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It can be heartbreaking watching your child struggle with a stuttering problem. But it can be even more heart-wrenching watching them stuttering when stressed. When they are involved with lots of other kids or rushed to decide their choice at a fast food place, you may notice their stutter becomes more pronounced. In this article, we will address the problem of stuttering while anxious and stressed. We will discuss why it happens and how to help your child combat this painful issue. What is Stuttering? Stuttering, also called stammering, is a fluency disorder that disrupts the flow of speech. Those that stutter know what they are trying to say, but have trouble getting the words across in a fluent way. There are several kinds of stuttering. Let’s explore them. Developmental Stuttering About 3 million Americans stutter. Although all age groups can be affected by stuttering, children tend to experience it most often. About 5 to 10% of all young children will stutter at some period. Typically it starts between the ages of 2 and 6 as they are learning to speak because oftentimes both their speech and language abilities are not developed enough to express what they want to say. This is called developmental stuttering, the most common type of stuttering, and will typically last between 3 and 6 months. Boys are more likely to stutter than girls. However, about 75% of children who stutter can outgrow it. For the other 25%, stuttering can become a lifelong communication impairment. What causes a developmental stutter? Researchers are still studying the exact causes, but there may be several factors at play. There are several possible causes of stuttering during childhood development. They are: Abnormal speech motor skills: The child may have abnormal speech motor control, including around things like timing, sensory coordination, and motor coordination. Family history: The genetic trait may be inherited in the family line. Neurogenic Stuttering When a stutter is caused by signal problems between the brain and all the various speech mechanisms in our body, this is called neurogenic stuttering. When the brain is unable to coordinate with the brain regions involved with speaking, there is an inability to speak clearly and fluently. This is typically caused by a stroke or brain injury. This kind of stutter most often will manifest through speech that is slow, has pauses, or repetitive sounds. Psychogenic Stuttering Psychogenic stuttering is rare but was once believed to represent all stuttering. Today we know that this condition seems to occur in people who have been through severe emotional trauma or suffer from a psychiatric illness. Oftentimes those with a psychogenic stutter will rapidly repeat the initial sounds in words. Besides the three kinds of stuttering, it is also possible for speakers who do not stutter to experience the same kind of speech disfluency. A stutter can happen for non-stutterers when they feel nervous or pressured. Symptoms of Stuttering Symptoms of this speech disorder may vary throughout the day and in different situations. Here are some common signs and symptoms of stuttering to look out for: Repetitions of a syllable, sound, or word (example: “W-W-W-What”) Difficulty forming the initial sounds of a word, phrase, or sentence Prolonging a word or sounds in a word (example: “SSSend”) Brief pause within a word due to problematic syllables or words. Stopped or blocked speech occurs when the mouth is open but no words are coming out Talking slowly The face or upper body carries tension or tightness when speaking May include movement and facial tics while speaking Adding interjections if the next words are problematic (example: “um” or “like”) Afraid/anxious to talk Being out of breath while talking Difficulty communicating effectively May experience rapid blinking, lip or jaw tremors, head jerks, and/or clenching fists Those children with severe stuttering will have physical symptoms, including increased tension. They will often try to hide their impairment or talk less. Severe stuttering more often occurs in older children. It can even manifest after the child has only had a mild stutter for months or years. It may even appear out of nowhere with no previous speech problems. For severe stutterers, there are speech disfluencies in just about every phrase or sentence spoken. Here are some symptoms of advanced cases of stuttering: One-second or longer disfluencies Prolongations of sounds are common Silent blockages are common Eye blinks, eye closing, looking away, Tension around the mouth and face The rising pitch of the voice during repetitions and prolongations “Um,” “uh,” “well” and other interjections are used when a stutter is expected Fear of speaking; will seem anxious or guarded in situations where they must talk Severe stuttering is likely to persist into adulthood. This is especially the case if the child has already been stuttering for 18 months or more. But do not give up hope; children have been known to recover spontaneously. If you suspect your child has a chronic stutter, consider visiting your child’s healthcare provider for a proper diagnosis and treatment plan. You may notice that the stutter will get worse when the person