The everyday act of producing speech is an amazingly complex process involving the coordination of our breath with the muscles and structures of our mouth and throat all with split-second precision. For most people, it is so automatic and seemingly effortless that we do not think about it or appreciate its complexity.  

However, for children with Childhood Apraxia of Speech (CAS), this process is not automatic. The American Speech Language and Hearing Association (ASHA) defines CAS as “a speech disorder that occurs when a child has a difficult time voluntarily planning and making the movements needed to produce speech sounds in the absence of any obvious neuromuscular weakness.”

This difficulty with motor planning can make the act of acquiring speech sounds challenging, making a child very difficult to understand. While speech pathologists do not fully understand the underlying reason or reasons why some children struggle to voluntarily make the movements needed to produce speech, we have identified some shared characteristics.

One feature of CAS is that the child’s production of words will be inconsistent. So, one time “Auntie Michelle” might sound like “ti muh el” and another time it may sound more like “tee sheh”. Also, there is often an increase in errors as the complexity of the utterances increases. Finally, the child’s speech may sound choppy or monotone. As children with CAS get older, this difficulty with planning can have an impact on their academics such as difficulty with sequencing their ideas to tell or write a story and learning to read.

There are different reasons why a child may be having difficulty with their speech production and it is important for a child to be seen by a speech-language pathologist to assist in an accurate diagnosis. As a caring and dedicated aunt who is eager to help, here are some suggested activities that you can try to complement your niece or nephew’s speech therapy program.

1. Read books with repetitive text. Think Eric Carle’s Brown Bear, Brown Bear, What Do You See? The predictability and repetition can help a child learn the motor plan needed to produce these phrases. As you are reading, pause when you come to a frequently repeated phrase and see if your niece or nephew will fill in the rest.

2. Be sure that your niece or nephew has the opportunity to watch your face as you are modeling a word for them. The visual cue of seeing how your mouth is shaped can be helpful.

3. Sing songs in unison!  As you are singing, play around with the pitch and speed of the lyrics and encourage your niece or nephew to imitate your changes.

4. Create a sound collage. You can choose a sound and then look for words that begin or end with that sound.

5. For children that are reading, read a play together and emphasize the natural inflection of the language, such as raising your voice at the end of sentence to indicate a question.

Published: July 3, 2010