Red Flags For Childhood Apraxia

Red Flags for Childhood Apraxia of Speech

In Infants and Toddlers

Excerpts taken from
Childhood Apraxia of Speech: Practical Strategies for Successful Treatment
presentation by Margaret A. Fish, MS CCC-SLP


Childhood Apraxia of Speech or CAS can be defined as a
childhood disorder in which the ability to produce consistent and accurate
mouth movements for speech is impaired, when other neurological/muscular
deficits are not present.  The primary
impairment is the ability to plan and execute complex sequences of movement
required for understandable speech.


Children with CAS require intensive, frequent speech therapy
sessions to improve their ability to coordinate motor movements required for
speaking.  Some early red flags for CAS

  • No
    sensory deficits, muscle weakness, or other neuromuscular impairment
  • Child
    understands more words/sentences than what he/she uses
  • Late
    in attaining first words- usually after age 2
  • Limited
    number of consonants and vowels in spoken words
  • Limited
    babbling or talking
  • Tendency
    to produce single consonants and vowels, rather than longer words or
  • More
    frequent loss of previously produced words
  • Use of
    signs/gestures for functional communication, rather than using words
  • Child’s
    speech is largely unintelligible, especially to strangers


If you are concerned about your child’s ability to make
understandable speech, here are a few guidelines for speech sound development:

  • By age
    2, parents (or close family members) should understand 75-80% of what
    their child says.  The child’s
    speech will not sound adult-like.
  • By age
    3, parents and strangers should understand about 75-80% of what the child
  • By age
    4, the child should be able to produce long sentences and tell short
    stories about their day.  They
    should be understandable all the time, but will likely have trouble
    producing some speech sounds like ‘r, th, v, l.’
  • By age
    8, all speech sounds should be correctly produced in conversational



DeeAnna Cook, MS CCC-SLP
Clinic Therapist  TherapyWorks