experiences excitement, fatigue, stress, pressure, or self-consciousness. The stutter will likely come out in situations like public speaking or even talking on the phone with a stranger. But you will notice that the person may speak perfectly when talking to themselves or when singing or speaking in unison with others. Why Does a Stutter Worsen Under Stress? If your child suffers from a stutter, it is important to realize that this does not indicate any mental health issues are at play. It is a fact that anxiety does not cause stuttering. However, anxiety and stress can make a stutter worse or activate a stutter that was already there. You may have noticed that when a person is afraid their stutter will manifest, it makes them stutter even more. And this fear of stuttering can be very detrimental to a child’s ability or desire to socialize, and to have friendships, and can greatly affect the overall quality of life. The reason why stutters increase with stress is physiologically related. When we’re stressed, this has a negative response on our bodies. Our bodies secrete hormones and our muscles tighten; building up tension in the chest, shoulders, jaw, neck, tongue, or lips. The muscle movements that the brain directs to control speech tense up, which can aggravate the stutter that is already existing there. This causes a negative feedback loop. The child has a stutter, which causes anxiety, which then causes the stutter to become more pronounced. This cycle can be very frustrating, and you are likely to see your child withdrawing from social events and activities. Half of the adults who stutter also have social anxiety. Anxiety does not cause a stutter but stutters increase the odds someone will be diagnosed with an anxiety disorder. Having a stutter can make you 6-7 times more likely to have anxiety and 16 to 34 times more likely to be diagnosed with social anxiety. Not only are children likely to withdraw from social interaction more often, but they are also likely to experience bullying and being isolated by their peers. With more experiences like these that can negatively impact self-esteem, adolescents are likely to withdraw even more, and perhaps carry some of these social behaviors into adulthood. How to Combat Stuttering When Stressed There are things you or your child can do to end the negative feedback loop that causes endless cycles of stuttering and anxiety. We recommend trying the following to combat stuttering when stressed: Know the problem: When the person who stutters gets educated on their speech problem, it can make it seem less daunting. Understanding what the stutter is, why it is, and how to overcome it can be half the battle. Speech therapy: It is often best to attack the issue at its core. Luckily, stuttering itself is treatable, which will automatically alleviate the associated anxiety. Get in touch with a certified speech-language pathologist (SLP) to help treat your child’s stutter. A speech therapist can also address any stuttering-related issues, making an easier path to coping with the issue. Electronic fluency devices: An electronic fluency device delays or alters the sound of someone’s voice, creating an echo. These types of devices can also mimic your speech as if you are talking in unison with another person. Both of these ways have proven to improve speech fluency. Cognitive behavioral therapy (CBT): CBT can help alleviate social anxiety by identifying, neutralizing, and preventing self-defeating thoughts. It is also good for increasing self-esteem. Also, consider family therapy. This can help remove the stigma around the stutter. Each family member will be given their own set of supportive strategies to help deal with the child’s stutter. Relaxation exercises: Learning mindfulness and meditation practices can do wonders for relaxation. Also, learning to breathe deeply with breathing exercises is a great skill to master. One easy exercise to focus on when feeling anxiety is learning to exhale deeply. When we exhale, this is linked to the parasympathetic nervous system, the system that helps our bodies relax and calm down. Teach your child this deep exhalation exercise: Do this technique standing up, sitting down, or lying down. Before taking a deep breath, make a long thorough exhale in its place. Try to get all of the air out of your lungs, then allow your lungs to take a natural breath and inhale on their own. Then keep breathing, but make the exhale longer than the inhale. You can start by inhaling for four seconds, then exhaling for six. Keep doing this for 2 to 5 minutes, then realize how much more relaxed you are. Support groups: When you or your child are around other people who stutter, it can make it much less isolating. The problem will then seem less important, which will make it easier to deal with in the future. Find events that include children with similar speech problems. Create a relaxed environment: A person who stutters should have a comfort zone where they can relax around communication. If you are the child of the stutterer, be sure to never talk over him or her, be impatient when they are stuttering, or correct their speech. Instead, listen attentively so he or she does not feel that you are bored or annoyed. Practice communication: When someone avoids