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What is Childhood Apraxia of Speech?

What is Childhood Apraxia of Speech (CAS)?

Childhood Apraxia of Speech, or CAS, is a motor planning disorder. This means that a child with CAS knows exactly what they want to say, but the words don’t come out right. The signals from their brains get distorted on the way to their mouths. The child may not be able to move their lips or tongue correctly, even though there is nothing physically causing difficulties (i.e. tethered oral tissue, muscle weakness).

What does CAS look like?

While it can look different for different people, there are three features that are the biggest signs of CAS:

  • Inconsistent errors with consonants and vowels in repeated syllables or words (i.e. producing “Minnie Mouse” as “any oh”, “Meh Mo’, and “Nee Now”)
  • Increased space between sounds and syllables (i.e. gaps between sounds in words)
  • Difficulties with Prosody (i.e. speaks with inappropriate volume, speed, pitch)

In addition to these main three signs, there are several other critical features that a child with CAS may possess:

  • Producing the wrong vowel sound in a word (i.e. says “buh” for “bed”.)*
  • Inconsistent voicing errors (i.e. sometimes switches “t” with “d” and “d” with “t” in words).
  • Oral groping (i.e. mouth looks like it’s trying to figure out where it needs to go to make the right sound)
  • Limited variety of vowels and consonants (i.e. uses a lot of the same sounds and syllables for multiple things.)*
  • Lack of cooing and babbling as an infant (i.e. didn’t say anything, and often didn’t put things in their mouth.)*
  • Has a “go to” sound (i.e. says “uh duh” for most everything.)*
  • Initial consonant deletion (i.e. says “uck” for “duck”)

*CAS can be diagnosed starting around 2-3 years of age, but it can be difficult. These are some of earliest signs of Childhood Apraxia of Speech.

Does a child with CAS ever improve?

With regular skilled speech therapy, a child with CAS can improve their speech. During these therapy sessions, the Speech Language Pathologist (SLP) will focus on training the child how to produce sounds, words, and sentences more clearly. Since there is no muscle weakness associated with CAS, muscle strengthening exercises are ineffective for helping improve speech.

Since CAS can take some time to improve, use of alternative means of communication may need to be utilized, such as sign language, picture boards, and speech generating devices. While some families may be hesitant to use anything other than verbal speech, these are excellent ways for children with Apraxia of Speech to communicate efficiently and effectively.

Heather Hall, M.S., CCC-SLP


  • American Speech-Language-Hearing Association. (2021). Childhood Apraxia of Speech. American Speech-Language and Hearing Association. Retrieved April 12, 2021, from
  • Hammer, D.W. (n.d.) Childhood Apraxia of Speech Therapy Strategies that Make a Difference. Course hosted April 14, 2018, Associates in Pediatric Therapy (APT), Louisville, KY, United States.