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Why is accurate diagnosis important?

CAS is considered to be a “low” prevalence speech disorder in children.  In fact, researchers and professionals believe CAS is a rare speech disorder. That means that out of all children with speech problems, few have CAS.  It also means that other types of speech problems are much more likely in children than is CAS.  Research in this area has been limited, but there are estimates that on a “typical” SLPs caseload of preschool children with speech sound disorders, only 3 – 5% of them would likely have apraxia of speech.  Highly experienced SLPs, that gain a reputation for providing excellent evaluation and treatment, would obviously have a larger proportion of children on their caseload with CAS than is typical.  Because it is so important to match a speech therapy approach to the nature of the child’s speech difficulty, misdiagnosis can prevent children from receiving the help that they really need.

Unfortunately, research has determined that childhood apraxia of speech can be over diagnosed.  Children – some of them extremely young – are given the diagnosis even though a thorough speech evaluation has not yet been possible.  Sometimes, due to a lack of experience with CAS, the professional may not fully grasp what should be involved in assessment and in distinguishing apraxia from other speech problems.  Misdiagnosis causes parents to have unnecessary worry, fear, and stress.  Firm diagnosis should not be made in extremely young children or children who are unable to give an adequate speech sample or cooperate and understand the tasks being asked of them in an evaluation.  In recent years, the term suspected CAS is used to identify a child who potentially has this speech problem and should be carefully watched and so helpful therapy can begin.

Some research also indicates that the apraxia of speech diagnosis is often “missed” in children who really do have it!  This is also not a good situation.  The speech therapy treatment for childhood apraxia of speech is different than it is for most other speech disorders or speech delay.  In addition to the speech therapy methods being different, children with apraxia of speech, at least for some period of time, require more speech therapy than children with other speech problems in order to improve their speaking ability.  Without proper diagnosis, children are at risk of not receiving adequate and appropriate help.

Parents who are concerned with their child’s speech and language development should first try to seek help from the child’s pediatrician.  Keeping a written record of concerns that can be discussed at an office visit can be very helpful.  Parents can request that the child be referred for a comprehensive speech and language evaluation.  At times, parents may have to be assertive about getting a referral to speech and language evaluation by a qualified speech-language pathologist.  Be persistent and do not give up!  Your child’s pediatrician has a responsibility to monitor and supervise your child’s development in all areas, including speech and language.  A good pediatrician will also listen and respond to a parent’s concern for their child’s development.  If your child is not developing as expected, your pediatrician should assist you in arranging for or referring to an appropriate professional or specialist.