problems we see in autism, even for children that are able to go through an assessment or treatment, are inattention or difficulty watching us. Those kinds of behaviors can get in the way [during an assessment] in a similar way to kids with ADHD, or just behavioral problems with kids who are so frustrated [that] they don’t want to do this anymore.” She shares that there are ways to compensate for that by evaluating what other issues are getting in the way, then adapting treatment strategies to help mitigate those.
For example, if a child has a cognitive disability, ”We would have to use multisensory kinds of cueing. We have to reduce the complexity of our language as we talk with them. Perhaps make the sessions a little longer or shorter or have more breaks to compensate and to recognize that their progress will be slower because learning is slower in that area.” This is one of the many reasons why SLPs use different treatment approaches, tailored to your child and their abilities so the SLP can address other conditions that might occur alongside CAS.
If you have a child with CAS, you might be wondering, “Will my child also experience difficulties learning to read?” While not all children with CAS have literacy challenges, many do have co-occurring language and literacy problems, such as delayed language development, expressive language challenges, and challenges learning to read and write. The difficulty your child might have producing spoken language can also lead to other challenges in understanding language as a whole.
Moorer says that CAS impact on expressive language can in turn “have an impact on their reading abilities and literacy, which will affect their academics and can also affect their social abilities.” While children with CAS generally understand language well, their inability to express themselves consistently through spoken language can complicate the various ways they use language.
Apraxia Kids lists these clues that your child might be having difficulty in reading and/or spelling:
A blended approach to learning how to read
As Dr. Strand tells us, “Not all children who have CAS have reading problems, but a number of them do. But we don’t know if that’s due to the CAS. More likely it’s due to the coexisting phonological or language impairments, because those children are quite at risk for early literacy problems.” She explains that often, reading issues can be misinterpreted as a child just having trouble making the correct movements for oral reading.
One main co-occurring challenge is in phonological awareness skills, which refers to an individual’s sensitivity to the sound structure of spoken language. It is an important skill that hearing children begin to acquire during preschool and continue to build in early elementary school as they learn to read. Phonological awareness can be very challenging for students with CAS who are not yet able to speak distinct phonemes.
One of the main issues is that many reading programs take a phonetic approach, one of them being isolating the sounds that make up words and mating them to letters, such as the sounds “cuh-at” to make the word “cat.” But for children with CAS, the challenge is in the actual movement of their mouth. “It’s not that they don’t know [the sounds] ‘cuh’ or ‘ah’ or ‘t’ necessarily,” Dr. Strand says. “They can’t round their lips. That’s what they can’t do. So if you have a child where you’re teaching reading that way, it’s going to be hard for them to do the blending. And then people interpret that as, ‘Oh, they can’t read,’ but really, they can’t make the correct movements for oral reading. That’s the problem.”
Another way to look at it is with the word “boy.” As Dr. Strand explains, “If you think about it, if you say the word ‘be,’ my lips start retracting. But if I’m going to say ‘boy,’ my lips start rounding. So it’s the same phoneme, it’s the same sound, but the movement is entirely different. And in treating CAS, we’re treating the movement because it’s programming that movement that the children have trouble with. So that’s what carries over into the reading issues.”
Dr. Strand tells us that sometimes a blend of using a phonics approach and a sight-word reading approach (learning some words by sight, or whole-word reading) works for kids with CAS, and modeling mouth movements. “If the person who’s working with the child on reading can have them blend [the approaches] right away and they can do that, then that usually works,” she says.
Speech therapy can be clinic- and school-based. At school, speech therapy falls under related services in the IEP — services and specialized supports that a child needs to meet their educational goals. These services and supports are determined by the IEP team and are based on the individual needs of each student. In school environments, SLP therapists focus on social pragmatics (communication within social settings), expressive language (how a student communicates their needs and wants), receptive language (how a student understands the language they hear), articulation (how a student pronounces their sounds), fluency (rate of speech), supporting any disfluencies a child may have (such as stuttering), and volume control. Speech and language services are often conducted both in individual sessions and in a group with similar-age peers. For more information on requesting speech therapy at school, check out our article 5 Tips to Help Parents Request Services in an IEP.
Every child is different, so treatment for CAS will look different for each child. There are several different ways SLPs approach treating CAS, which will be tailored to best foster their progress. The majority of interventions will address movements needed to produce words and help improve overall communication. Techniques SLPs will employ include augmentative and alternative communication or gesturing, depending on your child’s support needs. For any speech condition intervention is important, but for CAS, special therapy approaches are needed to address the condition. According to the NIH, “Frequent, intensive, one-on-one speech-language therapy sessions are needed for both children and adults with AOS.” Since CAS can differ from child to child, therapy will be specific to your child and individualized to treat other speech or language issues that might co-occur.
