Conquering Childhood Apraxia of Speech
Your 2 ½ year old daughter doesn’t say a word. As a matter of fact, she doesn’t make a sound. Judging by her frustration, she wants to talk at times but can’t. Your child could be suffering from a rare condition known as childhood apraxia of speech.
Childhood apraxia of speech (CAS) is a neurological disorder that impairs a child’s ability to speak. It is estimated that 1 to 2 children per 1,000 may have CAS. The condition can affect any child. The cause of CAS is unknown.
Children are more likely to have this condition if:
· A child’s language skills are stronger than their expressive communication and speech skills or if a child is limited to no speech.
· A child has difficulties chewing foods, using a straw or drinking from a cup and processing what they feel in their mouth.
· A child has difficulties with the development of reading, writing and spelling when they are school-aged.
· A child has problems with fine motor skills. For example, a child may have trouble drawing or picking up small items.
According to the Cleveland Clinic, CAS affects a child’s ability to communicate verbally despite being able to understand what someone is asking them. Although a child’s inability to speak is the reason for the diagnosis, it may also mean for some children, having trouble moving the tongue, mouth or lips.
CAS occurs because of difficulty programming the movements needed for articulation (speech) to occur.
Children with CAS may have interruptions in certain nerve pathways in their brains. These nerve pathways are responsible for planning the movements that are necessary for speech. In children who have CAS, the messages from their brain to the parts of their mouth used for speech are not being sent correctly.
Weakness or paralysis of the muscles involved in speech, including those of the lips, jaw and tongue, are not a cause of CAS.
In some cases, CAS is the result of an acquired brain injury, such as a stroke, which causes nerve pathway interruptions in a person’s brain.
There is some evidence that genetic conditions may lead to a CAS diagnosis. Studies show that a mutation of the FOXP2 gene leads to a severe form of CAS, along with other neurodevelopmental conditions like autism, attention-deficit/hyperactivity disorder and epilepsy. Research is ongoing to pinpoint the direct cause of CAS.
The symptoms of CAS vary depending on the child. But generally, children affected by CAS usually understand the language but have difficulty with speaking and communicating. Symptoms for children with CAS include:
· Making inconsistent errors in speech.
· Difficulty coordinating the movement from one syllable of a word to the next syllable.
· Distorting sounds.
· Attempting to pronounce a word several times before saying it correctly.
· Making errors in the tone, stress or rhythm of speech.
Speech language pathologists usually diagnose children with CAS. They check for mouth muscle weakness, how well the child makes consonant and vowel sounds, looks at nonspeech oral motor skills such as blowing, smiling, rounding lips and how quickly the child can move their mouth, observes how well the child changes the pitch of their voice, observes how well others can understand what the child is saying.
Treatment for CAS can be quite intensive. Some children will visit their speech language pathologist three to five times a week to improve their speaking skills.
Children with extreme CAS will have to do speech therapy for several years. The treatment plan for the child is speech therapy to address syllables, words and phrases, learning and using alternative forms of communication such as sign language and devices, and practicing repetitive language exercises at home.
Keep track of the progress your child is making and offer encouragement whenever possible. Just because your child is different, you don’t have to treat her as such.
