17911 Childhood Apraxia Of Speech

Overview

Childhood apraxia of speech is a speech disorder that makes it hard for a child to move their mouth, lips, and tongue in the right order to make sounds and words. The child knows what they want to say, but their brain has trouble sending the right instructions to the muscles used for talking. It is not caused by muscle weakness and is different from a speech delay.

Childhood apraxia of speech is considered a rare disorder. It affects about 1 to 2 children per 1,000.

It mostly affects young children, often from birth or as they start talking. It is more common in boys than girls. Some children with apraxia also have other conditions, such as autism, epilepsy, or genetic differences.

Symptoms

Common symptoms

• Difficulty making sounds and putting them together in the right order
• Groping or struggling when trying to move the mouth to speak
• Inconsistent errors, like saying a word correctly one time and incorrectly the next
• Speaking slower or with a choppy rhythm
• Difficulty copying words or phrases
• Understanding language much better than they are able to speak
• Frustration when trying to communicate

Symptoms in children

• Not meeting expected speech milestones for their age
• Babbling less as a baby, with limited sounds
• Using only a few consonant or vowel sounds
• Leaving sounds out of words or putting them in the wrong order
• Difficulty being understood by family members or others
• Adding extra sounds or repeating syllables in an unusual way

Symptoms in older adults

• In older adults, a similar condition can happen after a stroke, head injury, or brain illness. This is called acquired apraxia of speech, and it is different from childhood apraxia. In these cases, speech skills that were already formed suddenly become difficult.

Causes

Main causes

• The exact cause is often unknown
• Delays or differences in the brain areas that control speech planning and movement
• Genetic changes that affect brain development
• A neurological condition or injury before, during, or after birth
• Often no clear reason is found

Risk factors

• Family history of speech or language disorders
• Being male
• Other developmental conditions, such as autism spectrum disorder or intellectual disability
• Certain genetic syndromes or chromosomal conditions

When to see a doctor

See a doctor urgently if:

• If your child suddenly stops speaking, loses speech skills, or shows signs of stroke, such as face drooping or arm weakness
• If your child has a seizure or a head injury followed by speech changes

Book a routine appointment if:

• If you are worried about your child's speech or language development at any age
• If your child does not babble or make sounds by 12 months
• If your child uses few or no words by 18 to 24 months
• If your child is hard to understand by age 2 to 3, or older
• If your child seems frustrated or upset when trying to talk

Diagnosis

A qualified speech and language therapist (also called a speech-language pathologist) usually makes the diagnosis. They will watch your child closely and do a careful assessment of how they make sounds, move their mouth, and understand and use language. They may also work as part of a team with a doctor or psychologist.

Tests that may be done

• A hearing test to make sure hearing is normal
• An oral-motor exam to check the lips, tongue, and jaw
• A speech and language assessment to look at sound production and language skills
• Observation of your child's speech in different situations
• In some cases, genetic testing or brain scans if the doctor thinks there may be another condition

What to expect at your appointment

The diagnosis is not made from a single blood test or scan. Instead, the therapist will gather information over time and may need to see your child more than once. They will also look at how your child communicates outside the therapy room, such as at home or school. You may be asked to help by recording your child's speech or filling out a questionnaire.

Treatment

Speech therapy is the main treatment for childhood apraxia of speech. The goal is to help the brain learn how to plan and produce sounds and words more easily. Therapy works best when it starts early and is tailored to your child's specific needs.

Self-care at home

• Spend time talking, reading, and playing with your child every day
• Get down to your child's eye level when you speak to them
• Repeat words slowly and clearly so your child can see and hear how they are formed
• Praise your child for trying to talk, even if it is not perfect
• Avoid finishing your child's sentences or correcting every mistake
• Limit screen time and use real conversations instead

Medical treatments

There are no medicines that treat childhood apraxia of speech directly. The main treatment is speech and language therapy. Therapy may involve intensive sessions several times a week, as well as home practice. The therapist may use a variety of techniques, such as teaching the child to plan the movements for sounds, using rhythm or cues, and practicing simple word patterns. The therapist will also train parents to support practice at home. Sometimes other professionals, such as occupational therapists or psychologists, are involved if the child has other developmental needs.

When is surgery considered?

Surgery is not a treatment for childhood apraxia of speech. In rare cases, surgery may be needed for a separate problem, such as structural issues in the mouth, but this is not a direct treatment for apraxia.

Living with this condition

Living with childhood apraxia of speech means focusing on communication in many small ways. Your child may need extra time to speak, and that's okay. You can also use pictures, gestures, or sign language to support talking. Keep routines predictable and give your child many chances to communicate without pressure.

Lifestyle tips

• Build communication practice into daily routines like mealtimes, bath time, and play
• Let your child lead conversations and follow their interests
• Celebrate small progress and avoid comparing your child to others
• Work closely with your child's speech therapist to share what works at home
• Keep appointments with your health visitor, school, or specialist team

Diet and exercise

There is no special diet for apraxia of speech. A healthy, balanced diet supports overall brain and body development. Regular physical activity and sleep are also important for learning and development. If your child also has feeding or swallowing issues, talk to your doctor or a feeding specialist.

Mental health and emotional wellbeing

Not being understood can be frustrating and upsetting for a child. They may feel angry, anxious, or embarrassed when they cannot express themselves. As a parent, you might feel worried or stressed too. It is normal to feel this way. Emotional support is just as important as speech therapy. If your child shows signs of low mood, anxiety, or behavior changes, talk to your healthcare provider. For parents or caregivers, seeking your own support is also important.

Prevention

There is no known way to prevent childhood apraxia of speech because it is usually related to brain development or genetic factors. However, early recognition and early therapy can help reduce the impact on a child's speech, learning, and confidence.

Screening programmes

Routine developmental checks during well-child visits can help catch speech delays early. If you have concerns between checkups, you do not have to wait to ask for advice from a doctor, nurse, or health visitor.

Complications

If left untreated

• Ongoing difficulty being understood by family, friends, and teachers
• Frustration and behavior problems in young children
• Trouble learning to read and spell because speech sounds are hard to connect to letters
• Social challenges from difficulty communicating with peers
• Lower self-esteem or anxiety about talking

Long-term outlook

The outlook for childhood apraxia of speech is generally encouraging. With early and regular speech therapy, most children improve significantly. Some children catch up along with their peers, while others continue to need support, but they can still develop into confident communicators. Progress takes time and patience, and your child's team will be there to help. Many children with apraxia go on to lead full, happy, and successful lives.

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