Childhood Apraxia of Speech (CAS)

Also called:

Developmental Apraxia of Speech
Developmental Verbal Dyspraxia
Developmental Dyspraxia
Verbal Apraxia in Children


Childhood Apraxia of Speech (CAS) has long been a controversial diagnosis. There has been disagreement on whether the condition actually exists and if so, what it actually is. As well, there has been considerable debate about what might cause it. A particular concern has been (assuming it exists) with identifying those features that may be unique to CAS, those features which overlap with other related conditions, and/or those which reflect conditions which may co-exist with CAS.

Recently the American Speech-Language-Hearing Association attempted to address this problem.  They brought together an expert panel to study the question and in 2007 the panel issued a position statement and a technical report. In the position statement CAS is defined as:

Childhood apraxia of speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g., abnormal reflexes, abnormal tone). CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known or unknown origin, or as an idiopathic neurogenic speech sound disorder. The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody.

Thus we see from this definition:

1.  CAS does indeed exist
2.  There are several possible causes.
3.  It appears to be a problem of planning and/or programming the movements for speech.


The position statement and technical report also tell us that CAS may co-exist with:

Oral Apraxia - problems with sequencing the movements for non-speech oral activities such as chewing and swallowing.
Dysarthria - problems of muscle weakness


Some useful links for more information:

See the website for the Childhood Apraxia of Speech Association of North America at http://www.apraxia-kids.org/

For a detailed analysis of the position statement and some suggestions for assessment and treatment of this condition see http://www.slpinfo.org/product.html

And Shelley Velleman has also provided some useful information at:   http://people.umass.edu/velleman/cas.html

Caroline Bowen provides an excellent discussion of speech sound disorders in children that includes a discussion of CAS.  See http://speech-language-therapy.com/phonol-and-artic.htm



Peter Flipsen Jr., PhD, CCC-SLP, S-LP(C)
Associate Professor of Speech Pathology
Idaho State University