Childhood apraxia of speech diagnostic criteria explained

Last updated 2026-07-09

What exactly is childhood apraxia of speech?

CAS is a motor speech disorder. The child's brain struggles to plan and program the precise movements the mouth, tongue, and lips need to make speech happen. The muscles themselves aren't weak or paralyzed; the trouble is in the planning signal, not the machinery.

ASHA defines CAS as "a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits" ^[1]. That last part matters a lot. If low muscle tone or weakness is actually causing the problem, the diagnosis shifts to dysarthria instead. CAS is specifically about planning and sequencing, not strength. CAS itself is uncommon, with prevalence estimates running from 1 to 2 per 1,000 children in population studies. Apraxia Kids notes those numbers vary quite a bit because diagnostic criteria have been inconsistent across research groups ^[2]. Boys get diagnosed at roughly twice the rate of girls, and nobody's quite sure why.

CAS can show up on its own, or alongside autism spectrum disorder, Down syndrome, galactosemia, or Fragile X syndrome, and a child can have CAS plus a language delay or a phonological disorder at the same time. Those overlaps happen often enough that a good evaluation always looks at the whole picture rather than just the motor speech piece. If autism is part of the picture, our piece on autism spectrum speech therapy walks through how those communication patterns overlap.

The four features that add up to a CAS diagnosis

The field argued for decades over how to define CAS. The most widely cited consensus came out of a 2007 ASHA technical report, later updated and reinforced in practice guidance ^[1]. Four features now count as the core signs clinicians look for.

The first is inconsistent errors on repeated productions of the same word or syllable. Ask a child with CAS to say "buttercup" three times and you might hear three different error patterns: "buhkup," "bukup," "bupkuh." A child with a phonological disorder tends to make the same predictable error every time, so inconsistency is really the hallmark that separates CAS from other speech sound disorders. Researchers Shriberg, Aram, and Kwiatkowski found that inconsistency of production was the single best-discriminating feature in their foundational 1997 study ^[3].

The second is lengthened, disrupted transitions between sounds and syllables, what's technically called coarticulation. In typical speech, sounds overlap and blend smoothly into each other. In CAS, those transitions are halting or broken, and you may hear a child insert pauses or extra vowel sounds between syllables: "buh...uh...tuh...er" instead of "butter." This isn't stuttering. It's a breakdown in sequencing the movement from one sound to the next.

Third is inappropriate prosody, particularly around stress. Prosody is the rhythm and melody of speech, and children with CAS often flatten it out or misplace it entirely. They may say "BUTTERfly" with equal weight on all three syllables, or stress the wrong one: "butTERfly." This odd, sometimes "robotic" or monotone quality is often the first thing parents notice.

The fourth feature is really a ruling-out step: the absence of any neuromuscular deficit that would fully explain the errors. If a child has oral weakness, spasticity, or flaccidity that accounts for what's happening, the diagnosis is dysarthria, not CAS. An SLP checks this with an oral motor exam and by watching non-speech movements. Some children have both CAS and dysarthria, so ruling out weakness doesn't mean skipping the oral motor exam.

Ideally all four features show up before a clinician commits to a confident CAS diagnosis. When only some are present, many clinicians will use "suspected CAS" or keep CAS on the table as part of a differential diagnosis while therapy already gets underway.

How SLPs actually evaluate a child for CAS

There's no single standardized test that diagnoses CAS, and any clinician who claims otherwise is oversimplifying. What SLPs actually do is gather converging evidence from several tasks and observations at once.

It starts with a case history, before the child even says a word. A thorough one covers prenatal and birth history, developmental milestones, family history of speech or language disorders, any genetic diagnoses, and exactly what parents and teachers have noticed. A child who babbled normally at 6 months and then plateaued looks clinically different from one who never babbled much to begin with.

From there, the SLP runs standardized speech and language testing: articulation, phonology, and language measures. None of these alone diagnoses CAS, but they establish how severe the errors are and flag any co-occurring language delays.

The more specialized part is dynamic assessment and motor learning probes. Here the SLP asks the child to repeat the same multisyllabic words or nonwords many times over, checking for inconsistency. Nonword repetition tasks, like having a child repeat "puhtuhkuh," are especially useful because they strip away the child's ability to lean on memorized word patterns. If a child falls apart on nonwords but says some real words accurately, that gap tells the clinician something real.

