Childhood Apraxia of Speech (CAS)

What is childhood apraxia of speech?

Childhood apraxia of speech (CAS) is a motor speech disorder. Children with apraxia know what they want to say, but their brain has trouble planning and coordinating the precise movements of the tongue, lips, jaw, and palate needed to produce clear speech.

CAS is different from articulation or phonological disorders. In those conditions, a child consistently makes the same error. With apraxia, errors are often inconsistent; a child may say the same word differently each time they try.

Common signs

Children with apraxia may:

• say the same word differently each time
• have more difficulty with longer words or phrases
• struggle to imitate words or sounds on demand
• speak with choppy, unusual, or flat-sounding rhythm and intonation
• make groping movements with their mouth when trying to speak
• be understood less than expected for their age

For example, a child may say “banana” as “bana” one time and “nana” the next, or say “butterfly” as “bu-fly.” Speech may sound effortful or inconsistent.

How CAS is identified

CAS is diagnosed by a speech-language pathologist through a thorough assessment. There is no single test for apraxia. Diagnosis is based on observing specific speech characteristics, including:

• inconsistent errors on consonants and vowels
• difficulty moving smoothly between sounds and syllables
• disrupted rhythm, stress, or intonation (prosody)

Assessment typically involves listening to your child produce sounds, words, and phrases of increasing length and complexity. We also consider your child’s overall language development and communication needs.

Early identification is important because children with CAS benefit from a specific type of therapy focused on motor planning.

How speech-language therapy helps

At West End Speech, apraxia therapy focuses on:

• motor planning for speech, helping the brain learn to coordinate the movements needed for sounds, words, and phrases
• repeated practice of carefully selected targets
• building speech from sounds → words → phrases → sentences

Therapy often includes visual cues, tactile cues, slowed speech models, and frequent, intensive practice of meaningful words and phrases. Starting early and keeping at it makes a real difference.

Our approach

Our approach is grounded in principles of motor learning:

• High repetition: Children with CAS need many practice opportunities within each session to build and strengthen motor plans.
• Varied practice: Practicing targets in different words, phrases, and contexts helps the brain generalize motor plans.
• Multisensory cues: We use visual (e.g., watching mouth movements), auditory (e.g., listening to a model), and tactile (e.g., touch cues) supports to help children learn new movements.
• Systematic progression: We carefully increase complexity as the child builds skill, starting with simple syllable shapes and gradually moving to longer and more complex words and phrases.

For children whose speech is not yet meeting their communication needs, augmentative and alternative communication (AAC) may be introduced alongside apraxia therapy to support functional communication while speech continues to develop.

What to expect

Assessment

We begin with a detailed assessment to determine whether your child’s speech characteristics are consistent with CAS. This includes evaluating speech sound production, consistency, prosody, and motor planning abilities.

Therapy sessions

Apraxia therapy is most effective when it is frequent and intensive. Sessions are highly structured, with many opportunities for practice within each session. We make therapy engaging through games and activities your child enjoys while maintaining the repetition needed for motor learning.

Home practice

Home practice plays an important role in apraxia therapy. We provide families with activities and strategies to support practice between sessions, helping your child build motor plans more quickly.

How to get started

If you’re concerned that your child may have apraxia of speech, contact us to book an assessment. We offer apraxia therapy online across BC and in-home around Vancouver, in English and French.