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Speech Pathology Los Angeles

speech pathology LA

What is Childhood apraxia of speech (CAS)?

CAS is a motor speech disorder presenting itself as difficulty saying sounds, syllables, and words; not due to muscle weakness or paralysis. Apraxia comes from the root word “praxis” which means planed movement. It’s the brain’s problem in planning to move the body parts (lips, jaw, tongue) needed for speech. CAS is sometimes called verbal apraxia, developmental apraxia of speech, or verbal dyspraxia. CAS doesn’t effect their cognition as the child knows exactly what the child wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words. Children with CAS may present with delayed language development, other expressive language problems, difficulties with fine motor movement, hupersensitive/hyposensititve in their mouths,

General signs to look for in a very young child:

  1. Does not coo or babble as an infant
  2. First words are late, and they may be missing sounds
  3. Only a few different consonant and vowel sounds
  4. Problems combining sounds; may show long pauses between sounds
  5. 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)
  6. May have problems eating

General signs to look for in a very young child:

  1. Makes inconsistent sound errors that are not the result of immaturity
  2. Can understand language much better than he or she can talk
  3. Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
  4. May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and the jaw for purposeful movement
  5. Has more difficulty saying longer words or phrases clearly than shorter ones
  6. Appears to have more difficulty when he or she is anxious
  7. Is hard to understand, especially for an unfamiliar listener
  8. Sounds choppy, monotonous, or stresses the wrong syllable or word

Treatment options for CAS

Research has shown frequent therapy (3-5 times per week) is more effective for children with CAS. Treatment targets improving the planning, sequencing, and coordination of muscle movements for speech production. It’s crucial that the child gets feedback from a number of senses such as tactile, visual, and auditory that will help him/her readily repeat syllables, words, sentences, and longer utterances to improve muscle coordination and sequencing for speech. For children with cognitive capacity to understand picture stimuli, it’s very helpful to develop their core vocabulary with the use of pictures and books. Some of the specialized treatment methods are PROMPT, Oral-motor work, Kauffman’s apraxia of speech amongst other methods.


Some helpful links:



Donna Lederman