If your child has recently been diagnosed with childhood apraxia of speech, or if you are in the middle of trying to figure out why your child is struggling to speak clearly, you are probably feeling a lot of things right now. Confused. Worried. Maybe a little overwhelmed. You are searching for answers, and you want to make sure you are doing the right things for your child.
We want you to know: you are already doing one of the most important things. You are asking questions and seeking knowledge. That matters enormously.
At Bjorem Speech, childhood apraxia of speech is at the center of everything we do. Our founder, Jennie Bjorem, M.A., CCC-SLP, is a childhood apraxia of speech specialist who has spent her career assessing, diagnosing, and treating children with CAS, and training speech language pathologists around the world to do the same. This guide was built from that knowledge, and it was written for you.
What Is Childhood Apraxia of Speech?
Childhood apraxia of speech (CAS) is a motor speech disorder. That distinction matters more than it might seem at first glance, and understanding it is the key to understanding why speech therapy for apraxia looks different from other kinds of speech therapy.
When a child has CAS, the challenge is not in the muscles of the mouth, lips, tongue, or jaw. Those muscles are not weak. The challenge is in the planning and programming of the precise, coordinated movement sequences those muscles need to produce speech. In other words, the brain knows what it wants to say. The breakdown happens in the pathway between the brain's intention and the mouth's execution.
A child with CAS might:
- Say a word correctly once but struggle to repeat it the same way again
- Know exactly what they want to say but be unable to get the words out clearly
- Have speech that seems inconsistent, producing sounds differently each time they try
- Stress syllables in unusual ways or have difficulty moving smoothly between sounds within a word
- Have shown limited babbling as an infant or said very few words early on
- Show frustration when trying to communicate, because they understand far more than they can express
CAS exists on a spectrum of severity. Some children have mild CAS alongside other speech or language differences. Others have severe CAS and may be minimally verbal in the early years. Every child with CAS is different, and every child deserves a therapy approach tailored carefully to their specific profile.
One important thing to know: CAS is not something a child outgrows. Without targeted, consistent speech therapy, children with CAS do not simply catch up on their own. But with the right intervention and the right support, children with CAS can make real and meaningful progress. We have seen it happen, and the research supports it.
Why Speech Therapy for Apraxia Is Different
This is one of the most important things any parent of a child with CAS can understand. Not all speech therapy is created equal, and the therapy that works well for a child with an articulation disorder or a phonological disorder is not the same therapy that works for CAS.
Because CAS is fundamentally a motor planning and programming disorder, therapy must focus on motor learning. The goal is to help the brain and the body practice the movement sequences required for speech, in a way that gradually builds accuracy, consistency, and automaticity.
Here is what that means in practice:
Repetition and Intensity Matter Enormously
Motor learning research is clear: skills improve through repeated, targeted practice. Speech therapy for apraxia requires a high volume of practice within each session and frequent sessions, especially in the early stages. This is not because CAS children need to work harder than other children. It is because the nature of motor learning demands it. The brain learns movement through repetition, the same way a child learns to ride a bike or play the piano.
For children with moderate to severe CAS, individual therapy several times per week is often recommended in the early stages of treatment. As accuracy and consistency improve, the frequency and format of sessions can evolve.
The Targets Must Be Functional and Meaningful
Words and phrases used in therapy should be functional for the child's real life. A child who is motivated to say "more," "mama," "go," or the name of a favorite toy is going to engage more deeply with practice than a child drilling sounds in isolation with no meaningful context. Great CAS therapy starts with what the child wants to communicate and builds from there.
Multisensory Cueing Is a Core Tool
Children with CAS benefit from cues that engage multiple senses at once. This means combining what they see, what they hear, and what they feel as they attempt to produce speech. A skilled SLP might use visual cues like pictures or cue cards, tactile cues like gentle touch to guide awareness of where sounds are produced, auditory models of the target, and verbal instructions all working together to help the child's motor system find the right pattern.
