Co-Existing Conditions in Childhood Apraxia of Speech


Children with Childhood Apraxia of Speech are at risk of having troubles with literacy, language, memory, learning and other issues related to gross and fine motor planning and coordination and sequential memory functions. While children with CAS have normal intelligence, there are generally issues pertaining to language impairment in the majority of children. Studies have found that the receptive language abilities of children with CAS are frequently not as bad or far superior to their expressive language abilities. Children with CAS tend to have difficulties with reading, writing, and spelling, thought to be due to language impairment and possible with speech-sound discrimination and analysis. Spelling relies heavily on a variety of factors related to awareness of the sounds of letters and syllables (“phonological awareness”), including “phonological memory” and then assembly of these sounds that are associated with the corresponding letters and words. Phonological awareness alludes to the ability of the child to decode the sounds of individual syllables in words (phonemes) and match them to the corresponding letter of the Language , for example, the English script (graphemes). For this reason, phonics programs that teach literacy based on using phonemes and graphemes have been shown to be more effective in teaching children with Apraxia to read.

Furthermore, children with CAS have been found to have issues with memory/storage of programs, and difficulty with motor tasks that involve sequencing eg executing a command that has multiple sequential tasks to it. Children with CAS can have a variety of gross and fine motor difficulties associated with their speech planning and programming difficulties. However, with repetitive practice, these too can improve.

Parents therefore play an important role in getting the supports necessary to assist their children with reading, writing and spelling difficulties. In addition, Occupational Therapy support plays an important role in assisting with the gross and fine motor difficulties, including pen grip and writing legibility, as well as general overall gross motor functioning. With the necessary literacy and language supports, children with CAS can find academic success.

In Summary:
Children with Apraxia can have the following associated issues :

  • Problems with reading, writing, spelling (ie literacy) and memory.
  • Language impairment (Language Delay)
  • Expressive Language delay – eg. issues with expressive writing
  • Problems with social language

Additional issues that can be associated with CAS:

  • Gross and fine motor difficulties
  • Clumsiness, limb apraxia, difficulty with co-ordination
  • feeding difficulties
  • Sensorimotor difficulties.

In an ideal world all Early Childhood Service Providers/Early Intervention Programs should have a synthetic phonics program as children in these programs are generally at risk.  Alberta Education would be well served if it could convince Providers to intervene and get the appropriate programs to all locations. 

Read more: Literacy and Children with Apraxia of Speech, Sharon Gretz

Literacy Programs: Apraxia-Kids.Org/Reading and Other Literacy Related Resources and Programs

Center for Literacy, Edmonton

Easily accessible in Canada: Jolly Phonics

Jolly Phonics is a multisensory early literacy program that uses a synthetic phonics approach which is fun and easy to teach. It teaches children five core skills, namely :

  1. Learning the letter sounds of individual letters as well as diagraphs (phonological awareness).
  2. Learning letter formation using a multisensory approach, building the foundations of writing.
  3. Blending the sounds together to form words, thus learning to read.
  4. Identifying the sounds in words (segmenting, phonological awareness) thus enabling correct spelling.
  5. Tricky words that are not spelled the usual way are taught separately.

Read more about Jolly Phonics


Gaines R., Lefebvre P., Staniforth L.A. ,Literacy Skills of Children with Childhood Apraxia of Speech, McMaster University.

 Lewis B.A., Feebairn L.A., Hansen A.J., Iyengar S.K., Gerry Taylor H. (2004), School Age Follow up of Children with Childhood Apraxia of Speech, Language, Speech and Hearing Services
in Schools, Vol 35, 122-140.

McNeill, B.C., Gillon, G.T., & Dodd, B (2009) Phonological Awareness and Early Reading Development in Childhood Apraxia of Speech, International Journal of Language and Communication Disorders,44, 175-192.

Nijland L. , Terband H., Maassen B. (2015), Cognitive Functions in Childhood Apraxia of Speech, Journal of Speech, Language and Hearing Research, Vol 58, 550-565.

Peter B., Button L., Stoel-C., Chapman K.,  Raskind W.H. (2013), Deficits in Sequenctial Processing manifest in motor and linguistic tasks in a multigenerational family with Childhood Apraxia of Speech. Clin Linguist Phon. Author Manuscript, Downloaded from Google Scholar.

Skinder-Meredith A., Ph.D. & LaCoursiere A., M.S. Follow-up of Literacy Skills of Children with Childhood Apraxia  Department of Communication Sciences and Disorders,University of Minnesota-Duluth.

Stackhouse J. (1997) Chapter Seven “Phonological Awareness: Connecting Speech and Literacy Problems.” In B. Williams Hodson, M.L. Edwards, Perspectives in Applied Phonology,  Gaithersburg, Aspen Publishers Inc.