Childhood Apraxia of Speech


General Information for Parents

Childhood apraxia of speech (CAS, also known as DVD -- developmental verbal dyspraxia, and DAS -- developmental apraxia of speech) is a disorder that is more easily defined by what it is not. It is not a muscle disorder. It is not a cognitive disorder (although it may have some impact on language as well as speech). The problem occurs when the brain tries to tell the muscles what to do -- somehow that message gets scrambled. It's like trying to watch cable t.v. stations without the right descrambler. There is nothing wrong with the t.v. station, and nothing wrong with your set. It's just that your set can't read the signal that the station is sending out. The child's language-learning task is to figure out how to somehow unscramble the mixed message her/his brain is sending to her/his muscles. The visible results (symptoms) of CAS are: CAS has much more effect on volitional (voluntary, creative) speech than on automatic speech. This means that the more your child wants to communicate a particular message, the harder it will be! So, if you happen to hear her/him say something once when there is no pressure, and you say, "Say it again!", you are guaranteeing that she/he won't be able to. It is vital to put a minimum of communication pressure on the child. (NOTE: Your child's speech- language pathologist will need to put communication pressure on the child.) Low-pressure verbal activities are the most important thing a parent can do to help. These include: songs (especially repetitive songs, like Old MacDonald and finger-plays), poems, verbal routines (pat-a-cake, Willoughby Walloby Woo, etc.), repetitive books (such as some of the Mercer-Mayer books, Little Bear, etc.) and daily routines (prayers, social greetings, salute to the flag, etc.). You can make other activities into verbal routines: make up little sayings or poems that you say every time you do the same thing, label instead of counting objects in counting books ("Three dogs: dog, dog, dog"), verbalize repetitive activities (e.g., setting the table: "Plate, plate, plate, plate; fork, fork, fork, fork.."), and so on. Don't make a big fuss about whether or not your child is talking or singing along; just provide a supportive environment for her/him to do so. Don't ever say "You can't have it unless you say it first" -- that's sheer torture for a child with CAS. If your child is unable to communicate effectively right now, the use of sign language or a communication board to supplement speech temporarily not only decreases the frustration but also even seems to help with speech development. Don't be afraid to try it! Dyspraxia may affect other motor functions (e.g., fine motor control, gross motor planning) and other language functions (e.g., learning grammatical function words like "the, "is", "or", etc.; learning more complex grammatical forms like passive; spelling; putting words together into a sentence or sentences together into a paragraph, etc.). Occupational therapy, physical therapy, and learning disabilities assistance are often helpful for children who have these difficulties. CAS can be a very frustrating disorder at times. It is common for children to make progress in "fits and starts" -- good progress for a little while, then none, then more, etc. Don't get discouraged! The therapy is helping, even if you don't see the effects immediately.

An Internet Parent Support Group

Sharon Gretz, a parent of a child with dyspraxia, founded an Internet e-mail list for parents (and therapists) about this disorder which has grown into an international organization, the Childhood Apraxia of Speech Association, CASANA. There is a great deal of information for parents of children with CAS on their childhood apraxia web site.

An Article for Parents:

Stackhouse, J. (1992). Developmental verbal dyspraxia: A longitudinal case study. In R. Campbell (Eds.), Mental Lives (pp. 84-98). Cambridge, MA: Blackwell Publishers.

Some Key References for Professionals:

  • Caruso, A. & Strand, E. (1999). Clinical management of motor speech disorders in children. New York: Thieme.
  • Crary, M. (1993). Developmental motor speech disorders. San Diego: Singular.
  • Hall, P., Jordan, J., & Robin, D. (1993). Developmental apraxia of speech. Austin, TX: Pro-Ed.
  • Velleman, S.L. & Strand, K. (1994). Developmental verbal dyspraxia. In J. E. Bernthal & N. W. Bankson (Eds.), Child phonology: Characteristics, assessment, and intervention with special populations (pp. 110-139). New York: Thieme.
  • Velleman, S. L. (1994). The interaction of phonetics and phonology in developmental verbal dyspraxia: Two case studies. Clinics in Communication Disorders, 4(1), 67-78.
  • Velleman, S. L. (2002). Childhood apraxia of speech resource guide. San Diego: Singular.
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