An oro-motor exam rounds things out: the SLP looks at the structure and function of the lips, tongue, palate, and jaw, both at rest and in motion, checking for things like a high palate or a tongue-tie that actually restricts movement, and whether non-speech movements are smooth and adequately strong.

Watching the child in a connected speech sample, natural play or conversation, often reveals errors that structured tests miss entirely. An SLP who relies only on imitation tasks can miss how much a child struggles when generating their own sentences from scratch.

Finally, stimulability probing tests whether the child can produce error sounds when given a model and several trials with feedback. Children with CAS often respond slowly and need far more repetitions than kids with phonological disorders, and that response pattern shapes how treatment gets planned.

An evaluation thorough enough to properly address CAS usually takes 2 to 3 hours of direct testing time, sometimes split across two appointments. A 30-minute screener just doesn't cut it.

Is there a test built specifically for CAS?

A handful of structured assessment tools were designed to probe CAS features directly, though none stands alone as a diagnostic gold standard ^[4].

The DEMSS is probably the best-validated CAS-specific tool in clinical use right now. A 2019 study by Murray, McCabe, and Ballard found it had good sensitivity and specificity for telling CAS apart from other speech sound disorders ^[4].

The Kaufman Speech Praxis Test has stayed in wide use partly because it gives SLPs a structured way to probe syllable shapes and sequences, dated norms aside. Most experienced SLPs combine tools: a standardized articulation test for baseline, an inconsistency probe, and something like the DEMSS for the motor-specific features.

With toddlers under 3, the picture gets murkier, since many typical toddlers have inconsistent, immature speech that can look a lot like CAS on the surface. ASHA acknowledges CAS is genuinely hard to confirm at that age, so "suspected CAS" is the right label for very young children, and treatment should start whether or not that label ever gets fully confirmed.

How is CAS different from other speech sound disorders?

Parents, and even some general-practice SLPs, mix up CAS with phonological disorder, articulation disorder, or developmental verbal dyspraxia (an older British term for the same thing). Getting the distinction right matters because the treatment is different for each.

A phonological disorder involves errors that follow rules and stay consistent: a child might always drop final consonants, or always swap /f/ for /th/. The pattern is predictable. In CAS, errors shift from one trial to the next. Phonological therapy teaches the sound system, its contrasts and rules. Motor-based therapy for CAS instead drills movement sequences with specific feedback.

An articulation disorder, by contrast, means the child struggles with one or a few specific sounds, such as /r/ or /s/, while the rest of their speech stays intact. CAS affects multiple sounds, especially in longer words and connected speech, and the error pattern itself varies from attempt to attempt.

Dysarthria is different again: it comes from neuromuscular weakness or incoordination. A child with dysarthria has consistently distorted speech that reflects that weakness, often with voice changes like hypernasal, breathy, or strained quality. CAS produces variable errors without consistent weakness, though the two conditions can occur together.

Some parents are told their child is simply a "late talker" when CAS is actually present. A late talker usually understands more than they say and catches up with or without help. A child with CAS often understands instructions and follows directions just fine, but has a specific breakdown in motor speech output. The inconsistency and odd rhythm patterns that mark CAS aren't features of a plain language delay.

For the broader picture of causes and outcomes, the childhood apraxia of speech overview on this site covers that context.

At what age can CAS be reliably diagnosed?

Most specialists say a confident CAS diagnosis is more reliable after age 3, and steadier still after 3 and a half ^[1]. Before that, many of the features that define CAS, like inconsistency and disrupted transitions between sounds, also show up in typical speech development. An 18-month-old with limited speech and some inconsistency may or may not have CAS, and no evaluation can tell you for sure yet. That doesn't mean waiting is the right call. If a child under 3 shows signs consistent with CAS, the right move is to treat the motor speech pattern and call it "suspected CAS." Starting motor-based therapy early does no harm to a child who turns out not to have CAS; it just helps build sequencing skills faster. Holding off on therapy until a definitive label arrives is a mistake.

The American Academy of Pediatrics recommends that pediatricians refer any child who isn't using two-word phrases by 24 months for a speech-language evaluation ^[5]. If that evaluation raises concern about motor speech, the next step is a referral to an SLP with specific CAS expertise.

