If your child understands everything but struggles to speak clearly (samajhta sab hai, bol nahi pata), they may have Childhood Apraxia of Speech (CAS). The good news is that with intensive speech therapy and early intervention, most children with CAS make significant progress! CAS is a motor planning disorder - the brain has difficulty coordinating mouth movements for speech. It's not about intelligence or understanding - children with CAS are often very bright.
What is CAS?
Watch: Child hood obesity: an epidemic in kids every parent need to understand.
Childhood Apraxia of Speech is a neurological speech disorder where the brain struggles to plan and coordinate the precise movements of the tongue, lips, and jaw needed for clear speech.
Important to Know:
NOT caused by muscle weakness
NOT a hearing problem
NOT a language understanding problem
Child knows what they want to say but can't coordinate the movements
With proper therapy, most children improve significantly
Signs by Age
Infants (0-12 months):
Limited babbling
Few consonant sounds
Quiet baby
Delayed first words
Toddlers (1-3 years):
Very limited vocabulary
Words sound different each time
More gestures than words
Frustration when trying to speak
May lose words they previously used
Preschoolers (3-5 years):
Speech hard for others to understand
Struggles with longer words
Obvious effort to form sounds
Wrong stress on syllables
Can say sounds alone but not in words
CAS vs Speech Delay
CAS
Typical Speech Delay
Understanding is good
Understanding may be delayed
Inconsistent errors
Consistent errors
Harder with longer words
Proportional difficulty
Visible struggle to speak
Less struggle
Slower progress
Faster with practice
What Causes CAS?
Exact cause often unknown, but may include:
Genetic factors
Brain development differences
Associated with some syndromes
Sometimes no identifiable cause
Parents did NOT cause this - it's not related to parenting style or language exposure.
Treatment
Speech Therapy - Essential:
Intensive sessions (3-5 times/week initially)
Motor planning focus
Multisensory approach
Repetitive practice
Home practice crucial
Finding Help in India:
Government hospitals with rehab departments
Private speech therapy clinics
NIMHANS, AIIMS
Online therapy available
When to Seek Evaluation
Contact a speech-language pathologist if:
No babbling by 12 months
No words by 18 months
Very limited speech by 2 years
Speech very hard to understand at 3 years
Obvious struggle to produce sounds
Inconsistent speech errors
Home Support
Daily Practice (as guided by therapist):
Follow home practice plan
Make it fun with games
10-15 minutes, 2-3 times daily
Celebrate small victories
Communication Strategies:
Accept all communication attempts
Model correct pronunciation without forcing
Give processing time
Don't pretend to understand - ask gently
Reduce frustration with choices and visuals
Expert Insight: Dr. Sumitra advises: 'Growth charts are just one tool. Look at the overall trend, not individual measurements.'
FAQs
Q: Mera bachcha samajhta sab hai but bol nahi pata - is this CAS?
A: This could be CAS, especially if your child shows inconsistent speech errors and struggles visibly to form sounds. Children with CAS typically understand language well but have trouble coordinating speech movements. Get an evaluation from a speech-language pathologist to confirm.
Q: Is CAS curable?
A: CAS requires ongoing therapy, not a one-time cure. With intensive, consistent speech therapy, most children make significant improvement. Some achieve nearly typical speech, others may have mild residual differences. Early intervention is key.
Q: Will my child need therapy forever?
A: Duration varies by severity. Most need intensive therapy for several years, with decreasing frequency as they improve. Many are discharged by late elementary school.
Q: Can screen time cause CAS?
A: No, screen time does NOT cause CAS - it's a neurological condition. However, excessive screen time reduces speech practice opportunities. Balance screen time with face-to-face interaction.
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This article was reviewed by a pediatrician. Last updated: January 2025
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