This is precisely why high quality visual tools like the Bjorem Speech Sound Cues were developed: to give children a clear, consistent visual anchor for each sound, supporting the motor learning process session after session.
Oral Motor Exercises Alone Do Not Treat CAS
This is worth saying clearly because it is still misunderstood in some settings. Exercises that strengthen the muscles of the mouth, such as blowing bubbles, licking peanut butter, or doing tongue resistance exercises, do not address the motor planning deficit that characterizes CAS. The problem in CAS is not muscle weakness. Speech improves through practicing speech, not through non-speech mouth movements. A well-informed SLP will focus therapy time on actual speech production, not oral motor exercises.
Evidence Based Approaches Drive the Best Outcomes
Several specific treatment frameworks have been developed for CAS and are supported by research evidence. These include Dynamic Temporal and Tactile Cueing (DTTC), the Nuffield Dyspraxia Programme (NDP3), Rapid Syllable Transition Treatment (ReST), and Integrated Phonological Awareness Intervention. A specialist in CAS will be familiar with these frameworks and will choose or blend approaches based on your child's specific profile and needs.
What to Look for in an SLP Who Treats CAS
Because CAS requires a specialized approach, finding the right speech language pathologist matters. Here is what we recommend families look for and ask about:
Specific Experience with CAS
Speech language pathology is a broad field. Many excellent SLPs have limited experience with CAS specifically. Ask directly: how many children with CAS do they currently work with? What treatment approaches do they use for CAS? Have they received training in CAS beyond their graduate program?
Familiarity with Motor Learning Principles
An SLP who understands how motor learning applies to speech will structure sessions differently from one who does not. They will plan for a high volume of practice opportunities within each session, provide careful and strategic feedback, and think deliberately about how to build consistency over time.
Ongoing Professional Development
The research base for CAS has grown significantly in recent years. An SLP who is committed to their professional development will stay current with the literature and seek out specialized training. Organizations like Apraxia Kids offer training for SLPs, and events like the Apraxia Kids National Conference bring together leading researchers and clinicians.
Jennie Bjorem herself travels internationally to train SLPs in evidence based CAS assessment and treatment, because we believe that well-trained clinicians are one of the most important factors in a child's outcome.
Active Parent Involvement
A great CAS therapist will not ask you to sit in the waiting room and wait. They will involve you in the session, explain what they are doing and why, coach you in how to support practice at home, and treat you as a full partner in your child's progress. Parent involvement is not a nice bonus in CAS therapy. It is part of the treatment.
What a Speech Therapy Session for Apraxia Looks Like
If you have never been in a CAS therapy session, you might be picturing something very clinical. In reality, the best sessions for children with CAS are engaging, play-based, warm, and structured in ways that do not look like hard work from the outside even though a great deal of learning is happening.
A well-designed session for a child with CAS might include:
- A brief and predictable warm up that helps the child feel comfortable and ready to participate
- High repetitions of carefully chosen target words or phrases within a motivating activity or game
- Consistent multisensory cues: visual supports, tactile guidance, auditory models
- Strategic feedback from the SLP, calibrated to the child's level and moment of learning
- A wind down that feels positive and celebratory, ending the session on a note of connection and success
- A brief check-in with you as the parent or caregiver, sharing what was worked on and how to carry it into the week
The specific targets, activities, and cueing strategies will vary based on the child's age, severity, personality, and stage of therapy. What stays consistent is the commitment to meaningful practice, careful observation, and genuine connection between the child and the clinician.
How to Support Your Child Between Sessions
One of the most powerful things a parent or caregiver can do is bridge the gap between therapy sessions. Research consistently shows that children who practice between sessions make faster progress than those whose learning stays only inside the therapy room. And for children with CAS, frequency of practice is especially important.