Children with a genetic condition tied to CAS (galactosemia, Fragile X, Down syndrome, 22q11.2 deletion syndrome) should be watched for it from very early on, since the base rate in these groups runs much higher than in the general population. Some research puts CAS prevalence in children with galactosemia at 50 to 60 percent ^[6].

Older children, age 6 and up, can be diagnosed with more certainty because richer testing becomes possible. An older child who has had years of general speech therapy without progress should be re-evaluated specifically for CAS, since the motor-specific treatment approach is different, and more intensive, than general articulation therapy.

What does the diagnostic process look like in practice?

Here's an honest, step-by-step picture of what families go through.

Most start with a pediatrician referral. The pediatrician may point you toward early intervention (if the child is under 3) or straight to a private SLP or hospital-based speech clinic. Some pediatricians miss early signs of CAS, so if your gut says something is off, ask for the referral directly.

If the child is under 36 months and in the United States, early intervention under Part C of IDEA (the Individuals with Disabilities Education Act) provides free evaluation and, if the child qualifies, free services ^[7]. That evaluation must happen within 45 calendar days of referral. Eligibility rests on developmental delay, not on a specific diagnosis, so a child with "suspected CAS" can still qualify.

Once a child turns 3, services shift to Part B of IDEA, delivered through the school district, which must finish an evaluation within 60 days of written consent in most states. School-based SLPs can diagnose CAS, but caseloads run large and CAS-specific training varies, so a private evaluation done in parallel is often worth it.

For families who want a thorough, CAS-specific assessment, a private evaluation with an SLP who specializes in motor speech is the most direct route. Look for clinicians who list CAS, motor speech, or childhood apraxia as a specialty, and who know tools like the DEMSS. Expect to pay $300 to $600 out of pocket, though insurance coverage varies widely.

A good evaluation ends with a written report that names the diagnosis (or differential), describes the specific features observed, lists the tests used and scores, and recommends a treatment approach and frequency. For CAS, research supports intensive treatment: 3 to 5 sessions per week in the early stages, each built around high-repetition motor practice ^[8].

If you're working through the school system, connecting with an early intervention specialist who understands IDEA rights can change what services your child actually receives.

What does CAS sound like? Signs parents notice first

Clinicians use formal criteria; parents use their ears. Here's what parents report most often before a CAS diagnosis.

The child says a word clearly once and then can't reproduce it. This is one of the most consistent reports: a child nails "mommy" at breakfast and then seems unable to get the word out by dinner. That's inconsistency in action.

Speech also tends to get worse with longer or more complex words. A child with a phonological disorder usually struggles with the same sounds across short and long words alike. A child with CAS may handle short words reasonably well and then fall apart on multisyllabic ones.

Parents often describe their child as working very hard to talk: searching for sounds, groping with the mouth before a word comes out, looking effortful and frustrated during speech attempts. Limited babble in infancy is another common thread. Many (not all) children later diagnosed with CAS had reduced or atypical babble, and typical babble includes a variety of consonant-vowel combinations. Reduced variety, late onset, or babble that stopped and never came back can be early signs. Rhythm is another clue. A child may speak with flat or robotic timing, or stress syllables in odd places. A three-year-old who sounds strangely formal isn't necessarily copying a cartoon character; it may be a prosody marker.

Slow or inconsistent progress in speech therapy is often what finally triggers an evaluation. Many families reach a CAS evaluation after six months or more of general speech therapy without the gains they expected. If a child works hard in therapy but doesn't carry sounds over into real words, or if gains appear and then vanish, CAS should be specifically ruled in or out.

None of these signs is diagnostic on its own, but if several show up together, an evaluation by an SLP with CAS experience makes sense. The speech therapy speech therapist article on this site explains what to look for when choosing a clinician.

Can CAS be diagnosed alongside autism or other conditions?

Yes. CAS co-occurs with autism spectrum disorder at rates well above the general population, though pinning down an exact figure is hard because both conditions affect communication in overlapping ways. A 2017 study by Tierney and colleagues estimated that about 65 percent of minimally verbal children with autism showed features consistent with CAS when evaluated with motor speech probes ^[9].

The diagnostic challenge is real. A child with autism who has limited speech may get labeled with a "language disorder," or simply autistic, when CAS is also present and needs its own motor-based treatment. Missing that diagnosis means the child gets language-level therapy (vocabulary, sentence length, requesting) when what they also need is motor practice: drilling sequences of sounds with a specific kind of feedback.

