To Anna Kaka

This book is designed by Advait Bhat with Anisha Gejji.

Special Thanks to:

Saaket Agashe
Chinmay Parab
Aditya Behere
Prof. Anirudha Joshi
Vaishnavi Gejji
Adarsh Malviya
Rishabh Jain
Rohit Gupta
Sakshi Bhat
Makarand Bhat
Sonali Bhat
Milind Bhat
Jatin Parab
Flash Bhat
& Everyone who helped
Contents

About The Book 1

How To Use The Book 2
How Do We Speak 3
Meet The Speech Department 5
How Does The Department Of Speech Work 7
Speech Development Of A Child 9
What Is Childhood Apraxia Of Speech 11
What Happens When The Motor Planner
Is Not Developed? 13
What Have We Understood Till Now? 15
What Causes CAS? 16
How Does Therapy Work? 17
Home Training 18
Experts Say 19
Fin. 20
About The Book

You might have heard this disorder by many names.

Childhood Apraxia of Speech, Dyspraxia, Verbal Apraxia
or just Apraxia. For convinience we are going to use the
term ‘Childhood Apraxiaa of Speech’ or CAS while we try to
understand how speech works and how does this disorder
affect it. With proper therapy and regular home training,
CAS can be treated. In this book, we will try to understand
what does therapy and home training do and what are
some best practices to be followed while conducting home
training. Let’s dive right in!

1
How To Use This Book?

• Read this book with as much attention as possible. It is

going to be a great help in dealing with CAS provided
you pay proper attention to it.
• The advice provided in this book has been recommended
by experts all around the world and should be followed
for proper treatment.
• It is essential that you read this content patiently and
talk to your therapist regarding any doubt that you
may have about the material of this content as soon as
possible.
• It is essential that you follow this book in the order that it
is written.
• Every child is different and this book is giving you an
overall idea of the disorder.
• Before taking any steps, consult your therapist.

2
How Do We Speak?

Imagine you are enjoying a meal with your family; your

parents, in-laws, spouse, the bachha company. The menu
cards are placed on the table. You gaze through the menu
and the decisions are made. The elders want naan and roti
and the kids want pasta and noodles. The waiter comes to
you and you start giving your order…

But have your ever stopped and wondered how the

order in your mind reaches the waiter; how your brain
communicates?

Oh, its so simple,“Boss, aath naan, do paneer tikka masala, 2

dal fry aur ha baccho ke liye noodles”. That’s it right?

Now think about it. Your mouth and your tongue moved in
a very perfect manner to produce these sounds which were
meaningful words. As simple as it sounds there was a lot of
backstage drama involved in giving this order which was

3
 managed completely by your brain.
Your brain first had to put together the idea
of placing the order.

It then formed a meaningful sentence that

the waiter could understand. Your brain had
to consider the language to speak in, the
grammar of the language and a lot more.

Your brain has to then plan which muscles to

move to create the appropriate sounds and
pronunciations; the details of when to touch
your tongue to your teeth, when to just let it
be, need to be properly planned beforehand.

Then finally, muscles of the mouth follow

the exact plan to make the desired sounds.

Once this entire process is done, you can place your order
and finally enjoy your meal.

Now that we understand the very basics of how we talk, lets

meet the speech department of the brain and its employees.
All this information might have seemed too much at first,
however as you see the speech department at work everything
will soon be clear.

4
Meet the Speech Department !
The Thinker, The Linguist, The Motor Planner and The Mouth
Muscles. They form the speech department of the brain.
Whenever you feel the need of speaking, they are there to help.

Thinker

I am the mind. I think the things you want

to say. It all starts with me.

Linguist

I am the language expert here. I have

immense knowledge and understanding of
language. I decide the grammar, the form ,
the sounds and construct the sentences that
are to be spoken.

5
 Motor Planner

I am the perfectionist. They tell me what to

say, but I decide how to say it. I make of plan
what what the muscles have to do at what
point of time. I control the muscles. Without
me, they’d just relax.

Muscles

We are strong workers. It’s all about

teamwork for us. It’s us who do the real
‘talking’.

Now that we have met the speech department, lets see how
they work.
Lets say you want to communicate to someone that ‘you like
carrots’. How does does the speech department make that
happen?

Let’s find out...

(diagram on the next page.)

6
How Does The Department Of Speech Work?
If you want to communicate that you like carrots ...
Speech Development Of A Child

We just saw the speech department of the brain work at it’s

full force. But how did they get so good at what they do?

When all of us were born, all the employees of the speech

department of the brain were babies. But as we grew, these
employees, whom we just met, also grew. For most of us,
they became fully developed and well functioning adults by
the age of 7 years.
ie. It generally takes an average child to have fully developed speech
by the age of 7 years.