Here is how to support your child at home in a way that helps without creating pressure:
Practice Little and Often
Short, frequent practice opportunities scattered throughout the day are far more effective than one long drill session. Five minutes at breakfast, a few repetitions during bath time, a quick round of targets in the car: these moments add up significantly over the course of a week.
Follow the SLP's Lead on Targets
Ask your child's therapist which specific words or phrases to practice at home, and stick to those targets. Practicing the right things consistently is more valuable than practicing a wide range of random words. Your child's SLP has chosen targets deliberately based on where your child is in their motor learning progression.
Keep It Positive
Your energy in practice matters. Children with CAS often know exactly what they want to say and feel deep frustration when their speech does not come out the way they intended. Home practice should feel supportive, patient, and low pressure. Celebrate approximations, not just perfect productions. Progress in CAS is not linear, and every honest attempt is worth acknowledging.
Use Visual Supports
Many families find that the same visual tools used in therapy can help at home. The Bjorem Speech Sound Cues, for example, give children a consistent visual anchor they can reference independently, which helps generalize what they are learning in sessions to everyday communication.
Read Together Every Day
Reading aloud to your child, and eventually with your child, builds language, phonological awareness, and vocabulary in ways that directly support communication development. Children with CAS benefit enormously from rich language environments, even if they cannot yet produce all the words they understand.
How Bjorem Speech Supports Children with Apraxia and the Families Who Love Them
At Bjorem Speech, our connection to CAS is not incidental. It is foundational.
Jennie Bjorem built this company because she wanted other SLPs to have access to the tools she had developed and refined through years of working directly with children with childhood apraxia of speech. What started with stickers on sticks in a kitchen pantry has grown into a globally recognized set of resources trusted by SLPs, school districts, and families in countries around the world.
Every tool we make for CAS reflects the same principles that drive best practice in the field: motor learning, multisensory cueing, functional targets, and meaningful repetition.
Bjorem Speech Sound Cues
The most widely used cue card system in the field, the Bjorem Speech Sound Cue Cards give children a visual and tactile reference point for each sound in the English language. Used consistently across home and therapy settings, they help build the kind of stable, reliable motor patterns that CAS therapy is designed to develop. SLPs use them in DTTC, NDP3, and other evidence aligned approaches.
CAS Focused Tools and Curricula
We offer resources designed specifically for the motor learning needs of children with CAS, including syllable and word level practice materials, sequencing tools, and resources that progress through the complexity hierarchy that evidence-based CAS treatment follows. These materials are built to support the work of trained SLPs and to give families the tools they need to practice effectively at home.
Training and Community
Through the Bjorem and Bolles Apraxia Education Initiative, our nonprofit partnership, we support the training of speech language pathologists around the world in evidence-based CAS assessment and treatment. Because we believe that every child with CAS deserves access to a clinician who truly knows how to help them.
Check out our FREE BnB therapist network for therapists that have experience in assessing, diagnosing, and treating CAS.
A Note for Families Who Are Just Getting Started
We know this road can feel long, especially at the beginning. CAS is complex, and the journey toward clear, confident communication takes real time and real commitment. There will be sessions that feel harder than others. There will be weeks when progress feels slow. That is normal, and it does not mean your child is not capable of getting there.
What the research tells us, and what years of clinical experience confirm, is that children with CAS who receive frequent, specialized, evidence based therapy from a knowledgeable SLP and who have engaged, supportive families practicing with them at home make meaningful progress. Their voices develop. Their confidence grows. Their ability to connect with the world around them expands.
That is what this work is for. That is what every tool we create is designed to support. And that is what your child is absolutely capable of.
You are not alone in this. There is a whole community of SLPs, families, researchers, and advocates who care deeply about children with CAS and are working every day to make sure they have what they need. We are proud to be part of that community, and we are glad you found us.
Explore Our Resources for Childhood Apraxia of Speech
Whether you are an SLP building your CAS toolkit, a parent looking for home practice materials, or a family who is just beginning to learn what CAS means for your child, Bjorem Speech has resources designed with you in mind.