What should interventions focus on?
A thorough assessment of your child should determine what the intervention should focus on. As Dr. Strand tells us, CAS doesn’t occur by itself. Because of motor difficulties, children with CAS always have trouble with phonologic development as well. The clinician first has to determine what the primary problem is for the child, and it’s frequently the CAS. “So we treat that first and then bring in phonologic and language treatment as the child gets more verbal, “ Dr. Strand says. “What I’ve learned over the years is that many children who have come to me have had only treatment for phonology, or the development of the sound system for their language, and because they weren’t treated to focus on the issue, which was a motor programming impairment or inefficiency, they made very little progress. So it’s really important to be able to distinguish these children that have at least some level of inefficiency and motor programming.”
Dr. Strand says, ”The real key here is to help them really establish more automaticity in their motor programming.”
What happens in speech therapy?
Moorer explains how treatment and interventions for childhood apraxia of speech can look like, including an emphasis on helping children develop the motor plans needed for speech and guiding them through the transitions between sounds and words.
Here’s a cheat sheet for what an SLP would work on during speech therapy for CAS:
While there are several ways to approach treating CAS, there are a few therapy treatments specifically designed to address CAS. Let’s explore some of those therapy treatments:
One of the leading therapies for CAS is Dynamic Temporal and Tactile Cueing (DTTC), created by Dr. Strand. DTTC is an evidence-based, motor-based approach, designed to improve the brain’s ability to plan and program movements for speech. DTTC is a type of therapy treatment designed for children with high support needs; it’s a stimulation approach that helps establish accurate mouth movements through cueing. The difference between DTTC and other treatment modalities for CAS is that it focuses on “the movement gesture, rather than an individual sound. No sounds are worked on in isolation.” Here are a few more key points to remember about DTTC:
Dr. Strand explains why she created DTTC, what it entails, and how it helps kids with apraxia of speech:
PROMPTs for Restructuring Oral Muscular Phonetic Targets (PROMPT) is a touch-and-feel therapy that Moorer explains involves an SLP doing tactile (touch) cues on the child’s face to guide their jaw, lips, and tongue to correctly form words. Here are a few key takeaways about PROMPT:
Language Acquisition through Motor Planning (LAMP) combines several motor learning principles used to teach language and a speech-generating device to help develop independent and spontaneous communication.
Speech EZ is a multisensory therapy that addresses various levels of speech motor control, particularly motor preparation and execution processes.
Dr. Strand tells us, “No one treatment does all the job. As children’s characteristics change, as their motor programming efficiency improves, then we want to bring in strategies for the other systems as well.” Certain treatments will be more effective than others for your child. Some are more tactile and require an SLP to move your child’s mouth with their hands, while others are more based on cueing or utilizing augmentative and alternative communication (AAC) devices and services. Overall, when it comes to treating CAS, ASHA says, “Treatment takes place in naturalistic environments, is provided in a culturally appropriate manner, and involves as many important people in the child’s life as possible to facilitate carryover and generalization of skills.”
“As soon as you notice that the child’s not able to get their communicative needs across, so they’re having difficulty and they’re having frustration around that, you want to try to give them an alternate way to communicate,” Moorer tells parents. “Whether it is having pictures for them to point to or it’s sign language or it’s a speech-generating device that they can point to pictures on the device and it says the word or the sentence for them.”
Dr. Strand tells parents that if a child is not developing speech, it’s important to give them a way to communicate. First, start with some simple signs as full ASL can be a little hard to grasp. Dr. Strand tells us that another option to explore is Makaton — from Great Britain — a “unique communication program that uses symbols (pictures), signs (gestures), and speech to enable people to communicate.” Parents can learn it and teach their child. It’s very functional with a lot of naturalistic gestures that kids, even those with developmental coordination disorder, can grasp. Note that Makaton is not commonly used in the US.
For many children with CAS, augmentative and alternative communication (AAC) devices and programs can bring language alive and make communication possible. Examples can range from a high-tech speech-generating device to a low-tech picture board. Dr. Strand and Moorer gives parents some tips on AAC use for people with CAS:
The decision should be made collaboratively with the family and the speech-language pathologist. It’s important to consider all the environments where the child communicates — not just at home, but also at school, in the community, and with peers. Keep in mind that helping a child communicate with AAC takes dedication and teamwork from parents, teachers, and SLPs. It’s not as easy as giving them a device or picture book and saying, "Go for it!"
