How do I tell if it’s CAS or phonology?

Childhood Apraxia of Speech and phonological disorders can be differentiated through careful clinical assessment of speech patterns and motor planning abilities.

Differentiating Childhood Apraxia of Speech (CAS) from phonological or articulation difficulties requires careful clinical judgement.

CAS is a motor speech disorder. The core difficulty lies in planning and coordinating speech movements, rather than learning sound patterns.

Features more consistent with CAS include:

• inconsistent errors across attempts

• difficulty with longer or more complex words

• disrupted transitions between sounds and syllables

• increased errors as length and complexity increase

In contrast, phonological difficulties tend to present with more consistent, rule-based error patterns.

In clinical practice, differentiation is often supported through dynamic assessment. Observing how a child responds to cueing, modelling and adjustment of word structure can provide valuable information about whether the underlying difficulty is primarily motor planning or phonological.