Childhood Apraxia of Speech - With My Personal Account

What Is Childhood Apraxia of Speech?

Childhood apraxia of speech is also referred to as developmental apraxia of speech, speech apraxia, and dyspraxia. Childhood apraxia of speech (CAS) is a motor speech disorder that causes a child to have problems producing sounds, syllables, and words. In CAS the brain runs into issues when it sends signals to the mouth, tongue, lips, and jaws. The signals get mixed or lost when telling the mouth how to move to produce a certain sound. The individual knows what he or she wants to say but the brain has difficulty coordinating muscle movements necessary to say the words. It was explained to me that most people learn how to produce a sound once and it’s forever etched into their brain. There is no thinking about it because it’s just habit for the brain to send the signal and for the mouth to make the sound. For a person with CAS, the brain doesn’t remember how to make a certain sound automatically so the individual has to pause, think, and concentrate on getting the mouth, lips, and tongue to produce that sound. Over time a person with childhood apraxia of speech can memorize how to make sounds and produce words without pausing and concentrating so hard.

It is not known what causes childhood apraxia of speech but some possible causes include genetic disorders or syndromes and stroke or brain injury. CAS may be referred to as a developmental disorder but that does not mean the child will outgrow it. Childhood apraxia of speech will not get better without proper, intensive treatment. The number of cases of CAS appears to be on the rise because of increased awareness by professionals and families, increased availability of research, and earlier-age evaluation and identification. Boys seem to be more prone to developing childhood apraxia of speech than girls.

Source

Symptoms

There are different severities of childhood apraxia of speech and the symptoms vary from child to child. Some symptoms to keep an eye out for are:

  • No cooing or babbling as an infant
  • Delayed first words or first words missing sounds
  • Only a few different consonants and vowels
  • Problems combining words, long pauses between words or sounds
  • Simplifies words by replacing difficult words with simpler ones or by deleting difficult sounds (for example, my daughter picked up Spanish from Dora and used it to replace English words that were difficult for her to say)
  • May have problems eating or swallowing
  • Makes inconsistent sound errors
  • Is able to understand language better than he or she can speak it
  • May appear to be groping when attempting to produce sounds
  • Is difficult to understand even as he or she gets older
  • Sounds choppy, monotonous, or stresses the wrong syllables in words

Speech Language Pathologist and Young Child During Speech Disorder Assessment
Speech Language Pathologist and Young Child During Speech Disorder Assessment | Source

Diagnosis

Childhood apraxia of speech can only be diagnosed by a speech language pathologist (SLP). The SLP will perform several assessments to best identify your child’s specific speech disorder and the best method of treatment for your child’s severity of the disorder. The most common assessments are:

  1. Oral-motor assessment - to check for signs of weakness or low muscle tone in the mouth area, to see how well the child can control coordinated non-speech movements of the mouth, and to evaluate coordination and sequencing of muscle movements while performing speech tasks
  2. Melody of speech (intonation) assessment – to see if the child appropriately stresses syllables in words and to determine whether the child uses pitch and intonation to differentiate types of sentences and to mark different portions of sentences such as pauses between listing items or raising his or her voice at the end of a sentence when asking a question
  3. Speech sound (pronunciation of sounds in words) assessment – to evaluate both consonant and vowel sounds, to check how well the child says individual sounds and sound combinations, and to determine how well others can understand the child using single words, phrases and conversational speech

My daughter posing fancy
My daughter posing fancy

My Daughter's Story

When my daughter was 7 months old I took her to the doctor for her well-baby checkup. I voiced concerns to the doctor that my daughter didn’t babble like my other children had - she never really cooed at me either. The doctor’s response to my concerns was “she just doesn’t have anything to say yet.” I trusted the doctor and dropped the issue until my daughter’s 2 year check-up. Again, I voiced concerns that nobody could understand my daughter and she seemed to lack communication skills. I was the only one who could understand her. Yes, I was comparing my daughter to her sisters – both of whom were early talkers. But I could sense something just wasn’t right and I wouldn’t let it drop.

The doctor referred my daughter to a local children’s hospital for a consult with a speech language pathologist. My suspicions were confirmed. My daughter had something called childhood apraxia of speech (CAS) that hindered her ability to communicate. I was told she would need years of intensive speech therapy but that the prognosis was good. The speech pathologist referred me to a speech services clinic in my neighborhood and informed me that my local school had a program for preschoolers with speech disorders. I didn’t really understand what childhood apraxia of speech was so I went home and researched as much as possible about it. Then I sat down and cried and wondered what I did to cause this to my daughter. I wondered if she would ever be able to communicate her needs and wants like everyone else. I wondered how difficult life would be for her without the ability to talk like everyone else. How could something be wrong with my beautiful little girl? She didn’t look like there was anything different about her from any other toddler.

