CAS is a motor speech disorder, which means your child has trouble saying sounds, syllables, and words. This trouble is not because of muscle weakness or paralysis, but rather the brain having trouble planning how to move the body parts for speech (e.g., lips, jaw, tongue). Your child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.
Red Flags For CAS
The signs of CAS vary from child to child, but here are some red flags that are often seen:
First words are late and/or missing sounds
Limited consonant and vowel sounds used
Difficulty combining sounds (e.g., may mix them up, have long pauses between sounds, or delete sounds)
Simplifying sounds/words or replacing sounds/words for those easier to say
May have problems eating (e.g., very picky eaters, only like things that are easy to chew, very messy eaters, etc)
Appears to understand language much better than they can talk
“Groping” for sounds (i.e., odd and/or awkward movements of their mouth when trying to imitate or make sounds/words)
Difficulty saying longer words or phrases
It can be scary when you suspect or learn your child is not developing in the way you expected. And the lingo used when a diagnosis is given can be confusing and scary as well. However, as a parent it is important to understand a diagnosis in order to do what is best for your child.
If you suspect your child may have CAS or have been told your child has CAS, a complete evaluation of their oral musculature (i.e., lips, tongue, cheeks, jaw), speech sound repertoire, and their language skills should be completed to determine the most effective course of treatment for your child. It’s also important to take into consideration that there are often co-existing conditions (e.g., hypotonia, autism, sensory integration disorder, etc) that can be associated with CAS. Co-existing conditions would impact how your child’s treatment plan should be designed.
Research shows that children with CAS have more success when they receive frequent (3-5 times a week) treatment. A high-frequency and intensive treatment plan would help your child improve their motor planning abilities, as well as their coordination and sequencing of movements for speech sound production. Every child is unique and every child with CAS is unique as well! The duration of therapy your child may need depends on their severity, the commitment of parents and caregivers for completing homework, and your child’s personality. Your speech therapist should provide you with weekly homework to help guide you in the carryover of skills at home.
Our team is recommended providers on The Childhood Apraxia of Speech Association of North America (CASANA): Megan C. Littlepage & Monica T. Phillips. Additionally, we are trained in PROMPT, Sarah Rosenfeld-Johnson’s Oral Placement Therapy, and the Kaufman Speech Praxis kits. We have extensive experience working with children with CAS and their families. At The Speech Space we really take a “team approach” for our kids–this includes our team, your child, you, and other caregivers and educators!, The Speech Space offers free 30 minute consultations to help identify potential problems with speech, language and communication development, as well as, for feeding issues. If you have concerns or further questions about your child’s development, please feel free to contact us at The Speech Space!Important Resources for CAS:
Did you know that using sippy cups may hurt your child’s speech development? Over at The Speech Space, we are huge proponents of straw cups, straw drinking and open cups instead of sippy cups for younger children. The type of cup your child regularly uses can impact their speech development! Here are a few reasons why at The Speech Space we like straw cups instead of sippy cups:
1. Oral Musculature (or the muscles your child uses to talk!) When children have strong oral musculature (i.e., lips, tongue, cheeks, jaw stability), they are more likely able to clearly imitate a variety of movements needed for speech sounds. This is the core for developing clear speech. Children with weak oral motor skills have a higher risk of having a speech impairment. Straw cups and open cups are one way of helping your child develop these critical muscles that they will need to produce sounds. While using a sippy cup does not necessarily mean your child will need speech therapy, it’s best to encourage oral motor development by using straw cups at home.
Note that he’s using those lips instead of biting with his teeth to control the straw
You can start your child drinking from a cup early on!
2. Swallowing Another area of your child’s development is swallowing, which requires strength from all those oral structures we mentioned earlier! When your child drinks from a bottle or a sippy cup, the spouts prevent your child’s tongue tip from elevating, often requiring them to stick their tongue out in order to drink. Liquid rushes out from sippy cups, so your child doesn’t use their oral structures while drinking. This can contribute to weaknesses in your child’s lips, cheeks and tongue.
By drinking from a straw cup or an open cup your child must use more movement and control from their jaw, tongue, lips, and cheeks. This additional movement (in part to prevent spillage) works on strengthening their oral motor skills and can contribute to their speech development!
