All About Apraxia Of Speech In Children

Do you think your child has some difficulties in trying to speak words and syllables aloud? Have you tried sitting down with him and teaching him methodically, but nothing seems to help or work? Has your child’s doctor mentioned a condition called Childhood Apraxia Of Speech or CAS, and you want to know more about it?

If you are looking for more information on the causes, symptoms and treatment for Childhood Apraxia of speech in children, scroll down to know more.

What Is Childhood Apraxia Of Speech (CAS)?

Childhood Apraxia of speech, also commonly known as CAS, is not a very common disorder that affects children. Children suffering from the condition find it difficult to make the necessary movements for speaking.

To be able to speak correctly, your child’s brain has to learn to plan how his speech muscles need to work to move the lips, the tongue, and the jaw. It also has to decide the speed and rhythm of these movements. All the organs work together to execute the plan, help your child speak properly and make accurate sounds.

When a child suffers from Childhood speech Apraxia, the brain cannot coordinate these muscular movements to ensure correct speech. In this case, the brain of the child is not able to send the right signals to the right organs at the right time. It means that the child finds it difficult to make proper movements that will help him with forming sounds and speech. When your child has CAS, it does not mean that the muscles that will help him with speech are weak. It means that your child’s brain is not being able to direct the required muscles to do their job.

Childhood Apraxia of speech is essentially a neurological condition. In most cases, it is present right from birth. A child who has Childhood Apraxia of speech will have a much higher understanding of words and speech, but will not be able to express them coherently (1).

What Causes Childhood Apraxia Of Speech?

One of the first thing you should realize and remember as a parent is that nothing you did wrong can cause CAS in your child. How much you speak to your child as an infant or how much you try to teach him about speech and sounds will have nothing to do with the condition.

At the moment, there is not enough medical data to explain childhood apraxia of speech causes in children. Some experts do believe that it is a result of poor signal issues between the brain and the different muscles that your child uses to speak properly. Here are three reasons that could cause Childhood Apraxia of speech in children: (2)

1. Neurological Impairment:

• An infection, illness or injury to the brain may cause CAS.

• It could happen before or after the child’s birth.

• Sometimes, it could also be a result of an abnormality or a glitch that occurred at the time when the unborn baby was developing in the womb.

• Neurological impairment can cause Childhood Apraxia of speech in those children who have got a positive report after an MRI scan of the brain.

2. Complex Neurodevelopmental Disorders:

• CAS can sometimes also be a secondary characteristic of some other medical condition that may be affecting your child.

• It could be a genetic or metabolic disorder. In some cases, it can also be the result of a mitochondrial disorder.

• The risk of suffering from CAS is higher in children with the velocardiofacial syndrome and galactosemia.

[ Read: Common Developmental Disorders In Children ]

3. Idiopathic Speech Disorder:

• An idiopathic speech disorder is a condition that does not have a known origin.

• In this condition, your child will not have any noticeable neurological abnormality or neurodevelopmental condition.

The reasons as to what may or may not cause CAS in your child are still very vague.

[ Read: Types Of Communication Disorders In Children ]

What Are The Symptoms Of Childhood Apraxia Of Speech?

All children suffering from Childhood Apraxia of speech will not have the same symptoms. The symptoms may vary with age as well as the severity of the condition. Here are some of the most common childhood apraxia of speech symptoms: (3)

Symptoms Of CAS In A Very Young Child:

• Your little one will not be able to make any cooing sounds or babble.

• Your baby will utter those first words very late as compared to other babies of the same age. Even when he does say those first words, some very important or basic sounds may be missing.

• Your baby will be able to produce only very few sounds of different consonants and vowels.

• There may be a long gap in between the different sounds your baby makes while trying to say a word. He may try to think of how to say the same but will eventually not be able to do so, or will give up. Your baby will also find it very difficult to combine different sounds to make a proper word.

• To make up for the difficult sounds that he cannot produce, your baby will most likely try to fill up the gaps by creating easy sounds. Most babies may try doing this when they are just learning to speak. However, a baby who has Childhood Apraxia of Speech will do it a little too often, and in an obvious way. Also, your baby may make no effort to try and learn the right usage of sounds and words and may continue with an easy and made up version.

• A baby who suffers from Childhood Apraxia of speech may also have difficulty in eating.

[ Read: Types Of Learning Disabilities In Children ]

Symptoms Of CAS In An Older Child:

• Your child will make inconsistent phonetic mistakes, which are not due to his young age.

• If your child has been suffering from Childhood Apraxia of speech, his speech abilities will not match his high understanding of the language.

• Your child will have trouble in imitating speech or sounds, but as and when he does produce some sounds by listening to others, it will be much clearer than what he can say spontaneously.

• Your child could be visibly struggling to coordinate his lips, jaw, and tongue together to produce the desired sounds.

• It may be easier for your child to try say shorter words or phrases than longer ones.

• Each time your child is anxious or upset, he will find it more difficult to produce sounds or words.

• Those who are not familiar with your child will not be able to understand his speech at all, or may understand it only in parts.