I started my daughter at the local speech services clinic and made my way through the mountains of paperwork to get her into the school for speech therapy. Eventually, after several assessments by the school, in my home and in the school itself, my daughter started preschool. A month after turning 3, my daughter was labeled with a disability and started an Individualized Education Plan (IEP) in order to receive speech services for free through the state. I had a nervous breakdown – I was sending my baby to school before her big sister even got to go. I wasn’t ready for that, and add to it that the school had to label my daughter as having a disability and my heart broke. At least the preschool was the same building my daughter would attend for kindergarten and that her biggest sister had already attended for kindergarten. We were very familiar with the school and teachers.

My daughter stopped speech therapy services at the local speech clinic and spent 40 minutes a day, 4 days a week with the school’s speech therapist. She brought home flashcards and homework papers to help with letter sounds and we practiced them every night – even when school was out for the summer. Slowly my daughter picked up more and more sounds. She spent three years in preschool for speech therapy (because her birth date was a month after the cutoff for kindergarten the third year). By the end of the third year I was told my daughter did not require speech services and had graduated from the program in time for kindergarten.

My daughter is now 6 and has started kindergarten with NO speech services. She no longer needs an IEP and she can communicate her needs, wants, and feelings just like everyone else in class. She knows her rhymes, recites and writes her ABC’s upper- and lowercase, counts over 100, and even spells out simple words. Nobody knows she had a speech disorder unless we tell them. Half the time they don’t even believe us when we DO tell them! Childhood apraxia of speech is a difficult diagnosis to deal with but it CAN be treated. The earlier your child gets speech intervention the better the results.

(Thank you for taking the time to read about my daughter’s experience with childhood apraxia of speech. Please feel free to leave your experiences, positive or negative, in the comments below. You and your child are not alone.)

Other Sources of Information

Dyspraxia: Can We Talk? At http://www.tayloredmktg.com/dyspraxia/index.shtml

American Speech-Language-Hearing Association at http://www.asha.org/public/

Apraxia-KIDS Information Site at http://www.apraxia-kids.org/ (this is where I got my information when my daughter was diagnosed with CAS)

National Institute on Deafness and Other Communication Disorders at http://www.nidcd.nih.gov/health/voice/pages/apraxia.aspx

Speechville Express at http://www.speechville.com/diagnosis-destinations/apraxia/apraxia.html

The following video is exactly how a parent feels when he or she learns they have an apraxic child. It does ask for donations at the end. I do not work for or advocate for the organization. I simply had to share this video because it is spot-on.

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Comments 22 comments

Taleb80 profile image

Taleb80 5 years ago

My son is 3 years old, and he is facing the same problem.

Some people & doctors told me to not worry if he is spelling most of the letters (Sounds).

Mostly, he invents new easy words for everything.

After reading your Hub, I should start searching for treatment ASAP.

I am Happy that your daughter is well.

Thanks for sharing your experience.


leahlefler profile image

leahlefler 5 years ago from Western New York

My older son had CAS, and we are fortunate that he is completely done with speech therapy by kindergarten (early intervention is the key)! He started therapy at the age of 2, and graduated in Pre-K. His speech was so garbled that he would call everything "fah-vah." It was the only sound he could produce (his receptive language was great, though). Now he talks non-stop - we still have very minor articulation issues (the dreaded /r/ sound and he takes a long time to pronounce a new, difficult word), but his speech is great now.


Ardie profile image

Ardie 5 years ago from Neverland Author

Taleb, does your insurance require a referral before they'll pay for a consult with a specialist? If they don't require the referral you can make the appointment yourself with a speech language pathologist (if it's covered). Even if your son doesn't have CAS he may have another delay or disorder that can be treated. Best of luck hun.

Leah, Im so proud of your son for graduating the program! Im sure he had to put so much work into his speech. Isn't it amazing how much they talk when they finally can? My daughter loves to sing and it melts my heart every time. She even said she wants to be a SLP when she grows up.


Haunty profile image

Haunty 5 years ago from Hungary

Such a compassionate, heartfelt, and useful article, Ardie! I'm so glad you were an attentive mom and discovered her issue early. She not just learned how to speak, but also developed a love of speech. Disabilities and and how they can actually help outshine others is a topic I feel passionate about, because it goes to show the extent of one's personal power. I could go on about this. Is that Deena in the photo? She's awesome!

