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!
It’s only normal to worry about your young child’s speech and language development, particularly at the critical ages of 18-24 months. Your child’s development will impact their ability to engage with others and effectively navigate their world!
At two-years old, your child typically should be using between 100 and 150 words, consisting of familiar nouns (“cookie”, “dog”, “cup”) and verbs (“eat”, “go”). Additionally, your child should be combining words into 2-3 word phrases, for example: “Eat cookie”, “Mommy go”. You should see a language “explosion” around this age, where your child begins using new words more frequently than before and progress accelerates.
Furthermore, you should monitor your child’s ability to understand – technically called receptive language. At two, your child should be able to identify clothing and body parts, follow simple 2-step commands, respond to yes/no questions, and point to familiar items/objects. If your child struggles to understand language, it may be harder for them to learn and use new words.
You can encourage your child’s development through day-to-day activities, especially including ones at home:
Singing with your child and leaving off key words (e.g., “Twinkle, twinkle, little _______”) encourages them to use vocabulary in a familiar way
Reading is another great way to encourage language development! Make sure you read interactively with your child by asking your child specific questions while reading, for example:
ask about functions: “What is she coloring with?”
talk about specific parts of a picture: “the dog’s tail” or “the boy’s shirt”
label the different pictures or objects in the book as you go along
Daily routines build understanding through repetition!
Give your child multiple step commands during activities (e.g., “First put on your shoes and then bring me your coat.”)
Explain the steps of activities you’re doing and have your child retell the steps back to you, with your help and guidance (e.g., hand washing or making a snack)
If you are concerned about your child’s speech and language development, act now, as early intervention helps prevent your child from falling further behind. For children with speech and language weaknesses, speech therapy is imperative to address those weaknesses in order to help your child effectively communicate with others. If you have any questions about your child’s speech and language needs, please contact us at The Speech Space!
Do battery operated toys hurt your young child’s development? There is a lot of debate about this issue, but we believe that ultimately, if you (and others) engage your child with the toy and your child enjoys a toy, it does not matter whether it has batteries. However, in our professional practice at The Speech Space, we lean towards more toys without batteries in our therapy and play. Toys without batteries can be more open ended, therefore, encouraging more creativity when you use them to play with your child. Additionally, if a toy is not making a battery-operated noise, your child is more likely to make noise! It is easier to encourage speech and language when a toy isn’t making noise or ‘talking’ while you play.
Here are some of our favorite battery-free toys:
Pretend food: So versatile in the different games you can play with your child, and the vocabulary you can elicit with your child is extensive, fun, and practical! Not only are there tons of nouns (e.g., banana, plate, milk, oven, etc.), but there are countless verbs you can use that relate to your child’s everyday life (e.g., eat, drink, cut, cook, blow, etc.). With pretend food, you can encourage building your child’s understanding (technically called receptive language) by giving directions or having your child identify items by color, function and/or category. The opportunities for building their speech (technically expressive language) are also endless! Your child can label items, tell you what to do with each item (e.g. “You cut with the knife.”), explain the sequence of activities (e.g., “First we cook the food and then we eat the food.”), or simply describe what they’re doing (e.g., “I’m cutting this apple.”). We love Melissa and Doug pretend food because they are wooden (easy to clean!) and the velcro is very durable.
Blocks: In our professional sessions, we use wooden or cardboard blocks, but really, any blocks are great! There are so many things to build, which encourages the use of location vocabulary. For example, if your child has a superhero they love, you could decide “where” the superhero will live. Prepositions (e.g., in, on, under, next to, etc.) are easily incorporated while you play with your child. Quantity matters most with blocks – while 30 blocks may not retain your child’s interest, 100 blocks opens up many more possibilities! You can slowly build up their block collection with new blocks, or head over to eBay for some gently used blocks that are a little cheaper! Just remember to ask questions and give directions while you play and you can help your child’s speech and language development as well as their imagination!
Play-Doh: Yes, Play-Doh is still around and kids still love it! The variety of Play-Doh toys is abundant and you can pick some up pretty cheap on Amazon and eBay. Playing with Play-Doh encourages the use of verbs (e.g., cutting, rolling, pushing, etc.) and nouns (e.g., colors, animals, tools, etc.). One of our favorite things to do with Play-Doh is to hide small objects in a ball of it and let your child find the object (super fun surprises!). It helps you introduce vocabulary and encourages your child to explore the Play-Doh and the object. Children love getting to rip or tear the Play-Doh apart and generally use more language when they feel like they get to be a little ‘messy’!
Dress Up Clothes: Again, pretending is so important for your child to try out language and everyday activities by exploring them in their own environment. You can get dress up clothes from garage sales or Goodwill or on sale after Halloween. They don’t have to be made to be “dress up clothes”! For example, if you go to Goodwill, you can often find old lab coats or fancy dresses or military gear and this could all be dress up clothes. The important thing is to play with your child and help build their imagination and language!
Sensory Table: This may be one of the messier type of toys, but so worth it! Sensory tables are great to fill with water, sand, beans or many other things you and your child want to explore together. You can change the items in the table seasonally (e.g., leaves and pinecones in the fall; sand or water in the summer; cotton balls or white pom-pom balls or shaving cream in the winter) to encourage your child’s understanding and use of a wide variety of vocabulary. Additionally, children love using a variety of senses to learn and explore and sensory tables are perfect for that!
Building a water castle or city!
Playing with bugs in colored rice.
Digging for treasure!
The most important thing to remember when playing with your child is to find things that interest them and encourage their engagement and attention to play with you! Play is fundamental to your child’s development – it’s the foundation of language, critical thinking and problem-solving for later in life! Children learn best through play and real interactions, so make it fun!
Come back to our blog as we continue to post about more toys and ways to monitor and support your child’s development. If you have concerns or questions about your child’s communication development, please reach out to us at The Speech Space!
