A true developmental delay of speech is when the child is following the “typical” path of childhood speech development, although at a rate slower than normal. Usually this rate is also in pace with the child’s cognitive skills. In typical speech/language development, the child’s receptive and expressive skills increase together to a large extent. What is often seen in a child with apraxia of speech is a wide gap between their receptive language abilities and expressive abilities. In other words, the child’s ability to understand language (receptive ability) is broadly within normal limits, but his or her ability to use expressive language through speech is seriously deficient, absent, or severely unclear. This is an important factor and one indicator that the child may be experiencing more than “delayed” speech. In the case of such a mismatch in skills, the child should be evaluated for the presence of a specific speech disorder such as apraxia. However, certain language disorders may also cause a similar pattern in a child. A gap between a child’s expressive and receptive language ability is not sufficient to diagnose apraxia, in and of itself. And to complicate matters further, some children with apraxia of speech do have both reduced expressive language AND reduced receptive language.

Most often, children who have apraxia of speech will have other speech, language and communication challenges IN ADDITION TO, or possibly as a consequence of, the problem that they have with speech motor planning (apraxia).  Often, children with CAS will also need therapy time to work on using grammar and sentence structure (expressive language); pragmatic skills such as turn-taking, staying on topic, and other conversational skills; and/or receptive language skills such as auditory or language processing.  Research appears to be demonstrating that children with apraxia of speech may have weak preliteracy related skills and may have difficulty in the perception of speech sounds in addition to the production of speech sounds.

Each child is different in his or her communication strengths and weaknesses and so it is not possible to predict for sure the extent or degree of language related problems.  Anecdotally and in some published research, very few children with CAS have “pure” apraxia of speech with no other language or communication difficulties.  Talented SLPs can often weave goals together so that your child with apraxia is receiving intensive speech practice while also building other expressive and receptive language skills.

It is important for parents to understand and support their child with apraxia in all of the speech and language areas in which there may be weakness.  Even though what you may notice most is that your child with apraxia struggles so much just to get a thought or idea across or even to utter a single word, it is important to fully embrace that the child may also need speech therapy help for other aspects of the process of effective communication.

Reviewed on 11-1-19.