I have a girl in the neighborhood who is an opera singer. She travels the world a lot. She speaks at hyper speed, so I asked her why that is and she told me that when she was little she had difficulty speaking and she spent her childhood learning how to speak. Her mom helped her a lot and now she is very old and she takes care of her and sings to her. I don't know if she had CAS or something else, but she is an opera singer now, you know. :)


Ardie profile image

Ardie 5 years ago from Neverland Author

Thanks Haunty. Boy does she love to speak now hahah Its strange you bring up the opera singer because my daughter also loves to sing - and has the most precious voice I've ever heard. I think it first started because she could mimic a tune perfectly and feel understood even though the words weren't there. Its so sweet that your friend takes care of her mother and sings to her. I hope my kids feel the same way about me when they are grown. And yes, that's my baby girl. She's making her "Let's have tea and chat about current events" face!


Melovy profile image

Melovy 4 years ago from UK

Ardie, I hadn’t heard of this diagnosis. It’s very interesting. I once knew a little girl who probably fitted the symptoms, but we moved from where she lived, so I don’t know how she’s doing now. I also found the comments about singing interesting because I’ve heard that stutterers can often sing with no bother at all.

Glad to hear your daughter is doing so well now. What a shame that you felt guilty about your daughter having CAS, but that so often the case? We mothers blame ourselves far too often. Well done you for getting your daughter the help she needed.


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA

Ardie,

This is a wonderful article full of great information. My little sister has four boys. Her third son has Apraxia. When Zak was little, it was obvious that something was wrong with his speech. I remember sitting with him on my lap whenever I had the chance and reading with him. Saying a word and having him repeat it. It was difficult to watch him get so frustrated. He knew what he wanted to say but just couldn't get it out properly.

I always admired my sister and brother-in-law for never treating Zachary as "different." He was treated the same as his other brothers. The difference was he had to attend special speech classes.

Zachary is a junior in high school this year. He actually still sees a speech therapist at his high school. It isn't something that all his friends know about. All they know is that Zak is handsome, fun to be around and an awesome athlete. Because of his upbringing, his disability has never taken "center stage."

It is so wonderful to hear that your daughter received her needed therapy so early and that no one can even tell she had this problem. Thanks for sharing her story!

Sharyn


sholland10 profile image

sholland10 4 years ago from Southwest Missouri

Ardie, I believe my nephew had apraxia of speech. When he was in elementary school in the late 70's, he was labeled. He had reading disabilities so he was tutored in reading and speech. He was always slow with his speech, as if he was thinking about what he was going to say before he said it. It was heartbreaking because he carried these insecurities into his adult life. He worked hard, went to school, and got a great job, but he still felt he was labeled. I so wish there had been the capability to diagnose decades and decades ago. I am so glad there is suspicion from the doctors when children are infants now. Sounds like your daughter is a success story and that is AWESOME!! You are a good mom!

Informative and interesting hub! Up, useful, beautiful, awesome, and interesting!!


tammyswallow profile image

tammyswallow 4 years ago from North Carolina

I never heard of this before! Very well done and insightful!


Ardie profile image

Ardie 4 years ago from Neverland Author

Hello Melvoy and thanks for reading this Hub - its one of my favorites! I'd never heard of this disorder before my daughter got diagnosed either. I wonder what happens to the kids that dont get treatment...do they eventually fix their own speech or do they live with the problem forever? Sad... And stuttering, the people who overcome that are so so strong.

I did blame myself and I still do - I often wonder if the birth caused CAS because my daughter lost oxygen for quite some time... and I refused a C-section even though the doctors made me aware of the risks. But all ended well so I try not to dwell on that.


Ardie profile image

Ardie 4 years ago from Neverland Author

Oh Sharyn, I started crying reading about your nephew and you reading with him and working with him and how his parents never treated him as different. I know how hard it is to watch the kid know what he wants to say and he just cant. Its so unfair. But I love to hear the success stories like your nephew so much!!!! And to hear he is a junior (!) and has no lingering issues just makes me SO happy because I always wonder about my daughter's future. Go Zak! Im a fan now too :) And GO Sharyn and Zak's mom and dad - you all made a world of difference to him. It takes a lot of work, patience and determination to work with kids (most times).


Ardie profile image

Ardie 4 years ago from Neverland Author

sholland, that's so sad about your nephew :( He carried the label with him throughout his life and had to work twice as hard to get beyond it. I can only imagine how that made him feel growing up because people can be so cruel - even adults! When my daughter first started her speech she would make huge pauses between words and sounds too. She'd say sssss poon. But luckily she has learned how to mash the sounds together seamlessly. I hope your nephew is doing much better now.


