Parent question

Is it childhood apraxia of speech or a speech sound disorder?

Published 21 October 2026 · Updated 21 October 2026

The short answer

Childhood apraxia of speech (CAS) is a rare motor speech disorder: the brain has trouble planning the movements for speech, even though the muscles themselves work. Its hallmarks include inconsistent errors when a child repeats the same word, choppy transitions between sounds, and unusual rhythm or stress. It affects about 1 in 1,000 children and usually needs frequent, individual therapy, so an accurate diagnosis from a speech-language pathologist (SLP) matters.

What makes CAS different

ASHA describes three features with some agreement among experts, though none alone confirms CAS:

Inconsistent errors on consonants and vowels when the child repeats the same syllables or words.
Lengthened and disrupted transitions between sounds and syllables.
Inappropriate prosody, especially stress on syllables or words.

In a typical articulation or phonological disorder, errors tend to be consistent, like always saying “wabbit” for rabbit. In CAS, the same word can come out differently each time, and children may grope for mouth positions (ASHA).

How common it is

About 1 in 1,000 children aged 4 to 8 (ASHA Practice Portal; earlier estimates were 1 to 2 per 1,000).
Most children with CAS also have expressive language difficulties (ASHA Practice Portal).
There’s no single symptom or test for diagnosing it, and severity alone isn’t enough, which ASHA warns can lead to overdiagnosis (NIDCD; ASHA).

How therapy differs

NIDCD says children with apraxia need frequent, intensive, one-to-one therapy and won’t outgrow it on their own; home practice is important.
A systematic review found the strongest evidence for three approaches: integral stimulation (including DTTC), ReST, and integrated phonological awareness intervention (Murray et al., 2014).
A 2026 meta-analysis found therapy worked when given at least twice a week, for at least 45 minutes, over at least 12 sessions, though much data was missing (McCabe et al., 2026).

What to do if you’re unsure

Ask an SLP with experience in motor speech disorders for an evaluation, and ask how they distinguish CAS from other speech sound disorders. What happens at a speech evaluation.

Questions parents ask

Will my child outgrow apraxia?

NIDCD says children with apraxia of speech won’t outgrow it on their own, so therapy is needed. Many make good progress with frequent, individual practice.

How is apraxia different from a lisp or “wabbit”?

Lisps and gliding are consistent sound errors. In apraxia, errors vary each time the child says a word, and rhythm and transitions between sounds are affected too.

How often does apraxia therapy need to be?

Research suggests at least twice a week, often more intensively at first. Your SLP will set the schedule for your child.