3 Criteria for Apraxia of Speech - Accurate Diagnosis is Key

Updated: Jul 30, 2018

July 25, 2018

The American Speech-Language-Hearing Association (ASHA) has defined the top three characteristics of childhood apraxia of speech (CAS) in order to help speech therapists make an accurate diagnosis and distinguish it from other speech sound disorders.


They include:

  1. Inconsistent errors on consonants and vowels in repeated productions of syllables or words (meaning that if the child says the same word many times, it may sound differently each time)

  2. Lengthened and disrupted co-articulatory transitions between sounds and syllables (meaning that the child’s speech sounds choppy or disconnected due to trouble transitioning between sounds, or between words in older children)

  3. Inappropriate prosody, especially in the realization of lexical or phrasal stress (meaning that the rhythm, intonation, and stress of speech may sound off, the child may sound robotic, have incorrect phrasing, or stress the wrong words or syllables)

(Source: ASHA)


Yet parents know that not all children are the same and there are many subtle differences that each child has. So here is a list of some more possible characteristics of children with CAS:

  • More mistakes as longer or more difficult words are attempted, such as 2 syllable (e.g. "water") or 3 syllable (e.g. "dinosaur") words

  • The number and variety of vowel sounds is low; or errors when producing vowel sounds (vowels include /a,e,i,o,u/ sounds)

  • Sometimes “groping” behaviors are observed. This is when your child appears to struggle to place their tongue, teeth, lips or mouth in general to start or produce the syllable or word.  It is important to note that not all children show "groping" behaviors at all times.  If your child does not demonstrate groping during speech attempts, it does NOT necessarily rule out apraxia of speech.

Differential diagnosis between apraxia of speech and speech sound delays or disorders are crucial in order to provide the right type of therapy.

Children with apraxia of speech require specific evidence based treatment solutions that are unique to their needs. Therefore, a differential diagnosis between apraxia of speech and speech sound delays or disorders are crucial. Only a qualified speech language pathologist who has experience diagnosing or treating apraxia should be consulted to accurately assess a child's speech and language abilities.

To get help with diagnosis or treatment, or to schedule a free consultation with a speech therapist, please contact me at Speech Therapy that Works.

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