social settings, this can make the anxiety worse. Instead, actively seek out new opportunities to practice communication in a social situation through exposure therapy. The more practice, the easier and easier it will be. And much less terrifying. Also, be sure to set aside some quality time to talk to your child and allow him or her the opportunity to have a relaxed conversation without having to feel anxious. Bring up easy, fun topics that will interest your child, rather than difficult ones. Speak slowly, and your child will more than likely follow suit. Provide emotional support: You do not want your child to feel like a burden. Encourage him or her to talk about their feelings regarding stuttering. Knowing they have a listening ear will help them feel supported and less likely to hide their feelings, which can worsen their anxiety. Be positive as you listen, praising your child when you notice any small progress along the way. Ease the Anxiety that Comes With Stuttering Whether it be a developmental stutter, neurogenic, or psychogenic, having a stutter can cause a child to feel isolated from their peers. You must get professional help to help your child cope with their speech impairment. There are ways to learn to cope with both the stutter and the anxiety that can come with it. Although the stutter may not be curable, the anxiety can be dealt with. The earlier, the better. For more information on stuttering, or to get involved with our programs, contact us for more information here at the RiteCare Childhood Language Centers of California.

Along with language disorders, speech disorders can be particularly debilitating for children. Speech disorders can lead to learning disabilities and impact them throughout adulthood. It can also affect things like self-esteem and lead to depression. There are many types of speech disorders out there, but we will focus on some of the most common speech disorders in young children. With this information, we hope to serve as a guide stone to getting your child the treatment they need. Let’s take a look at common speech disorders in children. Stuttering Stuttering, or stammering, is a fluency disorder. It refers to the repetition of sounds, syllables, or words; sound prolongations; and blocks in which speech is interrupted. Certain words or sounds can make the stutter even more pronounced. Stuttering is fairly common; it can affect 5-10% of all children at some point. Symptoms Stuttering typically starts between the ages of 2 and 6. Many times, this period will last less than 6 months. People who stutter can have varying symptoms. Additionally, things like stress, frustration, or excitement can cause the stuttering to increase. Here are the most common symptoms and some physical symptoms that can accompany a stutter: Repeating words, syllables, or sounds Completely halting speech production Uneven speech rate Face and shoulder tension Quivering lips Clenched fists Jerky head movements A rapid succession of blinks If the stuttering lasts longer than 6 months, the child may need treatment. Boys are more likely to continue to stutter than girls, and those who start stuttering after the age of 3 ½ are more likely to continue. Causes There is no one cause of stuttering. But there are several possible causes. They are: Family history of stuttering Brain injury Emotional distress Emotional trauma Abnormal brain function Treatment Options If your child suffers from a stuttering problem, it can help to have support from you, other family members, and your child’s teacher to make a difference. Treatment may not completely eliminate the stutter, but it can help with things like improving speech fluency, developing effective communication, and participation in activities. Treatment options include: Speech therapy: A speech-language pathologist (SLP) can help the child slow down their speech and notice when the stutter occurs. Parent-child interaction: There are techniques you and your child can practice at home to help with stuttering. Talk with your child’s SLP to find the best approach that will work with your child’s issue. Cognitive behavioral therapy (CBT): CBT is a good way to help resolve stress, anxiety, or self-esteem-related issues associated with stuttering. Electronic fluency device: An electronic fluency device delays or alters the sound of someone’s voice which creates an echo. It can also mimic your speech as if you are talking in unison with another person. Both of these ways have proven to help those with stutters. Support group: Joining a support group with other children with similar problems can help your child feel less alone. Apraxia of Speech Apraxia of speech, or verbal apraxia, refers to the speech sound disorder in which brain damage has impaired a person’s motor skills that affect one’s ability to make speech sounds. The person often knows the words they want to say, but are simply physically unable to. Language problems like Aphasia can co-occur with speech disorders like apraxia of speech or dysarthria. These are all the results of brain damage. Aphasia is when the person is impaired in linguistic capabilities rather than motor skills used to speak. Apraxia of speech can also occur in children upon birth, though this is uncommon. It is called childhood