According to Edith Strand, the leading expert in child apraxia, “childhood apraxia of speech (CAS) typically occurs alongside other language delays or phonological impairments.  This can make diagnosing it a major challenge.”

Characteristics that are often present, but not discriminative, in childhood apraxia include:

• Limited consonant and vowel repertoire
• Use of simple syllable shapes and frequent omission of sounds
• Numerous errors-poor standard scores on articulation tests
• Poor intelligibility

More “discriminative” characteristics of apraxia of speech include:

• Difficulty moving from one articulatory movement to another  (ie saying the word “pancake” at a fast rate)
• Groping and/or trial and error behavior
• Vowel distortions
• Prosodic errors (putting stress on the wrong syllable)
• Inconsistent voicing errors (“teck” for “deck” or “van” for “fan”)

Distinguishing CAS from Phonological Impairment

The primary characteristics of  childhood apraxia of speech (CAS) are vowel distortions, segmentation and/or equal stress, awkward movement transitions and error behavior in words and phrases. On the other hand, children with only phonological impairment may make substitution errors of exhibit phonological processes that are fairly consistent.  The movements for those incorrect sounds will be accurate though, and rate and prosody are typically good.  For more information on this topic, see the March 2017 issue of The ASHA Leader “Appraising Apraxia”.

If you are concerned about your child’s speech or language be sure to contact an ASHA certified speech-language pathologist for an evaluation.   A list of providers can be found at http://www.ASHA.org