Ardie profile image

Ardie 4 years ago from Neverland Author

Hi Tammy! I hadn't heard of it before either. I was so sad at first because my beautiful baby was labeled as having a disability...but she looked perfect. It opened my eyes to a lot.


Teresa Coppens profile image

Teresa Coppens 4 years ago from Ontario, Canada

Another wonderful hub. I have on my list of hubs to write a similar story regarding my oldest son. He also has a communication-based disability. His visual processing is very slow which resulted in a reading delay ( learning to read was a huge hurdle for him). Writing is also difficult for him. He was diagnosed in Grade 6 with his learning disability but I only worked part time so I could give him the help he needed to better succeed in school. He also has an I.E.P. and uses assistive technology including a school laptop, Kurzweil which reads text to him and others. He has spoken on TV regarding his disability and is a strong advocate for himself at school. I am proud to say he is an academic program in highschool and is working towards attending University in a couple of years. I too felt guilty, wondering what I had done to bring this on. He went through many frustrating years and even now sometimes resents having to work so much harder than most others but he tries to keep his goals in focus and participates in football and other physical activity for an outlet. I am so very proud of him. I am so glad to hear of your daughter's triumph over her disability. It is wonderful to hear success stories. Ardie, great hub. I am very much enjoying your material!


Ardie profile image

Ardie 4 years ago from Neverland Author

Teresa, Im surprised it took until grade 6 for your son to get a diagnosis. The poor dear had to struggle when all the while he could've already had an IEP in place. Thankfully you were home to help him overcome and now look at him - he's such a strong young man taking on the world and helping others like himself :) Im so proud of BOTH of you! Please let me know when you've written your story about your son - you can send me an email or leave it in a comment :) I cant wait to read it! I too love a success story!


Teresa Coppens profile image

Teresa Coppens 4 years ago from Ontario, Canada

Ardie. His story has been written. Hope you get a chance to read it!


Ardie profile image

Ardie 4 years ago from Neverland Author

Teresa! I just saw this comment and I am headed over to read it immediately. May I link it to this Hub?


Teresa Coppens profile image

Teresa Coppens 4 years ago from Ontario, Canada

Please feel free to do so. I would be honored!


RTalloni profile image

RTalloni 4 years ago from the short journey

What a wonderful thing for you to post your daughter's experience so meaningfully in order to help others. How good it is to hear of her progress and all that she is able to do now--everything evidently! :) The key is parents having the info they need and the willingness to fight for and work with their child. You did a wonderful job and I'm glad you can encourage others to do the same.


Ardie profile image

Ardie 4 years ago from Neverland Author

Thanks RTalloni :) this is one of those Hubs that means a lot to me. I really appreciate that you read it and get what I wanted to do with the info I gained over the years. I just wish all kids could be success stories. I will have to look into stats and see how many kids grow up to overcome apraxia and how many still have speech issues as adults.


Kendra Lee 3 years ago

Thank you so much for your article. My 2 1/2 year old daughter has just been diagnosed with CAS after several months attending weekly speech therapy appointments. I have two older children and neither of them had any speech issues, and the older one was quite advanced in his speech so this is definitely new to me. I have experienced many emotions, particularly surrounding my daughter being labeled as having a disability. I worry greatly that she will be teased by other children but am hopeful, after reading your post, that her speech will develop properly by the time she is ready to go to school. We are currently looking for a preschool and will be able to receive funding for an on-site speech therapist which I am most thankful for. Thanks again, and I will definitely have my husband read this article as I am certain it will address the concerns he has. Take care, and best of luck!


Randi Callahan 3 years ago

Ardie, Thank you for this article this is the first I have looked for and read a success story on Apraxia of Speech I am usually researching trying to find a reason why my son has this or on what else I can do to help him. My son is 3 years 2 months and has been in speech therapy for about 1 year he is talking more little by little and you story has really given me hope that he may be speaking well by kinder. The feelings you describe are exactly how I have felt for more than a year now I literally have read you daughters story 3 times and can not hold back the tears. I have those same fears for my son but your daughters success makes me believe my amazing little guy can do it too! He starts preschool next Monday and we have his IEP in place for speech therapy at school in addition to his speech therapy he gets at home twice a week. I am very worried about preschool and how he may handle it but I know the other children will be great models for speech. Cam has about 100 words now and has worked so hard on his speech, he has so much he tries to say but just simply does not have the words yet. I am so truly happy for your daughters improvement in speech and thank you from the bottom of my heart for sharing your story! Did you give your daughter any fish oil? Or any other supplement that may have helped?

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