apraxia of speech (CAS), or developmental verbal dyspraxia. Symptoms These are some common symptoms of CAS: Difficulty pronouncing vowels Stressing the wrong part of the word Difficulty transitioning from a sound, syllable, or word to another Putting a pause between syllables Inconsistency in pronunciations; making different errors on the same word Difficulty pronouncing simple words Causes In most cases of CAS, the causes are not known. However, there are a few known causes of CAS: Neurological impairment: This may be caused by infection, illness, or injury, during or after birth. Some genetic conditions can also cause neurological impairment associated with CAS. Autism: Apraxia related to autism can be very difficult to diagnose. Take a few sessions with your SLP before a conclusion is drawn. Genetic disorder: Many different complex disorders have CAS as a secondary characteristic. That being said, not all children with that particular genetic disorder will have CAS. One common genetic disorder associated with CAS is galactosemia. Treatment Options To help improve your child’s speech to be more clear, there are several treatment options to try. Treatment will involve learning how to plan the movements needed to say sounds and make the movements at the right time. Treatment options include: Speech therapy: Working with an SLP 3-5 times a week, in the beginning, can make a difference with CAS and language skills. As your child's speech improves, the sessions can be less often. It can be helpful to do either individual or group therapy sessions. Speech therapy may include speech drills, sound and movement exercises, speaking practice, vowel practice, and paced learning. Home practice: Your child’s SLP can give you some words or phrases for your child to practice at home. You can do a quick 5-minute session twice a day. They can also get some practice in real-life situations by creating situations where it is appropriate for your child to say the word or phrase. Other communication alternatives: If your child has a severe case of CAS, it may be helpful to learn other communication methods, like sign language or natural gestures like pointing. However, as their speech gets better, these methods can be abandoned. Dysarthria Dysarthria is a speech sound disorder characterized by muscle weakness or difficulty controlling them. Muscle weakness or loss of control occurs in the parts that are needed for speech including the face, lips, tongue, throat, or chest. The speech is often slurred or slowed, making it difficult to understand. Symptoms Common symptoms of dysarthria speech problems include: Slurred, gurgly, monotonous, nasally, or breathy speech Mumbling A voice that is strained or hoarse Speaking too quickly or too slowly Very soft or quiet speech Difficulty moving tongue or mouth; may involve drooling Unable to speak in a regular rhythm due to hesitative speech Causes The cause of dysarthria can be either developmental or acquired. Some common causes could be: Brain or head injury Brain tumor Cerebral palsy Lyme disease Muscular dystrophy Some medications including certain sedatives or seizure drugs Treatment Options When it comes to dysarthria, it is important to treat the underlying cause of the issue. If it was caused by prescription medications, change or discontinue the medications to relieve the issue. For those suffering from dysarthria that persists, it is a good idea to get treatment from an SLP. Depending on your child’s level of impairment, he or she will work with your child to: Slow down the rate of speech Learn how to use more breath to raise voice volume Practice mouth exercises to strengthen muscles Practice lip and tongue exercises to strengthen muscles Enunciate words and sentences more clearly Introduce other communication methods including gestures, writing, or devices Articulation Disorder Articulation disorder is a functional speech sound disorder that occurs when the speaker has trouble with the motor functions that are needed to make certain sounds. Their lips, tongue, teeth, palate, and lungs are unable to coordinate. This causes the person to produce speech sounds that are distorted, or they will swap out sounds for ones that can make. Symptoms A child suffering from an articulation disorder may be hard to understand. Here are some articulation errors he or she is likely making: Addition: This occurs when sounds or syllables are added that don’t belong. As an example, “puh-lay” instead of “play”. Distortion: This occurs when a sound is changed. It can often sound like a lisp. For example, when the “s” sounds like a “th”. Omission: Excluding certain sounds that he or she has difficulty with. For example, “leaving out the “sc” in “scratch”. Substitution: This occurs when one sound is substituted for another. For example, not being able to form the “th” sound in “those” and replacing an “f” instead. Behavioral issues: When a child is aware of their articulation issues, he or she might often be quiet or seem shy, get frustrated when speaking, or just stop saying some words completely. It is quite often the child will struggle with a lack of confidence and self-esteem. Causes In most children, there is no known cause for their articulation disorders. However, some articulation errors