Childhood Apraxia of Speech: A Brief Overview
In 2015, Ronda Rousey, a famous UFC fighter, made national news for discussing her battle with Childhood Apraxia of Speech (CAS). Undiagnosed during childhood, Ronda and her parents were unaware of this speech disorder which left her unintelligible early on in her life. It wasn’t until her mother sought help from the speech pathology program at Minot State University in North Dakota to help overcome, arguably her most difficult opponent. Ronda stated on ABC news, “…I had all these words perfectly arranged in my head, it’s just when they tried to come out of my mouth they sounded different,” she said. “It was kind of like there was a divide between my brain and my mouth.”(Pereira, 2015)
What is CAS?
What is Childhood Apraxia of Speech? CAS is a motor speech disorder in which the precision and consistency of movement required to produce speech is impaired (ASHA, 2007b). CAS occurs when a child’s brain has difficulty planning and executing the muscle movement required to produce speech that is easy to understand. CAS is a condition that presents itself similar to other commonly developmental speech disorders such as phonological and articulation impairments, but differs in its approach in evaluation and treatment.
For example, a child with CAS may attempt to communicate the word ‘dog’. The child’s first attempt may sound like ‘dot’, and then may come out at ‘tog’, and the final attempt may be produced as ‘dog’. A child with an Articulation/Phonological impairment may consistently produce the word as ‘dog’ as ‘dod’, over the same three attempts. The question you have to ask yourself is, is the sound errors inconsistent or consistent? When Rhonda had difficulty producing the words, the problem was getting them out accurately and consistently due to errors in planning and execution.
Incidence and Prevalence
CAS occurs in approximately 1-2 out of 1,000 children (0.1%-0.2%; Shriberg et al., 1997). On average, CAS affects more boys than girls at a 2 or 3:1 ratio (Hall, Jordan, & Robin, 1993; Lewis, Freebairn, Hanson, Taylor, et al., 2004).
Signs and Symptoms
The signs and symptoms of CAS may include:
- Decreased or lack of babbling – “Quiet baby”
- Delayed onset of first words – later than 12 months
- Limited sound inventory
- Vowel errors
- Simple syllable shapes
- Limited intonation
- Words appear then disappear
- Facial groping/lack of flexibility when imitating speech
- Difficulty with feeding
(Caspari, 2015)
Diagnosis and Assessment
It is recommended that you seek counsel from your physician if you have concerns that your child may have a speech and language disorder. The physician can then provide you with a prescription for a comprehensive speech and language evaluation from a licensed speech language pathologist. The goal of an assessment is to determine the underlying cause of the speech and language difficulties. There is no standardized test that is reliable or valid in diagnosing CAS (McCauley & Strand, 2008), however, a comprehensive assessment can help differentially diagnose CAS from other similar conditions. To find more information about Childhood Apraxia of Speech, please visit The Childhood Apraxia of Speech Association of North America (CASANA) website at: http://www.apraxia-kids.org/. If you feel like your child is at risk for CAS or other communication disorders, please contact the speech therapy departments at Keystone Pediatric Therapies at (717) 709-7997 or Keystone Audiology and Speech at (717) 709-7920.
Greg Hoover, M.S., CCC/SLP
Greg received his Master of Science degree in Speech Language Pathology and his Bachelor of Science degree in Communication Science and Disorders at Clarion University of Pennsylvania. He holds a Pennsylvania state license in Speech Language Pathology and Certificate of Clinical Competence- American Speech-Language and Hearing Association.
Resources
American Speech-Language Hearing Association. (2007b). Childhood apraxia of speech [Technical report]. Available from www.asha.org/policy.
Caspari, S. (2015). Hands-On Childhood Apraxia of Speech Clinic: Part 1 – CAS Assessment, 2015 PSHA Convention, Harrisburg, PA., March 27, 2015.
Hall, P.K., Jordan, L. & Robin, D. (1993). Developmental apraxia of speech: Theory and clinical practice. Austin, TX:PRO-ED.
McCauley, R.J., & Strand, E.A. (2008). A review of standardized tests of nonverbal oral and speech motor performance in children. American Journal of Speech-Language Pathology, 17, 81-91.
Pereira, J. (2015). “UFC Fighter Ronda Rousey Delivers Message for Mom Who Helped Her Discover Childhood Speech Condition”. ABC News, http://abcnews.go.com/Entertainment/ufc-fighter-ronda-rousey-delivers-message- mom-helped/story?id=33361412, Accessed 18 October 2016.
Shriberg, L.D., Aram, D., & Kwiatkowski, J. (1997). Developmental apraxia of speech: Descriptive and theoretical perspectives. Journal of Speech, Language, and Hearing Research, 40, 273-285.