As the employees of the speech department grow, they obtain

new skills and get better at their job. Each of them is good
at their specific job only, hence, the speech department of the
brain can function properly only when all of them grow into
being fully developed adults.

Let’s see how they grow from being babies to fully developed adults.

9
the deveopment of the speech department as we grow

0 YEARS

7 YEARS

But, with some of us, one of the employees of the speech

department of the brain isn’t able to develop the way the
other employees do...

10
What Is Childhood Apraxia Of Speech?

childhood apraxia of speech or cas is a developmental

disorder where the brain’s motor planning centre is not as
developed as the other faculties. As a result, even if the child
affected by cas is able to think what to say,ww but as their
motor planner hasn’t grown yet, the muscles
of the mouth just do not know what to do...
The perfectionist planner that should have
existed in the child’s brain did not grow and
is just a baby!
The thinker and the linguist have absolutely
no idea that the perfectionist motor planner
is just a baby. They just keep doing their jobs
expecting everything to be perfect. The baby
motor planner however has no idea what
is going on! The muscles on the other hand
are expecting proper commands but all they
recieve is baby noises.

11
A lot of responsibility is shoved on this baby motor planner
and it is not able to keep up. He has to understand the
information that the linguist sends and then control all the
related muscles!! How can a baby motor planner possibly be
expected to make us talk properly?

12
What Happens When The Motor Planner Is Not Developed?
What Have We Understood Till Now?
Now that we understand how the speech department of the
brain is affected when the motor planner isn’t fully developed, let’s
look at some points to remember.

What is Childhood Apraxia of Speech?

• It is the inability to utilize motor planning to perform
movements necessary for speech during a child’s
language learning process.
• It is the brain’s inability to plan the actions that muscles
do in order to say a sentence.
• It is a disorder which can be treated with proper therapy
and regular training.

What is not Childhood Apraxia of Speech?

• It is not oral muscle weakness.
• It is not a lack of understanding in the child.
• It is not a fault in the nerves connecting the brain to the
mouth.
• It is not a structural problem in the brain.

These are few points to remember.They’ll help you to

communicate with others, what you have understood from
the speech department.

15
What Causes CAS?

The important thing to understand is that

you or you child haven’t ‘caused’ the disorder
in any way. Hence, blaming anyone for
the disorder is not only pointless, but also
counter-productive.

Scientits do not yet have a definitive

answer to the question ‘what causes
childhood apraxia of speech’. From what
we definitively know as yet, CAS is an
impairment in the motor planning abilities
of the brain and hence, the only productive
thing that one could do is to try and treat
this disorder intead of finding a cause.

It is found that CAS can be treated with proper therapy and

regular & consistant home training as instructed by the
therapist.

16
How Does Therapy Work?

As and when you progress with the therapy and do

regular home training, the motor planner grows into his
perfectionist self. With good training, the motor planner
picks up necessary skills required to become a fully
developed motor planner.

with therapy and home training

Consistent and focused effort is key for good development.

However, every child has a different pace of development,
hence, one should have patience and trust the therapist.

17
Home Training

You know your child the best. The therapist is only going
to show you the way. It is finally you, who has to become
your child’s therapist. Home Training is one of the most
important if not the most important thing that will help
your child develop their speech.
These are some important things you should remember while doing
home training:
1. Speech development is a slow process and requires
consistent efforts, hence, be patient.
2. It is important that you motivate your child to
communicate.
3. Follow the child’s pace but be consistant in the training.
4. It is important to do home training as many times the
therapist asks you to do it (eg. 4-5 times a day).
5. Focus on quality more than quantity.
eg. If the therapist asks you take make your child
practice 10 specific words, the therapist has asked you
to do so for a reason. Hence, make sure that your
child says only those 10 words properly.

18
Experts Say:
These are a few things that parents should knowafter reading this
book. Following this things would help in better development of the
child’s speech.

1. It is important to note that like every teacher or artist,

every therapist has their own unique style of therapy.
Thus, if we try to follow or consult more than one
therapists at a time, it is only going to confuse the child
and hinder their development.
2. Now that you understand how CAS works, it is
important that you ask the therapists questions and
understand why a certain exercise has to be done.
3. Be creative while making the child do the exercise> It
is okay to experiment if you know that the goal of the
exercise is fulfilled. IMP: Tell the therapist the next time
you meet them about the changes and before taking any
major actions consult the therapist.
4. The little things or subtleties that the therpist mentions
about the exercises are extremly important for the
speech development of the child (Ask your therapist why).

19
“The therapist is only going to
show you the way. It is you, who
has to walk with the child and
take them to the destinantion”

20
References
The information in this book was sourced from
apraxia-kids.org and wikipedia.org

Credits
Freepik.com