What is childhood apraxia of speech?

Childhood apraxia of speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g. abnormal reflexes, abnormal tone). CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known and unknown origin, or as an idiopathic neurogenic speech sound disorder. The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody. (ASHA, 2007b, Definitions of CAS section, para. 1).

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (American Psychiatric Association [APA], 2013) uses the term verbal dyspraxia to describe this disorder. It is discussed within the Speech Sound Disorders category, under the subheading, "Associated Features Supporting Diagnosis." Verbal dyspraxia is described in the DSM-5 as a disorder in which "other areas of motor coordination may be impaired as in developmental coordination disorder" (p. 44).

The term childhood apraxia of speech (CAS) is used in this ASHA Practice Portal page as a cover term for all presentations of apraxia of speech in childhood, whether congenital or acquired and whether or not associated with a specific etiology.

ASHA prefers CAS over other terms used for this disorder—including "developmental apraxia of speech" and "developmental verbal dyspraxia"—which typically refer to idiopathic presentations and not to acquired neurological etiologies. In addition, the inclusion of "developmental" in reference to childhood apraxia might be incorrectly interpreted as indicating that children can "grow out of" this disorder. Unlike speech delay, the characteristics of CAS are likely to persist past the developmental period (Lewis, Freebairn, Hansen, Iyengar, & Taylor, 2004).