What is Childhood Apraxia of Speech?
Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.
What are some signs or symptoms of Childhood Apraxia of Speech?
Not all children with CAS are the same. All of the signs and symptoms listed below may not be present in every child. General things to look for include the following:
A very young child:
- Does not coo or babble as an infant
- First words are late, and they may be missing sounds
- Only a few different consonant and vowel sounds
- Problems combining sounds; may show long pauses between sounds
- Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
- May have problems eating
An older child:
- Makes inconsistent sound errors that are not the result of immaturity
- Can understand language much better than he or she can talk
- Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
- May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
- Has more difficulty saying longer words or phrases clearly than shorter ones
- Appears to have more difficulty when he or she is anxious
- Is hard to understand, especially for an unfamiliar listener
- Sounds choppy, monotonous, or stresses the wrong syllable or word
Potential Other Problems:
- Delayed language development
- Other expressive language problems like word order confusions and word recall
- Difficulties with fine motor movement/coordination
- Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like toothbrushing or crunchy foods, may not be able to identify an object in their mouth through touch)
- Children with CAS or other speech problems may have problems when learning to read, spell, and write
(http://www.asha.org/public/speech/disorders/ChildhoodApraxia/)
Tips for improving speech in children with apraxia:
- Use repetitive books, repetitive songs, and carrier phrases such as "Ready, Set, Go!" Children with apraxia of speech will often find it easier to begin to speak when they are able to "drop" a word into a phrase they have heard many, many, many times.
- Start small and build up. Children with apraxia of speech have difficulty moving from one place to another in their mouth, so we don't make them do this at first. We start with very simple consonant-vowel words with easy sounds, such as "me" and "boo" and "hi" and then help them move to simple two syllable words such as mama and dada from there. Then we keep building. You can read more about which sounds and syllable shapes are easy and hard here.
- Help your little one learn to communicate with signs or pictures for a while. This will not prevent her from learning to talk, but it will help relieve some of the frustration that may result from her having difficulty expressing herself verbally.
- Have patience....this is the hardest, but the most important of all the steps. With hard work, determination, and time, things will get better.
(http://www.talkingkids.org/2011/06/childhood-apraxia-of-speech-what-it-is.html)