Childhood apraxia of speech, otherwise known as CAS, is a neurologically-based speech disorder in which the child struggles with the motor planning and execution of the complex oral movements required to produce sounds into motor units.  Although there are no standard diagnostic criteria to determine if a child has childhood apraxia of speech, professionals agree upon three primary features which include:

1. Inconsistent errors on consonants and vowels in repeated productions of syllables or words, which means a word may not be said the same way each time it is attempted by the child.
2. Lengthened and disrupted coarticulatory transitions between sounds and syllables, which means the sounds, syllables, and words may be distorted or altered resulting in broken or choppy sounding speech.
3. Inappropriate prosody, especially in the realization of lexical or phrasal stress between sounds and syllables, which means the rhythm and inflection may sound off and stress may be placed on the wrong syllable or word.  

Childhood Apraxia of speech or CAS is a type of speech disorder that is present at birth.  Someone with CAS has difficulty executing the movements required to sequence sounds within syllables and words.  CAS affects the brain pathways involved with sending signals to the speech muscles of the jaw, lips, and tongue.  In most children, these signals work effectively and the child can sequence sounds into words and words into phrases correctly and consistently.  A child that suffers from CAS has a brain that struggles to sequence and execute the required speech movements.  So, in effect, someone who has CAS knows what they want to say, has speech muscles that work appropriately, but their brain has difficulty sending the correct signals to the muscles to execute movement sequences necessary for speech.  Childhood Apraxia of Speech is not a speech delay, because with a speech delay the child follows a normal path to speech development, it just takes longer than normal. Those that have CAS can experience a mild or severe case, but the child will not outgrow it over time and requires skilled intervention.  Childhood Apraxia of speech is uncommon and affects boys more than girls.

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“We will wait and see.”  So often I hear parents say these words. “My child is 12 months old and has not said his first word, but we will wait and see.”  “My child is 18 months and is not talking yet, but we will wait and see.”  “My child is 2 years old and only has a couple of words, but we will wait and see.”