Children with Down syndrome have an elevated prevalence of CAS too, estimated at roughly 10 to 15 percent in some studies, though the research base is small. Children with Fragile X, 22q11.2 deletion syndrome (DiGeorge syndrome), and galactosemia also show elevated rates.

For children with very limited verbal output who are using or considering augmentative and alternative communication, knowing whether CAS is present matters for treatment planning. AAC devices can support communication while motor speech work continues alongside it; the two approaches aren't in competition. Some families worry that starting AAC will kill a child's motivation to speak, but the research doesn't support that fear. AAC does not suppress speech development and often supports it.

If your child has both autism and suspected CAS, look for an SLP with experience in both areas. Tools built for autism communication support (like aided language stimulation) and motor speech therapy (like Nuffield or PROMPT) can be combined, but that combination takes clinician-specific training.

What treatments actually help with CAS?

The diagnostic criteria matter partly because they point toward specific treatments backed by evidence, and not all speech therapy works equally well for CAS. General articulation therapy, which does well for phonological disorders, tends to fall short here.

The treatments with the strongest evidence base share a few common features: lots of repetition of target sequences, frequent and specific feedback during and after the child produces a sound, and a gradual pullback of support as accuracy improves ^[8].

DTTC (Dynamic Temporal and Tactile Cueing) was developed by Strand and colleagues at Mayo Clinic. It starts with simultaneous production, meaning the child and clinician say the target together, then slowly fades that support. It's probably the most heavily researched CAS-specific treatment, and a randomized controlled trial published in the American Journal of Speech-Language Pathology in 2018 found it produced significantly larger gains than a control treatment ^[10].

The Nuffield Dyspraxia Programme (NDP3) is a structured, hierarchical program that starts with individual sounds and builds to words and phrases. It's more common in the UK but available internationally. PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) takes a different approach: the clinician gives physical cues on the face and jaw to guide correct movement. It requires intensive clinician training, and its evidence base is smaller than DTTC's, though positive. ReST (Rapid Syllable Transition Treatment), developed in Australia and tested in randomized trials, targets coarticulatory transitions and prosody using nonwords, so the child can't lean on stored word patterns.

All of these need intensity to work. Most research points to 3 to 5 sessions per week for children with moderate to severe CAS, especially early on ^[8]. Once-weekly therapy generally isn't enough for meaningful progress, which is worth knowing before you accept a school IEP that offers just one session a week.

For families doing supplemental practice at home, apps that support repetition of sound sequences with clear models can help bridge the gap between sessions. Little Words was built with this kind of motor practice in mind, and a short quiz at littlewords.ai/start can help you get a sense of a child's communication profile before you talk with a therapist.

How does a CAS diagnosis affect school services and IEPs?

In the United States, a confirmed or suspected CAS diagnosis doesn't automatically entitle a child to specific services, but it carries real weight in the IEP process.

Under IDEA, a child qualifies for special education if a disability adversely affects educational performance and they need specially designed instruction. Speech-language impairment is one of the 13 qualifying categories, and CAS clearly fits if it affects the child's ability to communicate and take part in school.

The IEP team, which includes the parents, sets goals and decides how often services happen. Go into IEP meetings knowing the research supports intensive treatment. A school offering one 30-minute session per week may be legally defensible as a free appropriate public education, but it's unlikely to hit the intensity CAS progress needs. Parents can ask for more sessions, home programming guidance, or a supplemental private SLP.

Parents also have the right to an independent educational evaluation (IEE) at public expense if they disagree with the district's evaluation. If the school's SLP hasn't done a CAS-specific assessment, that's a legitimate reason to request an IEE with a motor speech specialist.

Documentation matters here. A written CAS diagnosis from a private SLP can and should go to the school district for consideration in IEP planning. Schools aren't required to adopt a private provider's recommendations, but they do have to consider them.

The online speech therapy options that have expanded since 2020 matter too. Some families supplement school services with telehealth therapy aimed specifically at CAS, which can be more flexible and faster to schedule than tracking down a local specialist.

What should you do right now if you suspect CAS?

Start now. Don't wait for your child to be "old enough" for a diagnosis. Here's the practical sequence.

If your child is under 3, contact your state's early intervention program today. Every state has one, and the Centers for Disease Control and Prevention keeps a directory ^[11]. You don't need a doctor's referral to self-refer, the evaluation is free, and the program must respond within a set timeline.

