Childhood Apraxia of Speech (CAS)

What is Childhood Apraxia of Speech? 

Childhood Apraxia of Speech (CAS) is a type of speech sound disorder. You may have also heard it called ‘Developmental Verbal Dyspraxia’. Some things that you might notice if a child has CAS: 

  • Even close family members can’t understand the child when they talk. 
  • The child seems to change how they say words, so it is really hard to guess what they are saying. For example, when the child asks to play on the ‘seesaw’ it could come out as ‘heegaw’, ‘geegaw’ or ‘eehaw’. 
  • The rhythm of the child’s talking seems unusual, or they don’t make their voice go up and down in a typical way. 

What causes CAS? 

We don’t know the exact cause of CAS. We do know that it can run in families. It involves difficulties in the way our brain deals with messages about how to move parts of our mouth, even though the muscles and nerves are fine. Children with CAS sometimes also have: 

  • Difficulties with talking. 
  • Difficulties with reading and writing. 
  • Difficulties using their mouth for activities such as blowing or sucking.  
  • Difficulties with the coordination of other parts of their body. 

CAS is more common in children with certain other diagnoses, such as Downs Syndrome.  

A child in my setting is very difficult to understand, could they have CAS?  

CAS is a very rare type of speech sound disorder. Around 60 out of every 1000 children will have a speech sound disorder, but only 1 in every 1,000 children will have CAS. A speech and language therapist needs to assess the child to diagnose CAS. This may take some time, as the speech and language therapist must rule out other speech sound disorders, such as inconsistent phonological disorder. It is important to get the right diagnosis as different speech sound disorders need different types of therapy. 

Does a child with CAS need speech and language therapy? 

Yes. Therapy for CAS needs to be individual, regular, and over a long period of time. Some children are not ready straight away to work on their speech sounds, so a speech and language therapist can focus on developing the child’s other communication skills and help find other ways for the child to communicate. For some children this may involve learning to sign or use a voice output device. 

Will children with CAS ever talk clearly? 

The good news is that most children with CAS improve if they have the right speech and language therapy. A small number of children may continue to need some extra help to communicate in adulthood. 

What can I do to help a child with CAS in my setting? 

It is very important that the child can communicate what they want and need. They need to do this so they can build friendships, learn at school, and get on in life. A speech and language therapist is the best person to do therapy for the child’s speech sounds, but there are plenty of other ways to help the child communicate: 

  • Focus on what the child is saying, rather than how they are saying it. See our ideas for supporting children with speech sound disorders. 
  • Show the child how to use other ways to communicate what they want and need. Our info on visual supports is a good starting point. 
  • There is no evidence that mouth exercises such as practicing blowing or sucking help CAS. 

You can find out more information about CAS/verbal dyspraxia from and  

For more tips on how you can support a child’s communication skills, have a look at some of our resources for educators: 

We also have a free speech and language advice line, which is a confidential phone call with an experienced speech and language therapist. During the 30-minute call, you will be given the opportunity to talk through your concerns and questions regarding a child’s development. You can book your phone call here.