Apraxia of Speech
- Limited frequency and diversity of sounds, vocal play, and jargon as a baby.
- Slow acquisition of words and of the ability to put them together into phrases.
- Poor speech understandability due to numerous sound errors and omissions of sounds and syllables.
- Discrepancy between receptive and expressive language skills (i.e., The understanding skills of children with CAS is usually stronger than their ability to express themselves.)
- Inconsistency in how the child produces a sound or word (e.g., A child may say the /s/ sound correctly in the word “sun”, but then say the word “sit” as “hit”.)
- The ability to correctly produce a sound or word spontaneously, but the inability to do so when asked to imitate the sound or word.
- A decrease in accuracy and understandability as the utterance length and/or complexity increases (e.g., The child can say each of the words, “cow” and “boy” clearly, but says the word “cowboy” as “buckoy”.) The speech of some children with CAS sounds slurred and run together, as they attempt to express themselves in longer phrases and sentences. Such children may be able to imitate the single words “butterfly” and “beautiful”, but when spontaneously using them in a sentence, they may omit sounds and syllables, making the words difficult to understand (e.g., “The buhfie is booful.” for “The butterfly is beautiful.”)
- A relatively poor repertoire of syllable and word shapes (e.g., The child may mainly produce consonant (C) + vowel (V) syllables, such as “boe, tee, doo” or CVCV reduplicated syllables, as in “mama”, “wawa”, “baba”).
- The ability to produce some consonant and vowel combinations, but not others (e.g., The child can say, “kay”, “kee”, and “kie”, but not “koe” or “koo”.)
- Distortions of vowel sounds. For children who are developing speech typically, accurate vowel acquisition is occurs early. Children with CAS often possess some vowel distortions (e.g., “tom” for “time”, “bod” for “bad”, and “ott” for “out”).
- Difficulty sequencing sounds in words (e.g., “ticky” for “kitty”), especially when attempting to produce longer words (e.g., “cuhvanoe” for “volcano”).
- A relatively poor repertoire of consonants and vowels (e.g., The child may only produce the consonants /p, b, m, t, d” and the weak vowels “eh” and “uh”.)
- Unusual stress or rhythm patters. The child may sound “robotic” due to the placement of equal stress or emphasis on each syllable (e.g., “I-am-pe-tting-the-pu-ppy.”)
First of all, your child’s speech-language pathologist will provide you with specific suggestions and activities for home practice. Consistent home practice is a big factor in helping your child overcome her difficulties.
As we always suggest, make your child’s message more important than how she says it. Don’t feel the need to correct your child when she tells you something. If you do not understand the whole message, try to mentally fill in the misunderstood parts in order to get the “gist” and respond to your child accordingly. In many cases, a parent is one of the only people who understands their child with CAS. This is extremely comforting and freeing to the child, when the rest of the world does not know what she is trying to say. At the beginning, you may need to speak for the child, but as she becomes more skillful and gains confidence when communicating with others, your role will be more supportive in nature
It is so helpful to know what your child’s abilities and limitations are, and it is crucial that she not be put on the spot to say something (e.g., “Tell Grandma what we did today!”) Instead, it is helpful to ask your child choice-of-two questions that would allow for a simple single-word or short phrase response (e.g., “Did we paint or make cookies?”)
Be patient and encouraged. With therapy, home practice, and time, your child should be able to make great strides toward becoming a clear communicator. Most children we see who had CAS tend to make up for lost time, becoming little chatterboxes!