Whether your child is having problems combining sounds, is hard to understand or is having another similar speech issue, it’s completely natural to worry. The possibility of a speech or language disorder is understandably anxiety-producing for most parents. While only a trained, licensed speech-language pathologist can diagnosis the actual disorder itself, understanding the basics is a first step to getting help. If you suspect, or know, that your child has Childhood Apraxia of Speech (or CAS), read on to learn what it is, why it happens, what the common signs/symptoms are and what the available treatment options look like.
CAS: The What’s and Why’s
At its most basic, CAS is defined as a motor speech disorder. This doesn’t mean your child has weak muscles or just isn’t strong enough to speak. Instead, the brain has problems communicating with the body -- specifically the muscles needed to speak. It’s likely that your child knows what they want to say. Forming the thoughts and understanding language isn’t the problem here. The problem arises when the brain tries to send that message to the muscles involved in speech. Something stops the flow of information, making it a challenge for your child to coordinate the action of speaking.
When it comes to the cause, we know that there is some sort of interruption between the signal in the brain, the message getting to the muscles and the muscles actually moving in coordination. If you’re looking for a more specific ‘reason’, you may not get an answer. It’s common for CAS to have no real known root source. Of course, that’s not always the case. Some children who have had a stroke, brain trauma or suffer from some genetic syndromes are more likely to develop CAS.
Spotting Signs and Symptoms
Before jumping to assume that your child must have CAS, keep in mind that only a trained professional can diagnose this disorder. Knowing the signs gives you an advantage, helping you to pick up on possible red flags. But, that doesn’t mean seeing a symptom will equal a definitive diagnosis.
So, what should you look for? It depends on your child and their age. Children are individuals, and may develop in somewhat different ways. Instead of counting the days after a missed milestone, look for a change in the sequence of them or one that is completely absent. For example, an infant who doesn’t coo, babble or produce developmentally appropriate sounds may be showing signs of CAS. Other signs to look for in young children (infants, toddlers and preschoolers) include a late start to speech, using only a few consonants or vowels, long pauses in-between sounds, often avoiding sounds that are difficult to make and difficulty eating/swallowing.
An older child may have shown some of these symptoms during their younger years and may continue to exhibit problem signs. These can include sound errors, better ability to understand language over speaking, speaking more clearly when imitating someone else talking, having an obvious motion problem when trying to speak (fumbling or having difficulty when moving the mouth and lips), difficulty producing speech that is clear enough for everyone else to understand. An older kiddo may have speech that sounds choppy, stress the wrong syllables/words, have a monotonous tone or have more trouble speaking when anxious.
A child doesn’t need to have every symptom on the list to receive a CAS diagnosis. On the other side, many (if not all) of the signs can also signal other disorders.
Treating CAS
Intensive, individual treatment is typically the route that most speech-language therapists recommend. This may mean between three and five therapy sessions per week – at least at first. The therapist will help your child with speech coordination in the office, and provide you with ways to practice at home. It’s important to note that treatment typically doesn't solely rely on verbal communication activities. Research has shown a multi-sensory approach, incorporating visual, tactile and auditory support, is most effective when treating CAS.
There’s no quick fix to treat CAS. A long-term treatment approach is necessary to see the best results possible. This requires hard work, from both caregiver and child. It won’t be easy. But, with time, commitment and help from you and your child's speech therapist your child can succeed!
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