How do I tell if my child has childhood apraxia of speech (CAS)?

Considering that CAS varies in severity and can appear along with co-occurring diagnoses, it might not be that simple to determine.

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.

• Vowel distortions because the speaker might not position their speech muscles (such as the tongue and jaw muscles) correctly, causing the sound to be off
• Errors in producing consonants, such as a “sh” sound when trying to say a “ch” sound
• Difficulty in smoothly connecting sounds or syllables when speaking
• Unusual speech rhythm, stress, or intonation, such as breaking words into awkward parts or pausing at the wrong moments while talking
• Difficulty programming and planning the movements of the mouth to say words
• Inconsistent speech errors, such as pronouncing the same word differently each time
• Visible effort or struggle when trying to speak, or trying saying a word multiple times before they say it correctly

If your child is showing these signs and symptoms, it’s best to contact 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.

There’s no simple test to confirm CAS. 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.

If you’ve been told your child doesn’t have enough language (or cognitive ability) for a proper assessment, 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.

For more information, see our full article Childhood Apraxia of Speech (CAS) 101.