What are the other Names for this Condition? (Also known as/Synonyms)

• Articulatory Apraxia
• Developmental Verbal Apraxia
• Speech-Language Disorder Type 1

What is Childhood Apraxia of Speech? (Definition/Background Information)

• Childhood Apraxia of Speech (CAS) occurs in children and is present from birth. It appears to be more common in boys than girls
• Children with this condition have difficulty planning and producing the precise, refined, and specific movements of the tongue, lips, jaw, and palate that are necessary for intelligible speech
• In many cases, the underlying cause of Childhood Apraxia of Speech is unknown (idiopathic). Some cases are associated with a known neurological cause (such as intrauterine or early childhood stroke, infection, trauma, brain cancer or tumor resection, traumatic brain injury, etc.)
• Other cases may occur as part of a complex neurobehavioral disorder (such as autism, epilepsy, fragile X syndrome, galactosemia, Rett syndrome, Prader-Willi syndrome, or certain types of chromosome abnormalities)
• In some cases, researchers have found alterations (mutations) in the FOXP2 gene or loss of genetic material involving this gene
• Treatment of Childhood Apraxia of Speech involves speech therapy with a speech-language pathologist. Those with more severe cases will require more therapy than those with mild cases. The goal of therapy is to increase speech production and intelligibility. In some cases, augmentative and alternative forms of communication may be needed

(Source: Childhood Apraxia of Speech; Genetic and Rare Disease Information Center (GARD) of National Center for Advancing Translational Science (NCATS), USA.)

Who gets Childhood Apraxia of Speech? (Age and Sex Distribution)

• Childhood Apraxia of Speech is a rare disorder. The presentation of symptoms occur in childhood
• Both males and females may be affected
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Childhood Apraxia of Speech? (Predisposing Factors)

The risk factors for Childhood Apraxia of Speech may include:

• Intrauterine stroke
• Infections
• Epilepsy
• Tumor in the brain
• Traumatic brain injury
• Certain conditions with chromosomal alterations, such as fragile X syndrome and Prader-Willi syndrome
• Rett syndrome
• Galactosemia
• FOXP2 gene abnormalities

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Childhood Apraxia of Speech? (Etiology)

Childhood Apraxia of Speech may be caused by:

• Abnormalities (mutations or deletions) of FOXP2 gene
• Autism
• Abnormalities in the brain, caused by intrauterine stroke, tumor, brain surgery, epilepsy, infections, or traumatic brain injury
• Certain genetic disorders, such as fragile X syndrome, Rett syndrome, or Prader-Willi syndrome
• Some metabolic conditions such as galactosemia

In some cases, the cause may not be known. Such cases of Childhood Apraxia of Speech are known as idiopathic Childhood Apraxia of Speech.

(Source: Childhood Apraxia of Speech; Genetic and Rare Disease Information Center (GARD) of National Center for Advancing Translational Science (NCATS), USA.)

What are the Signs and Symptoms of Childhood Apraxia of Speech?

The signs and symptoms of Childhood Apraxia of Speech may vary among affected individuals in type and severity, and may include:

• Abnormality of the basal ganglia
• Abnormality of the face
• Delayed speech and language development
• Incomprehensible speech
• Oromotor apraxia

(Source: Childhood Apraxia of Speech; Genetic and Rare Disease Information Center (GARD) of National Center for Advancing Translational Science (NCATS), USA.)

• Errors in phonologic speech; examples include:
  • Leaving part of the word unspoken ("cuh” instead of “cup”)
  • Sound substitutions (“Sawah” in place of “Sarah”)

How is Childhood Apraxia of Speech Diagnosed?

Childhood Apraxia of Speech is diagnosed on the basis of the following information:

• Complete physical examination
• Thorough medical history evaluation
• Assessment of signs and symptoms
• Laboratory tests
• Imaging studies
• Assessment by a speech pathologist, including physical impediment to speech 
• Hearing tests
• Biopsy studies, if necessary

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Childhood Apraxia of Speech?

The complications of Childhood Apraxia of Speech may include:

• Delayed language development, in terms of speaking as well as understanding language
• Reduced vocabulary in comparison to other children of the same age group
• Delay in reaching milestones in reading and comprehension
• Abnormalities in gross motor development (such as walking)
• Reduced fine motor skills, which may lead to delay in writing skills due to impaired hand-eye coordination
• Complications that may be present due to an underlying condition (if any)

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Childhood Apraxia of Speech Treated?

The treatment for Childhood Apraxia of Speech may include the following:

• If a pre-existing condition is the cause of Childhood Apraxia of Speech, seeking medical attention to address signs and symptoms of that condition
• Speech therapy
• Encouraging use of gestures and sign language
• Encouragement at home, for practicing speech 

How can Childhood Apraxia of Speech be Prevented?

Childhood Apraxia of Speech may not be preventable, if it occurs due to an underlying genetic disorder or medical condition.

• Seeking medical treatment at the onset of speech problems may help the affected individual grasp speech and language, and avoid complications 
• Active research is currently being performed to explore the possibilities for treatment and prevention of disorders such as Childhood Apraxia of Speech
• Regular medical screening at periodic intervals with tests and physical examinations are recommended

What is the Prognosis of Childhood Apraxia of Speech? (Outcomes/Resolutions)

• The prognosis of Childhood Apraxia of Speech is dependent upon the severity of the signs and symptoms and associated complications, if any
• Individuals with mild conditions have better prognosis than those with severe symptoms and complications
• Typically, the prognosis may be assessed on a case-by-case basis

Additional and Relevant Useful Information for Childhood Apraxia of Speech:

Childhood Apraxia of Speech may also be known by the following additional synonyms:

• Developmental Apraxia of Speech (DAS)
• Developmental Verbal Dyspraxia
• Speech and Language Disorder with Orofacial Dyspraxia
• Speech-Language Disorder-1

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/