Why we need a CAS Awareness Month
Why we need a CAS Awareness Month
This blog series is our small contribution. Over five posts, we'll walk through what the current evidence actually shows about CAS, autism, AAC, and the development of spoken language — and we'll do it in plain English, with full citations, so families and other professionals can read and share.
First, what is CAS?
Childhood Apraxia of Speech (CAS) is a motor speech disorder. Children with CAS know exactly what they want to say. They understand language, they have things to communicate, and the muscles of their mouth, tongue and jaw work fine in the ordinary sense. The difficulty is at the level of motor planning — the brain has trouble organising and coordinating the precise sequences of movements needed to produce clear speech.
That's why a child with CAS may say a word one way today and a different way tomorrow. Why they may grope visibly with their mouth as they try to speak. Why their prosody — the rhythm and stress pattern of speech — can sound flat or unusual. The American Speech-Language-Hearing Association (ASHA, 2007) outlined three core diagnostic features:
Inconsistent errors on consonants and vowels in repeated productions of the same syllables or words
Lengthened and disrupted transitions between sounds and syllables
Inappropriate prosody — particularly in stress patterns and the timing of speech
CAS is often described as rare, affecting around 1 to 2 children in every 1,000 in the general population. But that figure looks very different in some specific groups. Recent research from Maffei and colleagues (2024) identified suspected CAS in around one in four low and minimally verbal autistic individuals — a rate dramatically higher than in the general population, and one that has serious implications for how we assess and support these children.
Why awareness still matters
Despite all this, CAS is still under-recognised. We hear from parents who have spent years being told their child is "just delayed" or "just autistic" — when in fact, a co-occurring motor speech disorder was sitting there the whole time, shaping what spoken speech could emerge and how. We hear from families who were told AAC would stop their child speaking; from families who were told their child had "missed the window." None of those statements is supported by current evidence.
Some of these statements aren't just inaccurate. They become self-fulfilling prophecies.
Diagnosis matters because the intervention pathway changes. Motor speech approaches grounded in motor learning principles — like Dynamic Temporal and Tactile Cueing (DTTC), developed by Dr Edythe Strand, and the work of Dr Aravind Namasivayam and Dr Jennifer Moore — have a substantial evidence base for CAS specifically. They look quite different from general language stimulation, and they are not what most autistic children with CAS receive.
Awareness matters because parents need to be able to ask the right questions and to recognise when something they've been told doesn't quite add up. It matters because schools and other professionals need accurate information so they can support — rather than inadvertently undermine — a child's communication development.
What this series covers
Over the next four posts, we'll dig into three of the most damaging myths we still hear in 2026 — and what the research actually shows. Then we'll close with a post about what the evidence does support: the principles that consistently come up across studies as supporting communication development for children with CAS, including those who are also autistic, those who use AAC, and those who are gestalt language processors.
None of this is meant as criticism of individual practitioners. The information has shifted significantly in the last decade or so, and not every clinical conversation has caught up. What we want is for families to have access to current evidence — and to feel confident asking for it.
References
American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech [Position statement].
Maffei, M. F., Chenausky, K. V., Haenssler, A., Abbiati, C., Tager-Flusberg, H., & Green, J. R. (2024). Exploring motor speech disorders in low and minimally verbal autistic individuals: An auditory-perceptual analysis. American Journal of Speech-Language Pathology, 33(4), 1657–1675.
Shriberg, L. D., Paul, R., Black, L. M., & van Santen, J. P. (2011). The hypothesis of apraxia of speech in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 41(4), 405–426.
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Best wishes,
Sara & Rebecca
