How can we confirm if my child has Childhood Apraxia of Speech?

Childhood Apraxia of Speech is identified through a comprehensive assessment by an experienced speech pathologist, rather than a single test.

There is no single test for CAS. Instead, assessment involves observing how a child produces speech across a range of tasks and looking for patterns that are consistent with motor planning difficulties.

Some of the features that may be considered include:

• inconsistent speech errors

• difficulty producing longer or more complex words

• reduced coordination between sounds and syllables

It is also important to consider the child’s overall communication profile, including their understanding, expressive language, and any co-occurring needs.

A thorough assessment helps differentiate CAS from other speech difficulties such as articulation or phonological delay, as this has direct implications for therapy planning.

For younger children, or those who are not yet able to participate in a more formal assessment, it is still often possible to gather meaningful clinical information. This may include identifying:

• the child’s current sound repertoire

• the syllable shapes they are able to produce

• how they respond to different types of cues or support

In my clinical work, I often begin by working at the level of the child’s current motor capacity, particularly focusing on syllable shapes and movement sequences rather than isolated sounds or whole words. Speech is organised into syllable patterns (e.g. CV, CVCV), and therapy can begin from what the child can already approximate and build forward from there.

When CAS is suspected, it is not always necessary to wait for a definitive diagnosis before beginning intervention. A trial of motor-based therapy can provide valuable information about how the child learns and responds to different supports, which can further inform both diagnosis and treatment planning.

As outlined by Highman and colleagues, children with suspected CAS “need not wait for a definitive diagnosis to initiate intervention,” particularly given the importance of early support during periods of rapid brain development.

The assessment process is therefore not only about labelling the difficulty, but about understanding how the child’s speech system is currently working, and how best to support it moving forward.