Childhood Apraxia of Speech

The scope of this page is Childhood Apraxia of Speech in preschool and school-age children from 3 to 21 years of age.

"Childhood apraxia of speech (CAS) is a neurological childhood 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 and 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" (ASHA, 2007a, Definitions of CAS section, para. 1).

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (American Psychiatric Association [APA], 2013) uses the term verbal dyspraxia to describe this disorder and discusses it within the Speech Sound Disorders category, under the subheading, "Associated Features Supporting Diagnosis." Verbal dyspraxia is described in the DSM-5 as a disorder in which "other areas of motor coordination may be impaired as in developmental coordination disorder" (p. 44).

The term childhood apraxia of speech (CAS) is being used in the page as a unifying cover term for all presentations of apraxia of speech in childhood, whether congenital or acquired or associated with a specific etiology. CAS is preferred over other terms that have been used for this disorder, including developmental apraxia of speech and developmental verbal dyspraxia, which have typically been used to refer only to idiopathic presentations and not to acquired neurologic etiologies. Additionally, inclusion of the term developmental in reference to childhood apraxia may be incorrectly interpreted as indicating that apraxia is a disorder that children "grow out of." Unlike speech delay, the characteristics of CAS are likely to persist past the developmental period (Lewis, Freebairn, Hansen, Iyengar, & Taylor, 2004).

See the Childhood Apraxia of Speech Evidence Map for summaries of the available research on this topic.

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