are known to be caused by things like: Brain injury Development or cognition issues Deafness or hearing impairment Physical disabilities that impact speech like cleft palate or cleft lip Any nerve disorder that affects the nerves associated with speech Treatment Options To treat articulation disorder, it is very helpful for your child to undergo speech therapy. Having regular appointments with an SLP will make an improvement with articulation errors. This is what your SLP will focus on: Figuring out the exact sounds your child has difficulty with Correcting the way he or she creates sounds to produce the right sound Teaching or re-learning ways to control the motor functions of speech. This can include how to shape the lips to express a particular sound. Introducing exercises that strengthen the muscles involved in speech Giving you exercises for your child to practice sound formation at home Voice Disorders Children are also susceptible to voice disorders. They are very common; about 5% of children may experience a chronic voice disorder. Voice disorder occurs when the speaker’s voice sounds noticeably different from others’ voices of the same age and sex. But thankfully, most voice disorders are harmless and often disappear on their own. However, this may require some treatment to overcome. Typical voice disorders include laryngitis, muscle tension dysphonia, neurological voice disorders, polyps, nodules, or cysts on the vocal cords. Symptoms Harsh or hoarse voices A voice that is too high or too low A voice that is too loud or too nasally Breathiness Raspiness Strained voice Loss of voice Causes Excessive shouting Excessively loud talking Making too many harsh sound effects when playing Infections like a cold or laryngitis which inflame the vocal cords Paralyzed vocal cords Growths on the vocal cords such as nodules, cysts, polyps Recurrent Respiratory Papillomatosis (rare) Tumors/cancers (extremely rare) Treatment Options Having a hoarse voice can be common in children. However, if it is a chronic issue, we recommend getting an assessment from an ENT and a speech pathologist from a voice clinic. It can also make a difference to pay more attention to taking care of your child’s voice. Be sure to make sure he or she is drinking plenty of liquids. It is also a good idea to have quiet time where your child rests their voice or is encouraged to speak softer. Try to make sure your child does not spend a lot of time in smoky, dusty, or polluted environments. It also is essential that they are free from stress and anxiety so they can speak more calmly. In rare cases, surgery may be necessary. Pay Attention to Milestones in Your Child’s Development To detect any possible communication disorders in your child, it is important to pay attention to the normal milestones in childhood development. If you notice a language delay or any other developmental delays, you may want to reach out to your pediatric healthcare provider to get a more conclusive diagnosis. He or she will recommend an SLP, preferably certified by American-Speech-Language-Hearing Association (ASHA). We are also here to help. Here at the RiteCare Childhood Language Centers of California, we’ve made a difference in childhood speech disorders for 60 years. Our certified SLPs perform free services to children in our community. And we will continue to make a difference in speech disorders like stuttering, CAS, dysarthria, articulation disorders, and voice disorders.

Have you noticed unusual symptoms as your child enters the age of speech development? If he or she is not hitting the regular milestones of kids the same age, this could signal a speech disorder. There are many possible diagnoses, and some speech difficulties come and go. One possible diagnosis, though rare, may be apraxia of speech. However, obtaining this particular diagnosis must be considered by several doctors as the condition can easily be confused with other similar disorders. So in this article, we will discuss apraxia of speech and other similar disorders, as well as answer the question, “How rare is apraxia of speech?” What is Apraxia of Speech? Apraxia of speech, or verbal apraxia, is a rare speech disorder that involves difficulty moving the mouth to make sounds, syllables, and words. The brain has trouble directing the right signals or coordinating the movements of the mouth, lips, jaw, and tongue. With this articulation disorder, the speech muscles aren’t weak necessarily, but they do not perform normally. Those affected by apraxia of speech know what they want to say, but are unable to get their motor function to work with their brain’s instructions. There are two types of apraxia of speech: Acquired apraxia of speech: Any age group can acquire apraxia of speech, though it is more likely to occur in adulthood. Those affected will have loss or impairment of their speaking ability. This disorder is caused by damage to the parts of the brain that involve the motor function of speech. Stroke, traumatic brain injury, brain tumors, or other brain illnesses can specifically cause this disorder. Apraxia of speech is also linked to some disorders, like Down syndrome, autism spectrum disorder, Koolen de Vries syndrome, and Floating-Harbor syndrome. This disorder has been known to