Is It a Speech Delay or Childhood Apraxia of Speech? How to Tell the Difference & What to Do Next
If your child's speech isn't developing as you expected, you may be wondering if it's a typical delay or something more complex, like Childhood Apraxia of Speech. I'm Ellen McSpadden, MA, CCC-SLP, CAS, and I want to help you understand the key differences and what steps you can take.
Understanding Speech Development and Disorders
Children follow predictable patterns as they learn to talk, from babbling to their first words (which usually appear between 9 and 15 months of age). By 18 months, they may use 6-12 words, and their speech clarity is expected to improve significantly with each passing year. Speech sound development is usually complete by age six.
Here's a breakdown of common terms related to speech clarity issues:
Speech Delay: Your child follows the typical pattern of speech development, but at a slower pace. They consistently use sounds and words, but their skills are mastered later than their peers
Articulation Disorder: Difficulty positioning the mouth (lips, jaw, tongue) to produce one or two specific sounds that should have been learned at least a year ago (e.g., a lisp). All other sounds are fine and consistent
Childhood Apraxia of Speech: A Different Challenge
In contrast to a delay or articulation issue, Childhood Apraxia of Speech (CAS) is a neurological speech disorder. The brain struggles to send the correct motor message to the mouth to produce speech—controlling what to do, when to do it, how quickly, and in what order. The child knows what they want to say, but the motor plan is either incomplete, poorly formed or gets scrambled.
Key Warning Signs That Point to Apraxia
If you observe these "red flags," it suggests a problem beyond a typical speech delay:
Inconsistent Errors: Saying the same word differently each time (a major sign)
Difficulty with Vowel Sounds: Having a limited number of vowels or distorting them
Groping Behavior: Struggling to get the mouth into the correct position to speak
Long Pauses: Noticeable breaks between syllables or sounds as the brain attempts to plan the movement
Increased Errors: Making more mistakes in new, longer, or more complex sentences
These signs, especially when your child's understanding is good but their speaking is difficult, often indicate CAS.
What to Do Next
CAS does not resolve without specialized therapy. If you suspect CAS, immediate action is crucial:
Schedule a Comprehensive Evaluation: Seek an assessment that specifically looks at motor planning, consistency of speech, and oral-motor skills.
Start Evidence-Based Therapy: Specialized, intensive methods like DTTC (Dynamic Temporal and Tactile Cueing) or PROMPT (Prompts for Restructuring Oral Musculature Phonetic Targets) are essential for building accurate motor patterns.
Involve Your Child at Home: Supportive, regular practice outside of therapy is key to making lasting progress.
While many children are simply "late bloomers" with no lasting issues, consistent signs of inconsistent speech, groping, or pauses warrant investigation. Early diagnosis and specialized intervention offer the best outcomes for your child to develop clearer, more confident speech.
If you are located in or around Camden County, NJ, or anywhere in New Jersey, Pennsylvania, or Georgia (for teletherapy), I am happy to provide a professional evaluation.
