2.  Childhood Apraxia of Speech (CAS) 

From the American Speech-Language and Hearing Association (ASHA) website.  For more information visit 

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About Childhood Apraxia of Speech

In order for speech to occur, messages need to go from your brain to your mouth. These messages tell the muscles how and when to move to make sounds. When a child has apraxia of speech, the messages do not get through correctly. The child might not be able to move their lips or tongue in the right ways, even though their muscles are not weak. Sometimes, the child might not be able to say much at all.

A child with CAS knows what they want to say. The problem is not how the child thinks but how the brain tells the mouth muscles to move.

CAS is sometimes called verbal dyspraxia or developmental apraxia. Even though the word “developmental" is used, CAS is not a problem that children outgrow. A child with CAS will not learn speech sounds in typical order and will not make progress without treatment. It can take a lot of work, but the child’s speech can improve.

 

Signs and Symptoms

Not all children with CAS are the same. Your child may show some or all of the signs below. You should talk to your doctor and see an SLP if your child is older than 3 years and

• does not always say words the same way every time;

• tends to put the stress on the wrong syllable or word;

• distorts or changes sounds; or

• can say shorter words more clearly than longer words.

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Children with CAS may have other problems, including

• difficulty with fine motor skills;

• delayed language; or

• problems with reading, spelling, and writing.

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3. About Stuttering

From the American Speech-Language and Hearing Association (ASHA) website.  For more information visit 

 

We all have times when we do not speak smoothly. We may add "uh" or "you know" to what we say. Or, we may say a sound or word more than once. These are called disfluencies.  

People who stutter may have more disfluencies and different types of disfluencies. They may repeat parts of words (repetitions), stretch a sound out for a long time (prolongations), or have a hard time getting a word out (blocks).

Stuttering is more than just disfluencies. Stuttering also may include tension and negative feelings about talking. It may get in the way of how you talk to others. You may want to hide your stuttering. So, you may avoid certain words or situations. For example, you may not want to talk on the phone if that makes you stutter more.

Stuttering can change from day to day. You may have times when you are fluent and times when you stutter more. Stress or excitement can lead to more stuttering.

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Signs and Symptoms of Stuttering

The following typical disfluencies happen to many of us and are not stuttering:

• Adding a sound or word, called an interjection – "I um need to go home."

• Repeating whole words – "Well well, I don’t agree with you."

• Repeating phrases – "He is–he is 4 years old."

• Changing the words in a sentence, called revision – "I had–I lost my tooth."

• Not finishing a thought – "His name is . . . I can't remember."

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When children are learning a lot of words or new speech sounds, you may notice some of these typical disfluencies. This is normal.

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The following types of disfluencies happen when someone stutters:

• Part-word repetitions – "I w-w-w-want a drink."

• One-syllable word repetitions – "Go-go-go away."

• Prolonged sounds – "Ssssssssam is nice."

• Blocks or stops – "I want a (pause) cookie."

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You may also notice other behaviors like head nodding or eye blinking. Sometimes people who stutter use these behaviors to stop or keep from stuttering. They may also avoid using certain words or use different words to keep from stuttering.  

Feelings and attitudes can affect stuttering. For example, frustration or tension can cause more disfluencies. Being excited or feeling rushed can also increase disfluencies. A person who stutters may also stutter more if others tease them or bring attention to their speech. Stuttering may cause a person to be embarrassed and make them feel nervous about talking.

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Causes of Stuttering

Stuttering usually starts between 2 and 6 years of age. Many children go through normal periods of disfluency lasting less than 6 months. Stuttering lasting longer than this may need treatment.

There is no one cause of stuttering. Possible causes include the following:

• Family history. Many people who stutter have a family member who also stutters.

• Brain differences. People who stutter may have small differences in the way their brain works during speech.

 

You cannot always know which children will continue to stutter, but the following factors may place them at risk:

• Gender. Boys are more likely to continue stuttering than girls.  Data are currently limited to individuals who identify as male or female.

• Age when stuttering began. Children who start stuttering at age 3½ or later are more likely to continue stuttering.

• Family recovery patterns. Children with family members who continued to stutter are also more likely to continue.