Understanding Childhood Apraxia of Speech

“I Think They Know What They’re Trying to Say… 

But It’s Just Not Clear”

Many parents share a similar moment with me. Your child looks right at you, takes a breath, and says a word with so much effort. You can see their mouth working hard. You know they’re trying. And yet… the word doesn’t come out clearly. If this sounds familiar, you are not alone—and it does not mean your child isn’t trying hard enough or “behind.” For some children, this experience can be part of something called Childhood Apraxia of Speech.

What Is Childhood Apraxia of Speech?

Childhood Apraxia of Speech (often called CAS) is a speech difference that affects how speech movements are planned. In simple terms, your child knows what they want to say, but their brain has trouble sending clear, consistent messages to the muscles needed for speech.

This is not caused by weak muscles, and it is not related to intelligence or understanding. Many children with CAS understand language well and have a lot to say. Getting the words out clearly is the hard part.

Parents often notice things like:

• The same word sounding different each time it’s said

• Clear effort when speaking, especially for longer words

• Speech that becomes harder to understand as sentences get longer

• Frustration when others don’t understand them

These signs are about motor planning, not motivation or behavior.

How Is Childhood Apraxia of Speech Diagnosed?

A speech-language pathologist (SLP) trained to diagnose and treat childhood apraxia of speech can assess your child. There is no single test for CAS; instead, the SLP examines patterns over time rather than just a single instance. Walee Speech Therapy specializes on the evaluation and treatment of childhood apraxia of speech.

During an evaluation, the SLP may:

• Watch how your child moves their mouth when speaking

• Listen for consistency across repeated words

• See how your child responds when words are modeled

• Notice how much effort speech takes

Sometimes a diagnosis becomes clearer as your child grows and their speech develops. This is a thoughtful, ongoing process—not a rushed label.

How Is CAS Treated?

Because CAS is motor-based, therapy focuses on helping the brain learn how to plan and sequence speech movements.

One evidence-based approach our therapist uses at Walee is DTTC (Dynamic Temporal and Tactile Cueing).

What Does DTTC Look Like?

• Uses frequent practice of meaningful words and phrases

• Provides visual, verbal, and gentle tactile cues when helpful

• Adjusts support moment-to-moment based on your child’s needs

• Gradually fades cues as speech becomes more accurate

The goal is not perfection—it is clear, functional communication that feels achievable and supportive

Why Therapy Is Often Short and Frequent

Children with CAS benefit most from shorter sessions that happen more often, rather than longer sessions once a week.

A common recommendation is: 30-minute sessions, 4 times per week

This type of schedule supports motor learning, similar to how practicing a physical skill works best with consistent, repeated practice. Short, focused sessions help build confidence while respecting your child’s attention and regulation.

A Gentle Reminder for Parents

Children with Childhood Apraxia of Speech are capable communicators. Speech therapy is not about fixing your child—it is about supporting their ability to express themselves.

Many children use gestures, signs, pictures, or AAC alongside speech, and these supports are encouraged. Communication always comes first.

If you see your child trying with their whole body, their whole face, their whole heart—that effort matters. With the right support, progress is possible.

Reach out to us today at vivian@waleespeechtherapy.com for an evaluation and treatment of childhood apraxia of speech.

References

American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech [Technical report]. https://www.asha.org/policy/tr2007-00278/

Maas, E., Gildersleeve-Neumann, C. E., Jakielski, K. J., & Stoeckel, R. (2014). Motor-based intervention protocols in treatment of childhood apraxia of speech (CAS). Current Developmental Disorders Reports, 1(3), 197–206. https://doi.org/10.1007/s40474-014-0020-4

Murray, E., McCabe, P., & Ballard, K. J. (2014). A systematic review of treatment outcomes for children with childhood apraxia of speech. American Journal of Speech-Language Pathology, 23(3), 486–504. https://doi.org/10.1044/2014_AJSLP-13-0035