Will my child with Childhood Apraxia of Speech learn to speak?

Children with CAS can make meaningful progress in their speech over time, however outcomes vary depending on the individual child, the severity of their motor planning difficulties, any co-occurring needs, and the type and intensity of therapy they receive.

Many parents of children with Childhood Apraxia of Speech (CAS) worry about whether their child will learn to speak, or whether their speech will become clear enough for others to understand.

CAS is a motor speech disorder. This means the child knows what they want to say, but the brain has difficulty planning and coordinating the precise movements needed for speech. Because of this, progress is often not linear and may look different from other types of speech delay.

When CAS is suspected, I do not believe in a “wait and see” approach. Due to brain plasticity, early intervention is important. Young children’s brains are still developing rapidly, and this gives us an important window to support speech motor learning as early as possible.

Even if a child is too young or not yet producing enough speech for a confident diagnosis of CAS, a trial of motor-based CAS therapy can still be appropriate. How the child responds to this type of therapy can provide valuable clinical information and may help further inform diagnosis and treatment planning.

This approach is supported by Highman and colleagues, who note that children with suspected CAS “need not wait for a definitive diagnosis to initiate intervention” (Highman et al., 2024). Emerging evidence supports early identification and intervention for infants and toddlers with suspected CAS or those considered at high risk for motor speech difficulties. 

In clinical practice, many children with CAS do develop clearer speech and more effective communication when therapy is targeted, consistent and based on motor learning principles. For some children, additional communication supports may also be helpful while speech is developing.

The goal is not simply to “wait until speech comes”. The goal is to support the child’s communication early, actively and appropriately, while continuing to monitor their speech profile over time.

Reference

Highman, C., Overby, M., Leitão, S., Abbiati, C., & Velleman, S. (2024). Update on Identification and Treatment of Infants and Toddlers with Suspected Childhood Apraxia of Speech. Journal of Speech, Language, and Hearing Research, 67(9), 3288–3308.