• Your child may sound monotonous while trying to speak a sentence. Also, your child may put more stress on the wrong syllable and thus pronounce the word incorrectly.

[ Read: Language Disorders In Children ]

Can There Be Any Other Potential Problems Associated With CAS?

If your child is suffering from CAS, he is also likely to experience the following:

• Your child will show a delay in learning the language skills.

• It will be difficult for your child to recall certain words as well as remember their order, especially when he tries to say a phrase or sentence. Expressing himself in a language will always remain a challenge in such cases.

• Your child will find it difficult to learn fine motor movement and coordination.

• You may notice over sensitivity (a condition known as hypersensitivity) or under sensitivity (a condition known as hyposensitivity) in the mouth. In the case of over-sensitivity, your child may find it very difficult to do regular daily activities, like brushing his mouth, as he may find it extremely irritating. On the other hand, if your child has under sensitivity, he may be eating crunchy foods and may not realize what he is eating or how it tastes.

• If your child has Childhood Apraxia of speech, he will also have trouble in learning to read, write or even spell.

[ Read: Language Development Tips For Children ]

Diagnosing Childhood Apraxia Of Speech:

As of now there are no specific tests that can help medical practitioners diagnose the condition in your child. Your child’s doctor may want to note his age and details of his medical condition, the severity of his disorder, and social interactions. He may take the following steps to diagnose CAS: (4)

• The doctor will try to look for the presence of common and more than one symptom that point to the condition.

• He may try to check if your child can say words that range from very easy to easy and slightly difficult. He may use a few similar sounding words and ask your child to repeat them to gauge the severity of your child’s condition. An example could be a group of words like ‘play, playful and playfully.’

• A speech-language pathologist may interact with your child, to assess what syllables, sounds or words he can produce and understand.

• He may also want to examine your child’s mouth, tongue, and even his face. All this will help him look for any problems in your child’s basic speech structure that could be causing some of the symptoms related to Childhood Apraxia of speech.

• Your child’s doctor and the speech specialist will also want to know if your child is suffering from some other medical condition. For instance, the doctors may want to see if your child has a hearing problem.

• In most cases, doctors and therapists will not be able to diagnose the Childhood Apraxia of speech or CAS before your child turns two years of age. It is because most children are not able to produce sounds or say most of the words that they hear properly, until they turn two. Even though you may feel that your young child has CAS, it may just be that he is taking a little longer than others to speak.

[ Read: Major Stages Of Cognitive Development In Children ]

Treatment For Childhood Apraxia Of Speech:

The kind of treatment your child will need depends on his age, the severity of his condition and other factors. Here are a few childhood apraxia of speech treatment options that your child’s doctor may suggest:

• Your child’s doctor may suggest that your child should meet a speech and language pathologist three to five times in a week. He may reduce the frequency of the sessions later depending on your child’s progress.

• In some cases, the speech and language pathologist may also want to conduct a few sessions with the whole family. It will help the parents, siblings and other family members to interact better with the child who is suffering from Childhood Apraxia of speech.

• The therapist may ask your child to practice how to produce sounds to pronounce words correctly. Slowly, the doctor or therapist may ask him to try and use more words that will help him better his speech.

• Gradually, your child’s therapist will teach him how to use rhythm or melodies in his regular speech.

• As your child learns how to produce sounds and pronounce words, your child’s therapist may ask him to start using multisensory approaches. For instance, the therapist may ask your child to stand in front of a mirror and say a word aloud. The therapist will ask your child to watch his face and movements carefully as he makes those same sounds. He may ask your child to touch his face and throat to note the movements he makes when he says a certain word.

[ Read: Symptoms Of Auditory Processing Disorder In Children ]

• Some therapists are of the belief that using sign language can greatly benefit a child who is suffering from Childhood Apraxia of speech or CAS. They feel that it will especially help a child who has trouble in making others understand what he wants to say and express. In such a case, your child’s therapist will recommend that he learns the sign language and also practices saying the word. The approach will be a dual combination of using the sign language as well as speech for communicating better.

• In very severe cases, the therapist may ask the child’s family to consider the use of electronic devices that can help a child produce the sound more clearly for others to hear. For this, the therapist will suggest the use of an electronic assistive device, including computers. Such devices can aid your child in producing the difficult sounds.

• It is advisable that your child goes for one on one session with the doctor or the speech and language therapist instead of a group session with others. It will help him understand phonetics better and feel more confident. Once your child is comfortable and seems to make progress, the therapist may suggest him to join a group session. In case your child is not comfortable or is not making as much progress as he was making in the individual session, the doctor or therapist may switch him back to the earlier mode of therapy (5).

[ Read: Speech Therapy For Children ]

Your child’s doctor and therapist may give you assignments to practice as a family to help your child cope with the condition better. Make sure you listen to all the instructions carefully and help your child practice at home.

Give your child suffering from CAS a lot of love, time, and patience. While CAS does not have any specific cure, your supportive approach can help your child to make significant progress.

Did your child suffer from CAS? What did you do to help him overcome the condition? What treatment did the doctor advise? Please share your story to inspire other moms in a similar situation.

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