Comorbidity and Childhood Apraxia of speech

According to Chenausky et al., 2023, comorbidity and severity in childhood apraxia of speech is highly prevalent. The purpose of the study was to investigate comorbidity prevalence and patterns in childhood apraxia of speech (CAS) and their relationship to severity. The researchers gathered and analyzed medical records for 375 children with Apraxia. The researchers found that 83 children children were classified with mild apraxia. 257 with severe Apraxia and only one child with no comorbidities (Chenausky et al., 2023). Over 95% of children had comorbid expressive language impairment. Children with comorbid intellectual disability (78.1%), receptive language impairment (72.5%), and nonspeech apraxia (37.3%; including limb, nonspeech oromotor, and oculomotor apraxia) were significantly more likely to have severe CAS than children without these comorbidities. However, children with comorbid autism spectrum disorder (33.6%) were no more likely to have severe CAS than children without autism.

The researchers concluded that comorbidity appears to be the rule, rather than the exception, for children with CAS. Comorbid intellectual disability, receptive language impairment, and nonspeech apraxia confer additional risk for more severe forms of CAS.

What does this mean? Children with a syndrome, diagnosis, disorder is at increased risk for undiagnosed Apraxia of speech.

If CAS involves the brain, does it show up on an MRI?

Childhood Apraxia of speech cannot be seen on a routine MRI.

MRI’s are used to indicate structural differences in the brain, such as an injury, stroke, tumor, or other visible abnormality. The differences involved in CAS are often much more subtle and may involve how different areas of the brain communicate and work together rather than something that can be seen on a standard brain scan.

For this reason, a normal MRI does not rule out CAS.

CAS is diagnosed by a speech-language pathologist based on careful assessment of a child’s speech characteristics and speech-motor skills, not by MRI findings.

(Once Upon a Time foundation 2026).