Childhood Apraxia of Speech - Where Can I Start?

What is Childhood Apraxia of Speech?

[This series explores issues related to Childhood Apraxia of Speech, including assessment and treatment.]

Childhood apraxia of speech (CAS) occurs when a child has difficulty making the movements necessary to produce sounds. Children with apraxia know what they would like to say; however, their ability to physically produce this message is interrupted. Unlike speech delay, the characteristics of CAS are likely to extend beyond the developmental stage (Lewis, Freebairn, Hansen, Iyengar, & Taylor, 2004).

Although there are currently no validated features that differentiate CAS from other childhood speech sound disorders, experts agree that there are three features that occur most frequently in CAS cases:

  1. Inconsistent errors in repeated production of the same consonants and vowels
  2. Lengthened and/or disrupted transitions between sounds.
  3. Atypical prosody or stress intonation in speaking.

Other characteristics that may occur with CAS include articulatory groping behaviors, consonant distortions, difficulty with smooth transitions, increasing difficulty with length of utterance, schwa additions or insertions, slower rate of speech, voicing errors and vowel distortions.


Estimates of CAS prevalence are often considered to be unreliable because of the inconsistency of diagnostic guidelines and tools. Current estimates of CAS prevalence report roughly 1 to 2 cases per 1,000 (Shriberg, et al., 2007), with a higher ratio of cases in boys vs. girls (2-3:1) and with a higher chance of concomitance with a reading or spelling disorder. CAS and its associated characteristics are reported to have higher prevalence with syndromes such as galactosemia, fragile X syndrome, and velocardiofacial syndrome (Shriberg, Potter, and Strand, 2011). Research indicates that individuals with autism spectrum disorder (ASD) do not have a higher prevalence of CAS.

CAS may require a specific diagnosis, but even if suspected, there are several treatment techniques that are both available and specific to this condition. Future installments in this series will explore these topics.

Have questions about CAS or other speech disorders? Reach out to a Sidekick therapist today!

Paul Rice, M.S., CCC-SLP


Childhood Apraxia of Speech (

Shriberg, L. D., Potter, N., & Strand, E. A. (2011). Prevalence and phenotype of childhood apraxia of speech in youth with galactosemia.Journal of Speech, Language, and Hearing Research, 54,487–519.

Lewis, B. A., Freebairn, L. A., Hansen, A. J., Iyengar, S. K., & Taylor, H. G. (2004). School-age follow-up of children with childhood apraxia of speech.Language, Speech, and Hearing Services in Schools, 35,122–140.