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Question & Answer - Speech-Language Disorders and Treatment

How can parents help their children recover from Childhood Apraxia of Speech (CAS)?

Answer from Leslie Lindsay, RN, BSN of Chicago, IL

September 2013


Throughout human history--and long before--kids have been warming their parents’ hearts. They make them laugh, force them beyond their comfort zone, and give them a surge of pride. Yet, children can also confuse and baffle their parents. 

When my (2 ½ year old) daughter Kate was given the diagnosis of childhood apraxia of speech (CAS), I had little idea what that meant or how I might grow into a better parent from it. But, I did. Kate taught me many valuable lessons. Here are some things I learned to help my child with her speech problem and why they are important.

Leslie Lindsay, RN, BSN of Chicago, IL#1:  Imitation is hard for kids with CAS. We often ask our kids “Can you say what I say?” If imitation is hard for your child, try doing speech practice in unison (i.e., saying things together). Remember all of the chanting our grandparents did in school for memorization? Even singing the ABC song is a form unison practice. 

What Your Child Might Say: I like it when we sing songs and say words together. It’s fun, sometimes silly, and helps me feel confident. Plus, I think it’s cool when you teach me a new, grown-up word like “independent” or “gymnasium.” This is a lot more fun than repeating words and phrases like a parrot.

#2: Encourage your child repeat, repeat, repeat or practice, practice, practice when they can! Speech repetitions build strong motor programs. Practicing speech builds these programs. However, this needs to be done carefully with children who have difficulty repeating words and phrases. You might say, “Can you say that again, but no pressure if you can’t?” or “Let’s practice together.”

 What Your Child Might Say:  Patience is the key. If I don’t repeat the words you just said, don’t give up on me. I am new to this, and imitation is hard for me. I may need some time to develop the motor program (the sequence of movements needed to form words) to repeat or practice words. Practicing together can really help.

#3: Slow down your own speech. Your child is learning new speech motor programs. We often speak much faster than we realize. When you slow your own speaking rate, your child has a chance to process what you are saying. Children often try to match their parent’s speaking rate, but children with CAS don’t have the skills for this. Speaking slowly lengthens vowel sounds and increases speech intelligibility. There are even things like pacing boards or other pacing methods that can help you and your child slow your speech down. Talk to your child’s speech-language pathologist about this.

What Your Child Might Say:  I like it when you speak more slowly to me because it helps me listen to and understand what you are saying. Just don’t slow down too much, or you will sound weird!

#4: Provide lots of opportunities throughout the day to get your child to talk or vocalize—about anything. Help your child see that communication is indeed a fun part of life. Children are more likely to respond to statements than questions. Questions can be intimidating and increase pressure. Just be sure you give your child time to respond. Here are some examples of statements: You look happy. I bet you had fun at school today. Wow, that dog is really big!

What Your Child Might Say: It’s great that you want to talk with me and help me speak, but sometimes I get tired. Sometimes I just want to be quiet. Give me some down time, too. And most of all—don’t make me perform in front of Grandma and Grandpa or the neighbors. I’m still pretty self-conscious about my speaking abilities—or lack thereof. 

#5: Be goofy and funny. If you are relaxed and your kiddo is relaxed, words will come easier. Ask nonsensical questions or make nonsensical statements to elicit a response. Give silly options for answers. Here are examples: Is that a pink dog? Look at that pink dog! No, I think that is a green dog.

What Your Child Might Say: It’s good to chill-out with mom and dad. You take things too seriously sometimes. I love when we laugh together. We should do it more often. 

#6: Make talking and speech practice more about your lifestyle and less about “sit and speak” time. Work your child’s speech practice into your daily routines (e.g., snack time, mealtime, bedtime, car rides but don’t get distracted while driving). When you do spend some structured time on speech practice, keep it to 5 to 10 minutes at a time.

What Your Child Might Say: I spend a lot of time in speech therapy and school. If you make me sit at the dining room table (for a long time) to go over speech words, I might scream. If you make speech fun and useful then I just might go along with you. 

#7: The more talking feels like work, the less willing your kiddo will be to do it. Nobody likes to do things that feel hard for them, particularly under pressure. Speech development should not be hard work for children; however, children with CAS need to “work at it.”

What Your Child Might Say:  When you are worried and anxious about my talking, I feel it too. That doesn’t do either of us any good. Don’t make me work for my snack, or something else I want. If I can’t say it perfectly, don’t get stressed out; but do encourage me. You’ll know when I’ve had enough. 

#8:  You are mom or dad first. You do not need to become your child’s speech-language pathologist (SLP). Kids are smart. They will know what you’re up to and won’t participate if you act too much like their SLP. 

What Your Child Might Say: I totally get that you want me to talk more. But, I want time to just be your little girl or boy. I might really like my SLP, but mom and dad, YOU are the center of my universe!!!!!!


Leslie Lindsay was a child/adolescent psychiatric R.N. at the Mayo Clinic. Her daughter Kate is a bright and creative 2nd grader recovering from childhood apraxia of speech (CAS). It is because of her that Leslie wrote the first book designed for parents on this complex neurologically-based motor speech disorder. Speaking of Apraxia: A Parent’s Guide to Childhood Apraxia of Speech (Woodbine House, 2012) was as much a labor of love as it is a resource to help others along their apraxia journey. Leslie lives in Chicagoland with her husband, two daughters, and a basset hound where she writes full-time. Follow her blog, “Practical Parenting with a Twist” on which she writes 5 times per week about apraxia, education, parenting, and the writer’s life. “Like” her Facebook Page at Follow her on Twitter at @LeslieLindsay1.