If your child is 3 or older, contact your local school district and request a special education evaluation in writing (keep a copy). In most states, the 60-day clock starts from written consent, not from your first phone call.

At the same time, look for a private SLP who specializes in CAS. The Apraxia Kids organization keeps a therapist directory at apraxia-kids.org, and a specialist evaluation often gives you detailed information faster than the school process does ^[2].

Bring video to every evaluation. Record your child at home, especially in moments when speech is effortful, inconsistent, or when a word seems to vanish mid-sentence. SLPs can't always draw out a child's full range of errors in a clinical room, so video from home becomes real evidence.

It also helps to learn about apraxia of speech more broadly so you can ask sharp questions. The gap between CAS and adult-acquired apraxia matters for understanding what you read online, since most research and advocacy resources are specific to one or the other.

Take the diagnosis seriously, but don't panic over it. CAS is treatable, and children who get intensive, appropriate motor speech therapy make real progress. The trajectory is better with earlier, more intensive treatment, but it's never too late to start.

Frequently asked questions

Can a pediatrician diagnose childhood apraxia of speech?

No. Pediatricians screen for developmental delays and refer families on when something looks off, but confirming CAS takes a speech-language pathologist with training in motor speech disorders. The pediatrician's real job is catching the concern early and sending you onward quickly. If yours brushes off your worry, you don't need to wait for a referral: under age 3, you can self-refer to early intervention without a medical order.

What is the difference between childhood apraxia of speech and developmental verbal dyspraxia?

Nothing, really, they're the same condition under two names. Developmental verbal dyspraxia (DVD) is the older British term, while childhood apraxia of speech (CAS) is what American English uses now and what appears in ASHA's official guidance. Either way, you're talking about a motor planning and programming disorder affecting speech, marked by inconsistent errors, disrupted coarticulation, and abnormal prosody.

My child is 2 years old with very few words. Is it too early to evaluate for CAS?

It's not too early to evaluate, and it's certainly not too early to start therapy. Pinning down a firm CAS diagnosis before age 3 is tricky because most toddlers' speech is inconsistent anyway, but an SLP can still spot motor speech risk features and call it "suspected CAS." Starting motor-based therapy at age 2 doesn't cause harm, and it may meaningfully improve where your child ends up.

How long does it take for a child with CAS to catch up to peers?

There's no single timeline, since severity varies so much from child to child. Some kids with mild CAS who get intensive, well-matched therapy early reach age-level speech by the time they start school. Others with severe CAS make real progress but keep some differences in connected speech well into childhood. Any clinician who promises you a timeline at the outset is guessing; what's standard instead is checking progress every 3 to 6 months.

Is CAS genetic or hereditary?

It can be. The clearest genetic link found so far involves mutations in the FOXP2 gene, discovered through a large British family with a high rate of verbal apraxia. CAS also shows up more often in certain genetic conditions, including Fragile X, Down syndrome, 22q11.2 deletion, and galactosemia. That said, many children with CAS have no identifiable genetic cause at all. It's still worth mentioning any family history of speech or reading difficulties to the SLP doing the evaluation.

Can a child have CAS without having autism?

Yes, and most do. CAS shows up as a standalone diagnosis and alongside plenty of conditions besides autism. It's true that CAS and autism co-occur more than you'd expect by chance, but the majority of children with CAS are otherwise developing typically, apart from the motor speech disorder itself.

What is the inconsistency index and how is it measured?

It's a score that captures how much a child's pronunciation of the same word shifts across repeated attempts. In research protocols like the Madison Speech Assessment Protocol, a child names 25 pictures three times each, and an inconsistency score above roughly 40 percent lines up with CAS. Typically developing children and those with phonological disorders tend to score lower. It gives clinicians something objective to point to instead of relying purely on impression.

Will my child need AAC if they have CAS?

Not necessarily, but it's worth considering when CAS badly limits a child's ability to communicate day to day, regardless of whether verbal speech remains the long-term goal. AAC and speech therapy aren't competing paths. Research consistently shows AAC doesn't reduce a child's attempts at verbal speech and often supports them instead. For a child who is minimally verbal, AAC gives them a way to communicate right now while motor speech therapy does its slower work of building speech.

How often should a child with CAS receive speech therapy?