A parent might understand what a child is trying to say, but others — such as grandparents, teachers, or classmates — might not. At preschool, school, or even the park, a child might struggle to communicate with others, which can be frustrating, especially when they want to engage with peers. Providing an alternative way for them to express themselves is essential while they continue developing speech.
Some people use PECS, but Dr. Strand tells us that many kids prefer signing instead.
Most children with AOS, even ones with high support needs, are not going to need an AAC device more than a year or two if they get the right kind of therapy and if it’s frequent enough. Dr. Strand adds, “It’s up to whoever sees the child, along with the school personnel, to decide to what degree they need a device and what kind of device to help in school. But in terms of day-to-day communication, signing and even naturalistic gestures are very efficient. And frequently, it’s sufficient to get them through. But we have to give them some way to communicate, of course.”
Learn about the top AAC programs and devices in our article here.
Who pays for the device?
There are a few avenues of funding to be aware of. AAC devices and programs can be funded through the IEP process if they are deemed necessary for a child to access a free, appropriate public education (FAPE). You can also have a device funded through Medi-Cal, private insurance, Regional Center, and other grants or scholarships. Apraxia Kids, for example, awards speech tablets to children and families in need throughout the US and Canada. Children with apraxia can use these speech tablets for speech practice and/or as a speech-generating device. Find more information about eligibility and how to apply here.
Will alternative communication methods hinder speech development?
Moorer tells us no: “Just because a child learns signs or has a communication device doesn’t mean they’re not going to work on speech or that they’re not going to learn speech. We know that learning signs, or this other way of communication, does so much more to support their whole language development, and it actually encourages that speech and those motor plans for apraxia to come in. Maybe it’s because signing is a motor pattern of itself, and so it connects the neurons in our brains to help get those motor neurons going for the speech. But we know that it’s beneficial for those children to have an alternate way to communicate while they’re still working on their speech and getting that to come in.”
When it comes to your child’s progress in a school setting, IEPs will provide guidance and support to help your child and their teachers navigate their schooling. For the most part, the determination of what type of plan your child needs will depend on the level of support they need based on the severity of their CAS, as well as whether they have co-occurring diagnoses to consider. SLPs will make decisions as a part of the IEP team, including but not limited to determining your child’s eligibility for services, helping develop treatment plans, providing interventions and support services, and documenting your child’s progress.
Children with CAS can be included in general education with the right services and supports in place to make the placement successful. Moorer, shares some tips for parents when exploring what IEP accommodations and supports kids with CAS can receive.
Here are some examples of IEP accommodations relevant to speech therapy:
Parent tips for accommodations for CAS:
Find more sample accommodations in our article here.
Whatever type of plan might be laid out for your child, you will play a big role in your child’s progress. Think of the old adage, “It takes a village.” Dr. Strand emphasizes, “The parent-therapist partnership is huge.”
Assistive technology (AT) can also supplement different approaches and therapies to support children with CAS. AT is essentially any item, software, device, or piece of equipment meant to aid and empower children with disabilities both inside and outside the classroom. Examples of AT your child might use include communication boards, communication devices, text-to-speak programs, or instructional apps your child can use on a tablet.
Dr. Strand shares that some tech can be great tools for kids with CAS, especially programs like Siri and Alexa that not only provide real-time feedback — helping children see whether they were understood — but also serve as practical support in the classroom. She tells us that technology can be used with children who have CAS to give them feedback on how well they're understood. It helps identify where communication breaks down — by looking at the generated text from a speech-to-text app, both the child and the clinician can see what worked and what didn’t. This makes technology a helpful tool for learning and improving speech clarity.
For more information on how AT can help kids with CAS and samples of AT programs, tools, devices, and more, read our article Top Communication Tools, Apps, Assistive Technology, and More!.
Research and literature about CAS stresses the importance of providing your child with support and encouragement and consistently practicing with them at home. Moorer says your child will also need space to be frustrated, make mistakes, and deal with setbacks without the threat of consequences or criticism at home. It’s imperative to your child’s progression that you’re engaging with your child and providing them with a safe space.
Support is needed throughout the course of your child’s development, from identifying that they might need extra support, to working with your trusted clinicians to provide care, to carving out time to practice certain techniques and therapies at home. Dr. Strand talks here about the vital role parents play in the early stages of therapy for children with severe CAS:
CAS can be a challenging and frustrating diagnosis — for the child and for those who love them and want to help them be understood. But with appropriate therapy and communication supports, kids with CAS can make themselves understood. Here are a few tips for supporting your child:
Moorer shares more tips for parents on supporting a child with childhood apraxia of speech at home, including practicing targeted words and phrases at home and collaborating with a speech therapist.
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