occur with other conditions caused by nervous system damage. One is dysarthria, and another is aphasia, a language disorder. Childhood apraxia of speech (CAS): The developmental type of apraxia speech is called childhood apraxia of speech. It is also called developmental apraxia of speech, developmental verbal apraxia, or articulatory apraxia. The disorder seems to affect boys more than girls. Children who suffer from apraxia of speech are also likely to have reading difficulties, spelling difficulties, and learning disabilities. They may also have trouble controlling small and large muscle movements. The cause of CAS is not well known. There has been known evidence that this developmental disorder is caused by brain damage or brain abnormalities. Oftentimes kids that suffer from CAS also have a family member who had a communication disorder or a learning disability. CAS also can coexist with epilepsy and other seizure disorders. Research suggests that CAS is a genetic disorder. Symptoms of Apraxia of Speech The symptoms of CAS may vary depending on the age and the severity of the condition. But if you are worried your child may suffer from apraxia of speech, there are some common symptoms to look out for. In children, symptoms may include: Difficulties feeding as a baby Less babbling than other babies Language development is slower than other babies or children their age Speech problems, such as difficulty forming words or sounds, even simple ones Trouble moving from one sound, syllable, or word to the next Struggling with intelligibility, including by their own family Difficulty with moving their lips or tongue when making a sound emphasizing on the wrong part of a word (for example for the word banana, BA-nan-uh instead of ba-NAN-uh) Adding or dropping sounds to a word (example for umbrella, saying “umbararella”) Voicing errors (for example, saying “down” instead of “town”) May have language problems such as a limited vocabulary or difficulty with word order Inconsistency in pronunciations; making different errors on the same word May speak in a monotone Struggling with intonations Straining of the jaw, lips, or tongue to make the correct sound Equally stressing all syllables of a word (for example BA-NAN-UH) Vowel distortions Putting a pause between syllables This disorder can be very hard to diagnose due to its rarity and its similarities with other conditions. If you suspect your child may suffer from this disorder, contact your child’s health care provider. He or she will then refer you to a certified speech-language pathologist (SLP) who should be familiar with rare diseases. Your SLP will have several tests for your child to assess his or her condition. When it comes to CAS, the main symptoms to look out for include: the delayed onset of first words, a limited amount of spoken words, and limited ability to form consonants or vowels. These kinds of things are usually noticed around 18 months old to 2 years. Between 2 and 4, you will see your child experiencing vowel and consonant distortions, separating syllables, and voicing errors. However, you may need to wait till your child is around age 3 or 4 to be diagnosed with childhood apraxia of speech. Some symptoms are unique to CAS, but some symptoms may be a sign of a different disorder. Many other possible diagnoses could easily be attributed to your child’s symptoms. For this reason, it can be difficult to diagnose CAS if your child is experiencing overlapping symptoms with another disorder. Some overlapping symptoms include: Between the ages of 7 months and 1 year old, the child babbles less and makes fewer sounds vocally than others their age The child’s speech is difficult to understand Not saying first words until after they are 1 year old Only using a few select consonant and vowel sounds Omitting sounds Other Disorders Similar to Apraxia of Speech Let’s explore similar disorders that can be confused with CAS. Getting the right health information on other possible disorders can make it easier to diagnose your child properly. Other types of speech disorders with overlapping characteristics to apraxia of speech include: Phonological disorders: Like articulation disorders, phonological disorders (aka phonemic disorders) involve being able to plan and coordinate speaking movements, but those affected will have trouble learning to make some sounds. Phonological disorders are more common than CAS. Unlike CAS, children with phonological disorders can physically make the sounds, but cannot discern when to make the sound. Dysarthria: Another disorder similar to CAS is dysarthria. It is typically easy to differentiate from CAS unless it is caused by brain damage that affects coordination. This motor speech disorder is characterized by muscle weakness, spasticity, or difficulty controlling speech muscles. This problem can occur because the muscles are limited by how far, how strongly, or how quickly they can move. You may be able to identify dysarthria by a hoarse, strained, or soft voice, and sometimes slow or slurred speech. Autism: Apraxia of speech can get mistaken for autism because children may have difficulty with eye contact when talking and will have sensory issues. But those with CAS will have better receptive language skills than kids with