First, it is important for parents to understand that there is most likely nothing that you did to “cause” your child’s speech disability. It is not about how much you talked to your child or whether or not you had them in daycare, for example. Your child does not have apraxia because you separated from your spouse or because you moved to a new city. So while we know that parents have a strong role in healthy child development, unless there was abuse, neglect, or isolation, you are not responsible for causing your child’s speech problems.
The current knowledge that we have about CAS is this. Childhood Apraxia of Speech may occur in the following 3 conditions:
- Neurological impairment caused by infection, illness or injury, before, during or after birth. This category includes children with positive findings on MRI’s (scans) of the brain, or those with brain injury or trauma, etc.
- Complex Neurodevelopmental Disorders – We know that CAS can occur as a secondary characteristic of other conditions such as genetic, metabolic, and/or mitochondrial disorders. In this category would be Childhood Apraxia of Speech that occurs with Autism, Fragile X, Galactosemia, some forms of Epilepsy, and some types of chromosome translocations, duplications and/or deletions (genetic conditions). There are quite a few disorders in which CAS can arise, but that does not mean that all children with these disorders also have CAS. For example, many children with Galactosemia have a speech problem, and out of those children, only some of them have CAS. Only some children with autism also have CAS. Only some children with epilepsy have CAS and so forth.
- Idiopathic Speech Disorder (a disorder of “unknown” origin) – with this condition, we currently don’t know “why” the child has apraxia of speech. Children do not have observable neurological abnormalities or easily detected neurodevelopmental conditions.
Some speculate that CAS and other childhood conditions may be a result, in part, of environmental conditions such as exposure to pollutants and toxins before or after birth. Others speculate that nutritional deficits or malabsorbtions cause CAS. While toxins and nutritional deficits do cause some developmental problems, to date these theories, as they relate specifically to CAS, are only speculations with no research evidence to support them.
That said, a child’s positive health will contribute to their ability to benefit from their learning exposures every day and from therapy designed to help them. A child who is healthy is more fully capable of taking advantage of opportunities to learn. Children who are sick frequently with ear and sinus infections, enlarged tonsils and adenoids, asthma, allergies or have sleep disturbances, attention and behavioral difficulties are going to find it much more difficult to benefit from the help provided. Helping your child be healthy and thus more “present” and available to the learning opportunities around them is one important way parents can help.
Most likely in the future we will learn that CAS is caused by multiple factors and conditions, not one. To the extent that research evidence becomes available that CAS is caused by some factor that can be manipulated to reduce or eliminate it, will determine whether or not it is preventable. Until then, we do know one very critical thing – that appropriate speech therapy, tailored to the difficulty of speech motor planning and provided frequently, is the single most important opportunity for children with CAS to improve their speech capacity. Children who are able to maintain optimum health will most likely directly benefit the most from appropriate help.