A Mother’s Worry: My Son Has Childhood Speech Apraxia

As a mother, you always want your children to thrive. You imagine your children saying their first words or starting their very first day of school, making a bunch of new friends, and then telling you all about it when you pick him up.

My experience with my son, my first born, has been very different.

When Bryson was a baby and hitting the age where he was supposed to start saying “mama, dada, bye, hi,” or even just babbling in general, he wasn’t. One concern was that he actually started to say “mama” then he stopped saying it all together. His pediatrician told us not to worry and that not all children hit developmental milestones at the same time, and that all children do and say things when they are ready. The pediatrician even said that it was possible my son is just stubborn…which he most certainly was, and still is to this very day. The doctor told my husband and me that if Bryson wasn’t talking by the time he turned two, he would refer us to a speech pathologist. When he hit one and a half and still wasn’t talking, my motherly instincts kicked in and I said “THAT’S IT!! I’m calling his doctor!”

Bryson’s doctor referred us to Blount Memorial Pediatric Rehab, where they had us fill out a questionnaire with a million and one questions. Then Bryson had an evaluation with a speech therapist (who is still his speech therapist to this very day) to observe him and get to know him. Thankfully, he had qualified for speech therapy. About a year and a half into therapy, he had made a lot of progress. Bryson had also learned sign language so he could have a different way to communicate his needs to us. But something still didn’t sit right with me…his speech therapist even felt something was off about his progress.

After conducting a very specific speech evaluation, his therapist confirmed what she had been questioning…he was diagnosed with Childhood Speech Apraxia. Speech apraxia is very different than a child just having a speech delay. According to ASHA (American Speech, Language and Hearing Association), my son’s symptoms were spot on. Here is the information that helped me understand exactly what was going on with him, and what we were about to deal with.

What is childhood apraxia of speech?

Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.

What are some signs or symptoms of childhood apraxia of speech?

Not all children with CAS are the same. All of the signs and symptoms listed below may not be present in every child. It is important to have your child evaluated by a speech-language pathologist (SLP) who has knowledge of CAS to rule out other causes of speech problems. General things to look for include the following:

A Very Young Child

• Does not coo or babble as an infant
• First words are late, and they may be missing sounds
• Only a few different consonant and vowel sounds
• Problems combining sounds; may show long pauses between sounds
• Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
• May have problems eating

An Older Child

• Makes inconsistent sound errors that are not the result of immaturity
• Can understand language much better than he or she can talk
• Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
• May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
• Has more difficulty saying longer words or phrases clearly than shorter ones
• Appears to have more difficulty when he or she is anxious
• Is hard to understand, especially for an unfamiliar listener
• Sounds choppy, monotonous, or stresses the wrong syllable or word

Other Potential Problems

• Delayed language development
• Other expressive language problems like word order confusions and word recall
• Difficulties with fine motor movement/coordination
• Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like tooth brushing or crunchy foods, may not be able to identify an object in their mouth through touch)
• Children with CAS or other speech problems may have problems when learning to read, spell, and write

After reading all of this information, I was shocked because it’s like they were directly speaking about my son. I felt a sense of relief knowing that we had now figured out why my son was struggling with his speech and having such difficulties. I also felt a sense of panic and all sorts of things kept racing through my brain. Will he eventually be able to pronounce words? Will he be able to speak like the rest of us? Will people understand him one day? Will he make friends in school, or will he be left out? Will he be made fun of? There are waaaay too many questions to list.

There is no “cure” for CAS and there aren’t enough studies to explain how it may affect him as an adult. One thing to understand is that this disorder doesn’t affect his understanding of what anyone is communicating or saying to him. He is very aware of what is being said, he just has extreme difficulty expressing his thoughts and words. I can’t even begin to imagine how stressful this must be to him. Being able to express yourself verbally is something that comes so easily to most of us.

With LOTS of hard work from Bryson, along with several speech therapy sessions a week, he will thrive. It will also take hard work and patience from us, his parents. For any parent who has a child with a speech delay or disorder, everyday communication with your child can be challenging. These parents understand how hard it is to watch your child struggle with expressing his/her needs and wants. It can be extremely frustrating for you and your child, but one thing that is important to grasp, is that they will be ok.

Eventually, at the end of this long road, there is a rainbow.