autism. They will also be able to express their needs effectively when done in a nonverbal way, whereas autistic children generally struggle with this. For more information on other disorders and a helpful resource directory, check out the National Institute on Deafness and Other Communication Disorders’ Directory of Organizations. How Rare is Apraxia of Speech? Now that we’ve discussed other possible disorders that are more common than CAS, let’s discuss the rarity of this disorder. Apraxia of speech is very rare. It is only identified in 1 or 2 children in every 1,000 who visit a speech pathologist. However, it can occur at a higher rate when associated with other disorders, such as seizure disorders. Typically a parent will notice the condition when a child is learning to talk. However, the condition can continue into adulthood. Treatment for Apraxia of Speech Unfortunately, CAS is a significant, lifelong speech disorder. It does not naturally resolve like some childhood speech disorders. While there is no cure, there are things that can be done to treat CAS, especially if the problem is assessed early on. Once your child has been properly diagnosed by a medical professional, you will need to find some reliable treatment options. The goal of treatment for CAS is to help improve your child’s speech to be more clear. It will involve things like learning how to plan the movements needed to say sounds. Your child will also be learning to make the movements at the right time. Treatment options include: Speech therapy: It is best to find a speech therapist sooner rather than later. Working with an SLP 3-5 times a week, in the beginning, can make a difference with CAS and language skills. As your child's speech improves, the sessions can be less often. It can be helpful to do either individual or group therapy sessions. Speech pathology sessions may include speech drills, sound and movement exercises, speaking practice, vowel practice, and paced learning. Make sure your SLP has been certified by the American Speech-Language-Hearing Association (ASHA). ASHA offers a certification that represents a nationally recognized professional, and ensures consumers essential protection. It also ensures the professional has been educated in the right practices and ethical standards for the industry. Violations in the code can mean they will be removed from practice. Home practice: To get better, he or she must put a lot of practice into getting better at speaking. Your child’s SLP can give you some words or phrases for your child to practice at home. Do a quick 5-minute session twice a day. To make it less frustrating and tiring for your child, have him or her practice in real-life situations. This can be done by creating situations where it is appropriate for your child to say the word or phrase. Other communication alternatives: If your child has a severe case of CAS, it may be helpful to learn other communication methods, such as sign language. It will also be helpful to use natural gestures like pointing usinguse computers to help communicate. However, as their speech gets better, these methods can be abandoned. Other therapies: Depending on your child’s condition, he or she may also benefit from the services of a counselor, psychologist, physiotherapist, or occupational therapist. Support groups: Since CAS is pretty rare, it can be beneficial to know others going through the same things. Talking to and being around other kids with apraxia of speech can make it easier for your child to deal with. Join a support network online or find a support group near you. Apraxia Kids has a large community to help your child feel less alone. Are you in California? Come check us out! As your child attends speech therapy and practices living with this disorder, he or she can move into what is called “residual CAS” or “resolved CAS”. Residual CAS can occur when the child’s symptoms change into characteristics of a phonological disorder, language disorder, articulation disorder, auditory processing disorder, and/or stuttering speech impediment. They may still exhibit CAS symptoms, but these symptoms will be less apparent. Children can also experience resolved CAS, which is when strangers wouldn’t even know they are diagnosed with a speech disorder. This is the result of the right therapy and support. However, some stressors like fatigue, emotional stress, or narcotics can still stir up some residual symptoms from time to time. The time it will take to progress cannot be determined; it could take months or years. Get regular updates from your SLP as the prognosis can change as therapy continues. Shooting For Residual Or Resolved CAS Getting a diagnosis of apraxia of speech can be quite emotional for a parent. After all, we all want our children to live the most comfortable, healthy, and stress-free lives. But knowing what signs to look for and eliminating the possibilities of other disorders, you can focus on getting treatment for your child’s apraxia of speech. Here at RiteCare Childhood Language Centers of California, we aim to give you the right resources that can greatly lessen the burden of your child’s speech disorder. We’ve got certified SLPs to help navigate apraxia of speech and shoot for “residual CAS” or “resolved CAS” diagnosis.