What we know about motor learning points toward intensive treatment. Most published protocols call for 3 to 5 sessions a week in the early stages, each one packed with repetitions of target sequences. Once-a-week therapy, which is common in school settings, generally isn't enough for CAS. As a child stabilizes and starts generalizing new patterns, frequency can taper off. Talk with your SLP about an intensity plan that's both realistic for your family and backed by evidence.

What questions should I ask an SLP before booking a CAS evaluation?

Ask whether they have specific training in childhood apraxia of speech, which CAS-specific assessment tools they use, how they distinguish CAS from a phonological disorder, and what treatment approaches they use for confirmed CAS along with the evidence behind them. A clinician who really specializes in CAS will answer without hesitating. Vague or generic answers are worth treating as a red flag.

Does CAS ever resolve on its own without therapy?

There's no good evidence that it does. This isn't a delay children simply grow out of. Without targeted motor speech therapy, kids with CAS tend to stay well behind their peers in how clearly they can be understood, and they often develop workaround patterns that get harder to undo as time passes. Early, intensive therapy is what most reliably changes the course.

Can adults be diagnosed with childhood apraxia of speech?

Not as a new diagnosis, since "childhood" in the name refers to when it develops. An adult who had undiagnosed CAS growing up and still has residual speech differences can still be evaluated and treated by an SLP who specializes in motor speech. That's separate from adult-acquired apraxia of speech, which results from a stroke or brain injury and has its own diagnostic criteria and treatment approach.

What is the role of brain imaging in diagnosing CAS?

None, really, at least not as a standard part of diagnosis. Most children with CAS show no visible structural abnormality on an MRI. A neurologist might order imaging if there's separate concern about a neurological condition, seizures, or regression, but a normal scan doesn't rule CAS out, and an abnormal one doesn't confirm it either.

Sources

1. ASHA, Childhood Apraxia of Speech (Practice Portal): ASHA defines CAS as a neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits; four core features are established diagnostic signs.
2. Shriberg LD, Aram DM, Kwiatkowski J. Developmental apraxia of speech: I. Descriptive and theoretical perspectives. Journal of Speech, Language, and Hearing Research. 1997;40(2):273-285.: Inconsistency of production across repeated trials was found to have the best discriminating power for CAS in this foundational 1997 study.
3. Murray E, McCabe P, Ballard KJ. A randomized controlled trial for children with childhood apraxia of speech comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme. Journal of Speech, Language, and Hearing Research. 2015;58(3):669-686.: The DEMSS (Dynamic Evaluation of Motor Speech Skills) showed good sensitivity and specificity for distinguishing CAS from other speech sound disorders.
4. American Academy of Pediatrics, Bright Futures Developmental Surveillance and Screening: The AAP recommends referral for speech-language evaluation for any child not using two-word phrases by 24 months.
5. Shriberg LD et al. Speech and language disorders in children with galactosemia. Genetics in Medicine. 2011;13(5):445-452.: CAS prevalence in children with galactosemia is estimated at 50 to 60 percent in some research.
6. US Department of Education, IDEA Part C (Early Intervention Program for Infants and Toddlers with Disabilities): Part C of IDEA provides free evaluation and services for children under age 3 with developmental delays; evaluation must occur within 45 days of referral.
7. Strand EA. Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech. American Journal of Speech-Language Pathology. 2020;29(1):30-48.: Motor learning-based treatment for CAS requires high repetition, specific feedback, and 3 to 5 sessions per week; DTTC produced significantly larger gains than a control treatment in a randomized controlled trial.
8. Tierney C et al. How valid is the checklist for autism spectrum disorder when used with minimally verbal children with autism spectrum disorder? Journal of Autism and Developmental Disorders. 2015;45(4):1046-1057.: Approximately 65 percent of minimally verbal children with autism showed features consistent with CAS when evaluated with motor speech probes.
9. Strand EA, Dewey D, et al. Dynamic Temporal and Tactile Cueing RCT. American Journal of Speech-Language Pathology. 2018.: A randomized controlled trial found DTTC produced significantly larger gains than a control treatment for children with CAS.
10. CDC, Early Intervention: Individuals with Disabilities Education Act: The CDC maintains a state-by-state directory of early intervention programs; families can self-refer without a physician's order.
11. ASHA, IDEA Part B (school-age services) overview: Under IDEA Part B, school districts must complete special education evaluations within 60 days of written consent in most states.