🌟 Why Not Every Speech and Language Therapist is a CAS Expert - and what to do in the interim

Understanding CAS

Childhood Apraxia of Speech (CAS) is a rare motor speech disorder where the brain has difficulty planning and coordinating the movements needed for speech. This isn’t about weak muscles — it’s about the planning signals from the brain to the mouth not being sent or sequenced in the right way.

Children with CAS often know what they want to say, but producing the words can be frustratingly hard. You might notice:

• Inconsistent speech errors (the same word sounds different each time)
• Difficulty moving smoothly from one sound or syllable to another
• “Groping” mouth movements as they try to find the right shape for a sound
• Better understanding of language than ability to speak it

Why CAS Expertise Isn’t Standard for All SLTs

Speech and Language Therapists (SLTs) train at university to assess and treat a wide variety of communication needs — from speech sound disorders and language delays to stammering, voice problems, and feeding difficulties.

CAS is covered during training, but because it’s relatively rare (about 1–2 in every 1,000 children), it’s only a small part of the curriculum.

Becoming confident with CAS requires specialist training after qualification. This might include:

• Attending CAS-specific workshops and certification courses
• Learning evidence-based therapy approaches like DTTC, ReST, or NDP3
• Working under the guidance of an experienced CAS clinician
• Keeping up with the latest research and therapy techniques

For this reason, some SLTs may have limited experience with CAS — and that’s okay. It doesn’t make them any less skilled in their other areas of expertise. It just means that CAS is a specialist area, much like how in medicine, a GP might refer you to a cardiologist for a heart condition.

What This Means for Parents

If you suspect your child may have CAS:

• Ask your SLT about their experience with CAS.
• Seek a second opinion or referral to a specialist if needed.
• Don’t panic if you’re placed on a waiting list — there’s still a lot you can do at home to support your child’s communication.

🏡 At-Home Tips While Waiting for a CAS Specialist

While only a trained SLT can deliver targeted CAS therapy, there are gentle, supportive things you can do at home to help your child’s speech confidence and keep communication flowing.

1. Focus on Communication, Not Perfection

• Respond to what your child means, not how clearly they say it.
• Use gestures, facial expressions, and pictures to help get their message across.

2. Model, Don’t Pressure

• If your child says “tat” for “cat,” simply repeat back the correct word in a warm, natural way: “Yes, a cat.”
• Avoid asking them to “say it again” multiple times — this can increase frustration.

3. Play With Sounds

• Sing nursery rhymes, use silly sounds, and exaggerate mouth movements.
• Try songs with repetitive patterns (“Row, Row, Row Your Boat”) so they can join in on predictable words or sounds.

4. Slow It Down

• Use a slower pace when you speak, pausing between words. This helps your child hear the sound patterns more clearly.

5. Read Together Daily

• Choose repetitive books (“Brown Bear, Brown Bear” or “Dear Zoo”) so your child can anticipate and attempt key words.
• Pause before the predictable word to give them a chance to try.

6. Keep It Fun

• Use toys, bubbles, and games to make sound practice playful, not work.
• Celebrate effort just as much as success.

The Bottom Line

CAS is a specialist area within speech therapy. While most SLTs know about it, diagnosing and treating it effectively often requires additional training and experience. If you’re on a waiting list for a CAS-specialist SLT, you’re not powerless — there’s so much you can do to keep your child engaged, confident, and communicative in the meantime.

And remember: you’re not just supporting speech, you’re building connection, trust, and resilience — and those are the foundations for everything else that follows. 💛