Childhood Apraxia of Speech

Childhood apraxia of speech is a condition in which the ability of the child to plan and coordinate the movements of the mouth, tongue, and lips that are necessary for speech production is affected. It is a neurological disorder. There is no specific cause known resulting in the condition, but it has been suggested the problem is with the connections between the brain and the muscles necessary for speech production.

The child faces difficulty with speech and sound production which makes it difficult to communicate effectively. Children cannot imitate sounds or gestures. The child is usually diagnosed between 2 to 4 years of age. As the presentation of the symptoms varies it is difficult to diagnose the condition.

There is no treatment for the disease, but with on-time proper diagnosis and treatment, most children with childhood apraxia of speech can be helped to improve their speech and communication skills. Speech therapy focuses on improving the child’s ability to plan and coordinate speech movements, Other forms of therapy like language and articulate therapy, PROMPT, and educating the parent can help the child.

Childhood Apraxia of Speech: Causes

The exact cause is unknown, but several factors are suggested to cause the disease. The important factors include −

  • Genetics  Developmental apraxia of speech might have a hereditary basis. Children who have a family history of speech or language impairments are more likely to experience this, according to research.

  • Neurological causes  Improper brain development or harm to the parts of the brain that control speech, such as cerebral palsy or traumatic brain injury can cause this condition.

  • Premature birth or low birth weight children are more likely to acquire developmental apraxia of speech. This could be a result of the children possibly having a higher risk of brain injury or atypical brain growth.

  • Environmental elements such as exposure to chemicals or illnesses during pregnancy can also contribute to the development of the condition.

  • Unknown causes  In some instances, the reason for apraxia of speech in children is unknown. To learn more about the illness and its underlying causes, research is still being done.

Childhood Apraxia of Speech: Symptoms

The child with apraxia of speech presents with the following symptoms which include −

  • Children with CAS frequently create speech sounds inconsistently, which might cause them to pronounce the same word differently on each attempt. While attempting to speak "dog," for instance, they would initially say "doh" and then "go."

  • Children with CAS frequently create speech sounds inconsistently, which might cause them to pronounce the same word differently on each attempt. While attempting to speak "dog," for instance, they would initially say "doh" and then "go."

  • Children with CAS may start speaking later than other kids their age because of their delayed speech development.

  • The child may only be able to make a few sounds or words and may have a small speech sound repertoire.

  • The child may speak slowly or laboriously as they try to organize and carry out the movements required to make speech sounds.

  • The child may also make irregular vowel sounds, which can make it challenging to understand their speech.

  • The child may have trouble understanding or using longer or more complex words or phrases because they require more planning and coordination of speech movements.

Childhood Apraxia of Speech: Risk Factors

Some of the factors that contribute to or increase the risk of the development of apraxia of speech, which includes −

  • Family history of apraxia of speech

  • Premature birth as in these kids the brain development may be affected

  • Children with neurological disorders such as cerebral palsy, epilepsy, or Down syndrome

  • Low birth weight babies are susceptible to developing neurological problems, which can contribute to CAS.

  • Children with other developmental disorders such as autism spectrum disorder or developmental delay

  • Exposure to toxins, such as lead or mercury, during pregnancy or in early childhood

Childhood Apraxia of Speech: Diagnosis

The diagnosis of apraxia of speech in children can be diagnosed by the following methods, which include −

  • The child's medical history, developmental milestones, and any family history of speech or language impairments should be taken.

  • Clinical examination to look for any anomalies or deficits that could affect the speech output should be done. The child's oral muscles and tissues should be examined.

  • Speech evaluation is very important. The child's ability to create speech sounds, including their precision and consistency, their capacity to form lengthier words and phrases, and their ability to correctly sequence sounds and syllables should be checked.

  • The child's vocabulary, grammar, and comprehension as well as their knowledge and use of language can be done.

  • Some of the cognitive skills like attention and memory can affect speech production, testing the child's cognitive ability is also important.

  • Response of the child to the feedback and support during speech tasks should be assessed. This can help to determine the child's potential for improvement with therapy.

Childhood Apraxia of Speech: Treatment

The treatment of apraxia of speech in a child includes −

  • Motor-based treatment  This aims at improving a child's motor planning and coordination abilities for speech production. It may include activities that encourage the integration of sensory and motor information as well as repetition and practice of speech sounds and movements.

  • Articulation therapy  Using exercises and activities that target certain sounds, this type of therapy aims to help the child generate individual speech sounds appropriately

  • Oral Muscular Phonetic Targets Restructuring Prompts (PROMPT)  It is a form of motor-based therapy that involves the use of tactile signals to direct the child's oral motions while speaking.

  • Language therapy  This aims to increase a child's overall language skills, such as vocabulary, grammar, and understanding.

  • Parent education  Using particular methods and strategies at home to reinforce therapy objectives might help parents and other carers assist their child's speech development.

  • Alternative and augmentative communication (AAC)  In some situations, AAC tools, like picture boards or technological gadgets, may be utilized to enhance or support the child's capacity for speech output.

Childhood Apraxia of Speech: Prevention

There are no preventive measures for this condition, but some of the measures can help the child that includes −

  • Early diagnosis and treatment can help the child to get better early.

  • Regular reading to the child can help to improve language and vocabulary development, as well as strengthen the child's overall cognitive abilities.

  • Exposure to toxins such as lead or mercury during pregnancy or in early childhood should be avoided.

  • Encouraging the child in communicating even before they start to talk, through gestures, facial expressions, and other forms of nonverbal communication. This can help build a strong foundation for speech and language development.

  • Maintaining good health during pregnancy with regular prenatal al care, healthy diet, and avoiding exposure to harmful toxins or substances.

  • A well-balanced diet can support the child's overall growth and development.


Apraxia of speech in children is a disorder affecting the child’s speech because of the factors involving the speech centers of the brain. The exact cause is unknown. Some factors like low birth weight or premature birth and neurological disorders are known to cause this.

The child presents with speech issues, unable to mimic, no proper word coordination, delayed speech development, and improper speech. The diagnosis is based on history, clinical examination, and evaluation of the speech. Early diagnosis and treatment can help to improve the child’s recovery better.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha