Childhood Apraxia of Speech: Symptoms, Causes, Diagnosis and Treatment — What You Need to Know

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026

Quick Answer

Childhood apraxia of speech (CAS) is a rare speech disorder in which the brain can't properly direct the lips, jaw and tongue to create speech sounds clearly or at the proper speed. Importantly, the speech muscles aren't weak — they simply can't form words the right way.

Signs appear at different ages: less babbling between 7–12 months, first words after 12–18 months, and (between ages 2–4) unclear sounds, pauses between syllables, wrong word stress, and difficulty imitating simple words. Unique markers like "groping" movements and inconsistent word production help specialists distinguish CAS from other speech disorders.

CAS doesn't go away on its own, but speech therapy works. A speech-language pathologist typically treats CAS with frequent one-on-one sessions (often 3–5 times per week at first), heavy repetition, cues to the sound and feel of speech movements, and short daily home practice.

TL;DR

Childhood apraxia of speech (CAS) is a rare disorder where the brain can't direct the lips, jaw and tongue to produce clear speech at the right speed. The speech muscles aren't weak — they can't form words correctly. Symptoms vary with age and severity: reduced babbling (7–12 months), late first words (after 12–18 months), and between ages 2–4 unclear vowels/consonants, pauses between syllables, voicing errors ("pie" sounding like "bye"), groping movements, wrong stress ("BUH-na-nuh" for banana), and saying the same word differently each time.

The exact cause often can't be found, but brain injuries (stroke, infection, traumatic brain injury), genetic conditions, and metabolic conditions can cause it. About one-third of children with CAS have gene differences (e.g., FOXP2 gene changes, chromosome 22q11.2 deletions, or syndromes like galactosemia). Children with CAS don't outgrow it — unlike typical speech delays — but they can make strong progress with speech therapy: frequent individual sessions, speech drills, vowel and syllable practice, paced learning, cues, home practice, and sometimes alternative communication (signs, tablets) started early. Diagnosis is based on a pattern of symptoms examined by a speech-language pathologist, often including hearing tests and oral-motor assessment.

Limitation statement: This article is based exclusively on two expert-reviewed clinical overviews dated December 12, 2025. The sources provide no prevalence, incidence, or therapy-success statistics beyond the finding that about one-third of children with CAS have gene differences, and no other statistics are presented or invented here. Treatment outcomes depend on individual circumstances and the judgment of the treating speech-language pathologist.

When Should You Have Your Child Evaluated?

CAS can't be prevented — but the sources are clear that early diagnosis and treatment may reduce the risk of long-term complications. The guidance is straightforward:

If your child has trouble with speech, have a specialist — a speech-language pathologist — evaluate your child as soon as you notice any issues.

Early signs vary by age, and they can overlap with other speech and language disorders, so a specialist's evaluation is the right first step rather than waiting to see if your child "outgrows" it.

Age window	What you might notice
7–12 months	Babbling less or making fewer vocal sounds than is typical
12–18 months	First words arriving late — typically after 12 to 18 months
18 months–2 years	Limited consonants and vowels, leaving out sounds, speech hard to understand; symptoms at this age may suggest "suspected CAS"
2–4 years	Unclear vowels and consonants, pauses between syllables, voicing errors (e.g., "pie" sounding like "bye")

"Symptoms at this age may suggest a condition called suspected CAS. Suspected CAS means a child may develop CAS. The child should receive ongoing exams in addition to speech therapy." — Source overview [1]

What Exactly Is Childhood Apraxia of Speech?

Childhood apraxia of speech, also called CAS, is a rare speech disorder. Children with this disorder have trouble controlling their lips, jaws and tongues when speaking.

Here's the key concept: in CAS, the brain isn't able to direct the lips, jaw and tongue to create speech sounds clearly or at the proper speed. The speech muscles aren't weak — they are simply not able to form words the right way.

Think of it as a planning and coordination problem, not a muscle problem. The child knows what they want to say, but the brain struggles to tell the mouth how to say it.

CAS is treated with speech therapy. During speech therapy, a speech-language pathologist teaches the child to practice how to say words, syllables and phrases correctly.

What Are the Signs and Symptoms of CAS?

Children with CAS may have various speech symptoms. Symptoms vary depending on a child's age and whether their speech problems are severe.

Early Signs

CAS can result in several early patterns that parents and caregivers may notice:

Early sign	Typical age
Babbling less, or fewer vocal sounds than typical	7 to 12 months
Speaking first words late	Typically after 12 to 18 months
Using a limited number of consonants and vowels	Toddler years
Leaving out sounds when speaking	Toddler years
Speech that is hard to understand	Toddler years

Signs Between Ages 2 and 4

Children usually talk more between the ages of 2 and 4. Signs that may indicate CAS at this age include:

Sign	Example
Unclear vowels and consonants	Speech sounds fuzzy or unclear
Pauses between syllables or words	Words come out in separated pieces
Voicing errors	The word "pie" sounding like the word "bye"

The Unique CAS Markers

Some characteristics — called markers — help distinguish CAS from other types of speech disorders:

Marker	What it looks like
Trouble moving smoothly between sounds	Difficulty transitioning from one sound, syllable or word to another
Groping	Off-target movements of the jaw, lips or tongue as the child searches for the correct movements for speech sounds
Vowel errors	Saying vowel sounds incorrectly
Wrong stress in a word	Pronouncing "banana" as BUH-na-nuh instead of buh-NA-nuh
Equal emphasis on all syllables	Saying BUH-NA-NUH
Pauses or gaps between syllables	Words broken apart
Inconsistent production	Saying the same word differently when using it more than once
Trouble imitating simple words	Difficulty copying even simple words
Voicing errors	Saying "down" instead of "town"

Many children with CAS also have language disorders, such as reduced vocabulary or trouble with word order.

Diagnosing Is Not Always Simple

Some CAS symptoms also occur in other speech or language disorders. CAS may be hard to diagnose if a child has symptoms found in both CAS and other disorders. That's why a specialist's pattern-based evaluation matters.

How Is CAS Different from Other Speech Disorders?

Other speech sound disorders are often confused with CAS because some symptoms overlap — such as voicing errors and leaving out certain sounds. These include articulation disorders, phonological disorders and dysarthria.

Disorder	What's happening	Key difference from CAS
Articulation disorders	Trouble learning how to make and use specific sounds; more common than CAS	Unlike CAS, the child doesn't have trouble planning or coordinating movements to speak
Phonological disorders	Trouble learning how to make and use specific sounds; more common than CAS	Same — no movement planning problem
Dysarthria	The speech muscles are weak — they can't move as far, as fast or as strongly as needed; may include hoarse, soft or strained voice; slurred or slow speech	Muscle weakness is the cause, not planning; often easier to identify than CAS

Symptoms of articulation and phonological disorders may include:

Symptom type	Example
Substituting sounds	"fum" instead of thumb, "wabbit" instead of rabbit, "tup" instead of cup
Leaving out final consonants	"duh" instead of duck, "uh" instead of up
Stopping the airstream	"tun" instead of sun, "doo" instead of zoo
Simplifying sound combinations	"ting" instead of string, "fog" instead of frog

One important note: when dysarthria is caused by damage to brain areas that affect coordination, it may be hard to determine the differences between CAS and dysarthria.

Don't confuse childhood apraxia of speech with the adult-onset form. Read our guide to Primary Progressive Apraxia of Speech to see how apraxia of speech looks when it develops later in life.

What Causes Childhood Apraxia of Speech?

CAS has many possible causes. But often a cause can't be found. There usually isn't an obvious change in a child's brain with CAS.

However, CAS can be the result of brain conditions or injuries. These may include stroke, infections or traumatic brain injury.

CAS also may be a symptom of a genetic condition or syndrome or a metabolic condition.

An important distinction: CAS is sometimes referred to as developmental apraxia — but children with CAS don't make typical developmental sound errors, and CAS does not go away as a child grows older. This is unlike what happens in children with delayed speech or developmental conditions who follow typical speech and sound development patterns but at a slower pace.

Is CAS Genetic?

CAS is linked to gene differences in about one-third of children with the condition:

Genetic factor	Detail
Single-gene changes	Sometimes caused by a change in one gene; for example, risk may increase due to a change in the FOXP2 gene, which helps the brain control muscles needed for talking — especially planning how to move the mouth
Larger chromosome changes	Parts of chromosomes missing or repeated, affecting many genes; for example, missing part of chromosome 22q11.2 can raise the risk of speech sound disorders, including CAS
Genetic syndromes	CAS can be part of syndromes affecting the whole body; one example is galactosemia, a condition affecting how the body breaks down certain sugars in the blood — children with galactosemia have a higher chance of having CAS

What Complications Can Happen Alongside CAS?

Many children with CAS have other conditions that affect their ability to communicate. These conditions aren't due to CAS, but may happen along with it:

Co-occurring condition	What it involves
Delayed language	Trouble understanding speech, reduced vocabulary, or not using correct grammar when putting words together in a phrase or sentence
Developmental delays	Delays in intellectual and motor development; trouble with reading, spelling and writing
Motor and coordination trouble	Trouble with motor movement skills or coordination
Social communication trouble	Trouble using communication in social interactions

Because these can travel together, a complete evaluation looks at the whole child, not just speech sounds.

How Is CAS Diagnosed?

Diagnosis of CAS isn't based on a single test or observation. A diagnosis is made based on the pattern of symptoms. A specialist called a speech-language pathologist (SLP) leads the evaluation.

Who Evaluates Your Child?

Your child is likely to start by seeing a pediatrician, or a doctor trained in treating children with neurological conditions (pediatric neurologist) or developmental disorders (developmental pediatrician). Your child will likely be referred to a speech-language pathologist.

What Happens During the Evaluation

The SLP reviews your child's symptoms and medical history, examines the muscles used for speech, and looks at how your child produces sounds, words and phrases. The SLP also may test language skills, including vocabulary, sentence structure and the ability to understand speech. The specific tests depend on your child's age, ability to cooperate and whether speech issues are severe.

Diagnosing CAS can sometimes be hard, especially when a child speaks very little or has trouble engaging with the SLP during the exam. Still, identifying whether your child shows CAS symptoms matters because the condition is treated differently from other speech disorders. The SLP may be able to determine the best treatment approach even if the diagnosis is not certain at first.

Evaluation component	What happens
Hearing tests	Ordered to determine if hearing trouble could be contributing to speech concerns
Oral-motor assessment	The SLP examines the lips, tongue, jaw and palate for structural changes such as tongue-tie or cleft palate; looks for low muscle tone (usually not associated with CAS, but may signal other conditions); watches how your child moves the lips, tongue and jaw in activities like blowing, smiling and kissing
Speech exam	Watches ability to make sounds, words and sentences during play or other activities; may ask the child to name pictures to check for trouble with specific sounds, words or syllables; looks at coordination and smoothness of movement — the child may repeat syllables such as "pa-ta-ka" or say words such as buttercup; if the child speaks sentences, the SLP watches melody and rhythm of speech (how stress falls on syllables and words); the SLP may provide cues such as saying the word or sound slower, or touch cues to the face
Therapy trial	A trial of speech therapy to see how your child responds to CAS treatment can help the SLP confirm CAS

To learn more about how hearing problems are identified and managed, see our guide to hearing loss: symptoms, causes, and treatment options.

How Is Childhood Apraxia of Speech Treated?

Children don't outgrow childhood apraxia of speech — but speech therapy can help them make the most progress. A speech-language pathologist may treat CAS with many therapies.

What Speech Therapy Looks Like

Aspect	What the sources say
Frequency	Depending on the extent of the speech disorder, your child may need speech therapy 3 to 5 times a week; as your child improves, sessions may reduce to weekly
Format	Children with CAS generally benefit from individual therapy — one-on-one allows more practice time per session
Focus	Because children with CAS have trouble planning movements for speech, therapy often focuses the child's attention on the sound and feel of speech movements
Practice	It's important that children get a lot of practice saying words and phrases each session; it takes time and practice to learn to say words and phrases the right way
Cues	The SLP may ask your child to listen carefully, to watch the SLP's mouth form the word or phrase, or may touch your child's face while they make certain sounds (for example, helping round the lips to say "oo")

Principles of Effective CAS Therapy

No single speech therapy has been shown to be the most effective for treating CAS. But the sources highlight important principles:

Principle	What it means
Speech drills	Saying words or phrases many times during a therapy session
Sound and movement exercises	Listening to and watching the SLP's mouth while speaking, seeing the movements that go with the sounds
Speaking practice	Practicing syllables, words or phrases rather than isolated sounds — children with CAS need practice moving from one sound to another
Vowel practice	Children with CAS tend to distort vowel sounds; practicing words with vowels in different syllables (e.g., "hi," "mine," "bite" or "out," "down," "house")
Paced learning	Starting with a small set of practice words and slowly increasing as the child improves
Movement, stress and smoothness	Focusing on correct movement, where stress falls in words, and smoothness — children with CAS need more than just correct sounds

Practice at Home

Speech practice at home is very important. Home practice, in addition to therapy sessions, may help your child's progress, and the SLP may encourage family involvement.

Home practice sessions can be short — for example, five minutes twice a day with words and phrases the SLP provides. Children also need to practice in real-life situations: create moments for your child to say a word or phrase, such as saying "Hi, Mom" each time Mom enters a room. This makes it easier for your child to say practice words automatically.

Alternative Communication Methods

If your child can't effectively communicate through speech, other methods can help:

Method	Examples
Sign language or natural gestures	Pointing, pretending to eat or drink; using signs to ask for a cookie
Electronic devices	Tablets can sometimes be helpful in communication

Starting early with these methods may help your child become less frustrated and may also support language skills such as vocabulary and putting words together in sentences.

Therapies for Coexisting Conditions

Many children with CAS also have language development delays and may need therapy for language issues. Children with trouble in fine and gross motor movement of the arms or legs may need physical or occupational therapy. If a child has another medical condition, treating it may improve speech. One caution from the sources: schedule sessions so your child gets rest breaks and doesn't become too tired.

For a look at how speech therapy helps adults regain language after brain injury, see our guide to aphasia and how speech therapy helps.

What Does NOT Help

Some treatments don't help improve the speech of children with CAS. For example, there is no evidence that exercises to strengthen speech muscles improve speech in children with CAS. Since the muscles aren't weak, strengthening them isn't the solution.

How Can Parents Support Their Child?

At times, it may be challenging when your child has trouble communicating. The sources suggest practical ways to cope and support.

Find a support group. Support groups are available for parents of children with CAS. They offer a place to find people who understand what you're going through and who can share similar experiences. Local groups can be found through childhood speech-apraxia family organizations.

Encourage your child. Having CAS can also be difficult for your child. Encourage and support your child as they practice speech and language skills. Your child will likely feel good about improving their speech with your support.

What Should You Prepare for Your Child's Appointment?

Your child is likely to start with a pediatrician, pediatric neurologist or developmental pediatrician, and will likely be referred to a speech-language pathologist. Preparation helps make the most of limited appointment time.

What You Can Do

Preparation step	What to do
Write down symptoms	Including any that may not seem related to the reason for the appointment; bring the list
List medicines	All medicines, vitamins and supplements your child takes
Write down questions	For your child's healthcare team and speech-language pathologist
Bring a progress report	A recent progress report, if available
Bring the IEP	Your child's individual education plan (IEP), if you have one

Questions worth asking the speech-language pathologist include:

Your questions	Their questions
Does my child have CAS or any other speech or language disorders?	When did you first have concerns about your child's speech development?
How is CAS different from other speech disorders?	Did your child babble — cooing, then syllables like "ba-ba-ba" or "da-da-da"? When did that start?
Is my child's condition going to improve?	At what age was your child's first word?
What treatments are available, and which do you recommend?	At what age did your child's vocabulary include five words they often used?
What can I do at home to help my child?	How many words does your child use that most people would understand?
Are there brochures, printed materials, or recommended websites?	In what other ways does your child communicate (pointing, gestures, signs, acting out)?
—	Has anyone in your family had a speech or language disorder?
—	Has your child had ear infections, and about how many?
—	Has your child's hearing been tested? When, and was any hearing loss detected?

Conclusion

Childhood apraxia of speech is a rare disorder in which the brain struggles to direct the lips, jaw and tongue to form clear speech at the right speed. The speech muscles aren't weak — the challenge is planning and coordinating the movements. That distinction matters, because it means CAS looks different from more common speech sound disorders, is treated differently, and does not go away on its own.

Early signs show up across developmental windows: less babbling at 7–12 months, late first words, and by ages 2–4 unclear sounds, pauses between syllables, voicing errors, wrong stress patterns and inconsistent word production. The unique markers — especially groping movements and difficulty imitating — help speech-language pathologists identify CAS from a pattern of symptoms, often alongside hearing tests and an oral-motor assessment.

The encouraging news is that speech therapy works. With frequent individual sessions, deliberate practice of syllables, words and phrases, and short daily home practice, children with CAS can make meaningful progress. Alternative communication methods, started early, reduce frustration and support language growth, and treating coexisting conditions (language delays, motor difficulties, ear infections, hearing loss) matters just as much.

If you have concerns about your child's speech — at any age — have your child evaluated by a speech-language pathologist as soon as possible. Early evaluation is the single most helpful step you can take. Bring a list of symptoms, your child's medical history, and any school progress reports, and ask the specialist what you can practice at home starting today.

Sources

[1] Childhood Apraxia of Speech — Symptoms & Causes — reviewed by medical experts; dated December 12, 2025.

[2] Childhood Apraxia of Speech — Diagnosis & Treatment — reviewed by medical experts; dated December 12, 2025.

FAQ

What is childhood apraxia of speech (CAS)?

CAS is a rare speech disorder in which the brain isn't able to direct the lips, jaw and tongue to create speech sounds clearly or at the proper speed. Children with CAS have trouble controlling their lips, jaws and tongues when speaking.

Are the speech muscles weak in CAS?

No. The speech muscles aren't weak in CAS — they are simply not able to form words the right way. This is a key difference from disorders like dysarthria, where the muscles are weak.

What causes childhood apraxia of speech?

CAS has many possible causes, and often a cause can't be found. It can result from brain conditions or injuries such as stroke, infections or traumatic brain injury, or it may be a symptom of a genetic or metabolic condition. There usually isn't an obvious change in a child's brain with CAS.

Is CAS genetic?

CAS is linked to gene differences in about one-third of children with the condition. It can involve single-gene changes (such as the FOXP2 gene, which helps the brain plan mouth movements for speech), larger chromosome changes (such as missing part of chromosome 22q11.2), or whole-body genetic syndromes like galactosemia.

Does my child outgrow CAS?

No. Children don't outgrow CAS, and it does not go away as a child grows older. This is unlike children with delayed speech who follow typical speech development patterns but at a slower pace.

Can CAS be prevented?

You can't prevent CAS. But early diagnosis and treatment may reduce the risk of long-term complications. Have a speech-language pathologist evaluate your child as soon as you notice any speech issues.

What are the early signs of CAS in babies?

CAS can result in babbling less or making fewer vocal sounds than is typical between ages 7 and 12 months, and speaking first words late — typically after the age of 12 to 18 months.

What signs appear in toddlers?

Children may use a limited number of consonants and vowels, leave out sounds when speaking, and use speech that is hard to understand. These symptoms are usually noticed between ages 18 months and 2 years and may suggest "suspected CAS" — meaning the child may develop CAS and should receive ongoing exams plus speech therapy.

What signs appear between ages 2 and 4?

Signs include unclear vowels and consonants, pauses between syllables or words, and voicing errors — such as the word "pie" sounding like the word "bye."

What are the markers that distinguish CAS from other speech disorders?

Markers include trouble moving smoothly from one sound to another, groping (off-target jaw, lip or tongue movements while searching for the right movement), saying vowels incorrectly, wrong word stress ("BUH-na-nuh" for banana), equal emphasis on all syllables, pauses between syllables, saying the same word differently each time, and having a hard time imitating simple words.

What does "groping" mean in CAS?

Groping refers to off-target movements of the jaw, lips or tongue as the child searches for the correct movements for speech sounds. It is one of the characteristic markers of CAS.

Why is CAS hard to diagnose?

Some CAS symptoms also occur in other speech or language disorders. CAS may be hard to diagnose when a child shows symptoms of both CAS and other disorders, or when the child speaks very little or has trouble engaging during the exam. Diagnosis is based on the pattern of symptoms, not a single test.

How is CAS different from articulation and phonological disorders?

A child with an articulation or phonological disorder has trouble learning how to make and use specific sounds but doesn't have trouble planning or coordinating movements to speak — unlike in CAS. Articulation and phonological disorders are also more common than CAS. Examples include saying "fum" for thumb or "duh" for duck.

How is CAS different from dysarthria?

Dysarthria happens because the speech muscles are weak and can't move as far, as fast or as strongly as needed for clear speech. It may include a hoarse, soft or strained voice, or slurred or slow speech. Dysarthria is often easier to identify than CAS, though brain-related dysarthria can be hard to distinguish from CAS.

Who diagnoses CAS?

A speech-language pathologist (SLP) leads the evaluation. Children typically start with a pediatrician, pediatric neurologist or developmental pediatrician, then get referred to the SLP.

What tests are used to diagnose CAS?

Evaluation may include hearing tests (to rule out hearing-related speech trouble), an oral-motor assessment (examining lips, tongue, jaw and palate; watching movements like blowing, smiling and kissing), and a speech exam (watching sound production during play, picture naming, repeating syllables like "pa-ta-ka," checking melody and rhythm of speech, and using cues). A trial of speech therapy may also help confirm CAS.

What is the treatment for childhood apraxia of speech?

CAS is treated with speech therapy. A speech-language pathologist teaches the child to practice saying words, syllables and phrases correctly. Treatment often involves frequent sessions (3 to 5 times a week at first), individual one-on-one therapy, heavy repetition, and cues to the sound and feel of speech movements.

How often does a child need speech therapy for CAS?

Depending on the extent of the speech disorder, a child may need speech therapy 3 to 5 times a week. As the child improves, sessions may be reduced to weekly.

Why does CAS therapy focus on sound and feel of movements?

Because children with CAS have trouble planning movements for speech, therapy often focuses the child's attention on the sound and feel of speech movements, helping the brain connect what it hears with what the mouth must do.

What are speech drills for CAS?

Speech drills are when the therapist asks the child to say words or phrases many times during a therapy session. Lots of practice in each session is important because it takes time and practice to learn to say words and phrases the right way.

Why is vowel practice important in CAS therapy?

Children with CAS tend to distort vowel sounds. The SLP may choose practice words containing vowels in different types of syllables — for example, "hi," "mine" and "bite," or "out," "down" and "house."

What is paced learning in CAS therapy?

Depending on severity, the SLP may start with a small set of practice words and slowly increase the number as the child improves.

Can parents practice speech at home?

Yes, and it's very important. The SLP may provide words and phrases for home practice; each session can be short — for example, five minutes twice a day. Practicing in real-life situations (like saying "Hi, Mom" when Mom enters a room) helps children say practice words automatically.

Do signs or tablets help children with CAS?

If a child can't communicate effectively through speech, sign language, natural gestures or electronic devices such as tablets can help. Starting early may reduce frustration and help develop language skills like vocabulary and putting words into sentences.

Do muscle-strengthening exercises help CAS?

No. There is no evidence that exercises to strengthen speech muscles improve speech in children with CAS. The muscles aren't weak — the problem is planning movements.

What other conditions often occur with CAS?

Many children with CAS also have delayed language (trouble understanding speech, reduced vocabulary, incorrect grammar), delays in intellectual and motor development, trouble with reading, spelling and writing, motor or coordination trouble, and trouble using communication in social interactions. These aren't caused by CAS but often occur alongside it.

Will my child's speech improve?

Children with CAS generally benefit from speech therapy and can make strong progress with practice and support. The SLP can tell you what to expect for your child's specific situation — this is a key question to ask at the evaluation.

How can parents support a child with CAS?

Encourage and support your child as they practice speech and language skills; they will likely feel good about improving with your support. Support groups for parents are also available and can connect you with people who understand.

What questions should I ask the speech-language pathologist?

Ask whether your child has CAS or another speech/language disorder, how CAS differs from other disorders, whether your child's condition will improve, what treatments are recommended, what you can do at home, and for printed materials or recommended websites.

Should I bring my child's school records to the appointment?

Yes. Bring a recent progress report and, if you have one, your child's individual education plan (IEP). Also bring a list of symptoms, medicines, vitamins and supplements, and written questions.

External References

• American Speech-Language-Hearing Association (ASHA): https://www.asha.org

• National Institute on Deafness and Other Communication Disorders (NIDCD): https://www.nidcd.nih.gov

• Apraxia Kids (support groups and resources for families): https://www.apraxia-kids.org

• National Institutes of Health — GeneReviews (FOXP2): https://www.ncbi.nlm.nih.gov/books/NBK1116

Medical Disclaimer

This article is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking care because of something you have read here. Speech development varies widely among children, and many speech difficulties are not CAS — only an evaluation by a speech-language pathologist can determine the correct diagnosis and treatment plan for your child.