This little girl is using her lips, cheeks and tongue to drink!
Notice this little girl’s flat lips and protruded jaw (and thus tongue).
3. Dental Concerns A final concern is liquid pooling around your child’s teeth when using a sippy cup. Sugars from drinks sit on their teeth causing decay (both milk and juices have sugars). Furthermore, if your child pushes their tongue forward to swallow (more likely with sippy cups instead of straw cups), there is a possibility their front teeth will get pushed forward. This might impact future speech development, particularly for certain sounds.
If you’re interested in trying out straw cups with your child, there are some great ones on the market! Some of our favorites are available here and here, but there may be cups you like more. As a parent, we know you are solving for a variety of factors (when traveling, something that doesn’t leak, your child may have a favorite color or character, or a handle so your child can hold the cup by themselves). The most important thing to look for in a straw cup is that the straw is not too soft (so your child cannot bite it too easily–that’s cheating!) and not too thick.
If you have any further questions or concerns feel free to reach out to us at The Speech Space! Until then, bottoms up…or straws up, we should say!
Holidays and seasons are a great way to incorporate new vocabulary and build your child’s language and understanding of traditions or routines! Read more below about a few Valentine’s Day themed books for different ages and the fun ways you can interactively read with your child. We’ve also shared a few of our professionally-recommended easy and inexpensive themed-activities for you and your child to do at home!
For younger children (Toddlers & Preschoolers:18 months to 3 years)
Where is Baby’s Valentine? In this book Baby has lost her Valentine’s Day card and you have to help her find it! This book is great for working on everyday, common vocabulary (e.g., things around your home), yes/no questions, simple WH-questions (what, where, who) and also prepositions (e.g., “Is it under the table?” or “Show me what is on the table.” or “What is next to the table?”, etc).
Llama Llama I love you This book is good for simple sequencing of events (the steps to making the cards, giving the cards, sending the cards, etc), for verbs or action vocabulary (e.g., cutting, glueing, walking, etc), simple WH-questions and yes/no questions. There are also some rhyming words in this book (though your toddler or preschooler is still a little young for pre-reading and phonemic awareness skills, it’s still beneficial to read books with a variety of concepts!).
For children around Pre-K (4-5 years old)
Happy Valentine’s Day Curious George! We love Curious George books! They are great for WH-questions (who, what, where, when, why), inferences (“Why is the man upset?”, “Why does George looked worried?”), predictions (“Uh oh. What might George do?”, “What might happen?”) and recalling details and events of the story after the book
Lily’s Chocolate Heart This is a simple, but very cute book which is great for prepositions (e.g., under, next to, on, above, etc.) and vocabulary, as well as, WH-questions and recalling details about the story.
There Was an Old Lady Who Swallowed a Rose There are a lot of different “Old Lady Who Swallowed a….” books. These books are silly and fun and good for recalling details in sequential order (e.g., the items she swallows) and vocabulary.
For children who are a little older (Kindergarten, First Grade)
Franklin’s Valentines Franklin worked so hard on his Valentine’s Day cards, but something happens to them! This book is great for sequencing the events of the story, recalling details of the story, inferencing (e.g., “How do you think Franklin feels?”, “Why is Franklin sad?”, etc.) predicting (e.g., “Uh oh! His backpack is open! What might happen?” , “What might they do next?”, etc.) and problem-solving (“What is the problem?”, “What could he do to fix the problem?”, etc).
The Day It Rained Hearts In this book the main character, Cornelia Augusta, is very thoughtful with how she makes her Valentine’s Day cards and who will receive them! This book is also great for sequencing, recalling details, retelling events, making inferences and predictions.
Activities You & Your Child can do at home!
You can also do short, fun, holiday-themed activities at home with your child to work on ways to build their vocabulary and language skills. Here are a few easy and inexpensive ideas:
getting a box of valentine’s for their class and looking at what is the same or different with each valentine (e.g., they both have superheroes; one has iron man and the other has spider man)
describing what is on the valentine
sorting a box full of candy conversation hearts into colors
These are just a few ideas, but maybe you have some other ideas or activities you already do with your child. Feel free to leave your ideas in the comments section for others to try out too!
If you have any questions or concerns about your child’s development you can always reach out to us at The Speech Space!
