Age 0-3

The page contains specific information on young children who are minimally verbal or pre-verbal. Usually these are children who are beginning their apraxia journey and are newly diagnosed or in the process of being diagnosed. If your child is young and already saying and imitating words, you will also want to look at information on the 3-5 year old page.

What Should Speech Therapy/Diagnosis Look Like?

What Speech Sounds Like at This Age

Speech and language skills children should be doing between birth and 3 years of age and activities that can be done to encourage development in those areas from the American Speech-Language-Hearing Association (ASHA).


Dr. Megan Overby and colleagues completed research that provides red flags for children under 2 years of age that could indicate a higher risk for a child having CAS.


The information presented below describes addressing therapy needs for young minimally verbal children.

Home Practice

Because a speech therapist’s time with your child is limited, it is important that you know what you can do at home to support communication skill development.

Encouraging Communication at Home

What can be done at home to help?

How to Practice Communication In Daily Routines

Home routines are great!


Utilize this tool for communication across providers! SLPs or teachers can fill this out with therapy targets, spelling words, important updates, or anything else worth noting! Keep these organized in a binder for ease of communication about your child.

IEP Resources

When your child is 2-3 months from their 3rd birthday, plans need to be started for them to receive services through the local school district. If your child is being seen by your state early intervention (EI) program, EI staff will start talking with you and will guide you through the transition into your local school district. If you are not connected to an EI program, then you can contact your neighborhood elementary school and ask about getting your child tested for services. Some states have a “Child Find” program where they will hold screenings to identify children who need additional testing to determine eligibility for school based services. Services can include speech, occupational, and physical therapies as well as classroom based instruction in Pre-Kindergarten classes or in classrooms for children with disabilities. Click below to learn about the process for having an Individualized Education Plan (IEP) through the school district.

How Can You Support Your Child?

Develop Risk Takers

One of the biggest hurdles we face when teaching a child with apraxia to talk is convincing him/her to try. Children learn at a young age that failing doesn’t feel good. We want to change this thought as soon as possible because, much like learning to ride a bike, your child is going to have to “fall” a lot when learning to talk.

How to Make a Picture Communication Board

At this age, it is very important that you help establish a way for your child to communicate with you at home. This could be through a set of pictures on a communication board or put on the refrigerator that the child can point to in order to make requests or to tell you something. Parents can also choose to teach their child signs for everyday communication. These simple ways of communication can reduce the frustration that both child and parents feel when the child is not understood.

Picture Communication Boards
Here are some things to consider when you are creating your own communication boards for your apraxia star:

  • Pictures of foods/drinks they like and don’t like. They can use this picture to talk about these foods/drinks, request to put them on the shopping list, add what they like to their pizza, or even order in a restaurant
  • Pictures of their friends/teachers/activities/toys at school to talk about when they’re at home, if applicable • Pictures of family/extended family/pets to talk about (cousins, siblings…)
  • Pictures of things they like to do or places they like to go – even if they can’t go there right now, they can express it
  • Emotion pictures or emojis to let them tell you how they are feeling – mad, happy, bored, scared, hurt, sick, sleepy, hungry, etc.
  • Pictures of descriptions – funny, silly, yucky, yummy, pretty, big, small, colors, etc.
  • Pictures to use while playing games – my turn, your turn, wait, stop, yes, no

You can search online and print out pictures, take pictures with camera and print, have your child help draw/color pictures and you can glue them on file folders. Then put these in a small photo book you can find at the dollar store, or on index cards, and put them on a ring to make them last longer and keep them organized.

An Easy Way To Make Pictures
Most computers have a “photo” or “take picture” function (on the MAC it is control-shift-three) and it will take a picture of whatever is on your screen. You can then take the “picture” you took and manipulate / resize / add text or whatever in your graphics program. You can do this with any favorite computer programs that are running, take “pictures” of favorite cartoon characters on web sites, toys or games at your favorite toy website such as or or etc….it is a GREAT way to get pictures for a communication picture board.

More Information About Making Your Own Picture Boards
PrAACtical AAC
Do 2 Learn
Teachers Pay Teachers
PECS Communication Board System

Use of Sign Language

Sign Language Cautions and Suggestions

It is wonderful that you are open to sign language usage for your child. If done correctly, it can enhance your child’s verbal skills. One bit of advice is to never accept a sign alone without some form of vocalization, even if it is just a vowel sound. Too often, children are not required to use their voice with their signs and that is one thing that can lead to interferences with verbal gains. Parents have stated that and are two of the most useful and parent-friendly resources for learning sign language. Please remember that your therapist can be your guide about which signs to teach and reinforce. Often, the first signs taught are “please” and “thank you”. While we do want children to be polite, these are challenging words for our children with apraxia to say, and if our use of sign language is in part seen as a prompt for verbal speech, then early sign choices should be primarily words that can be targeted in therapy and are most likely to be mastered by the child to build confidence in saying words.

Apraxia Kids Sign Language Articles

Using Sign Language with Children Who Have Apraxia of Speech

Sign Language and/or Cueing to Facilitate Speech in Children with CAS

Additional Resources

Gallaudet University

Signing Savvy

Hand Speak

Sign Language 101

Signing Time


Keeping kids motivated and successful in speech therapy can be challenging at times. We may be asking kids with childhood apraxia of speech to do things that feel really hard or unsuccessful for them. Creating a positive learning environment, providing motivating activities, and making sure that kids experience success from the start are key pieces to keeping kids engaged and participating in treatment sessions. This article includes ideas to help keep your child engaged in speech therapy and how to manage refusals if they arise.

Listen to Dr. Ruth Stoeckel discuss rationale for selecting functional words as targets.

Other Family Members Can Support

When a child is first diagnosed with any special need, the parents or main caregiver is often overwhelmed and consumed with concerns, fears, and practical issues such as learning about or arranging for the correct type of help for the affected child. Supportive family and friends are so meaningful and needed! Below are an article and webinar that describe what family and friends can do to help.

Developmental, Academic, And Learning Challenges

Developmental skills

This resource has skills and ways to encourage development across all domains of learning from birth to 5 years of age from CDC.Gov.

Motor Skills 0-3 Years

Recorded on Monday, July 6, 2020
Presented by: Dr. Priscila Tamplain, Motor Neuroscience

Developmental Coordination Disorder (DCD) and Childhood Apraxia of Speech (CAS) are both motor disorders that can be explained by impaired planning and execution of voluntary movements. DCD is defined as poor motor proficiency in children. These motor impairments interfere with a wide variety of behaviors and skills, including academic achievement, daily living skills (such as dressing, tying shoelaces, and brushing teeth), and the ability to engage in sport and other motor activities. This session will define and explain DCD as a condition, its consequences and highlight findings from Dr. Tamplain’s preliminary study exploring the co-occurrence of DCD in children diagnosed with CAS.

Download Presentation Handouts Here.

Additional Resources
Article: Developmental Coordination Disorder – Resources

Comorbidity: Autism

Presented by: Molly Beiting, M.A. CCC-SLP, PhD candidate

Join an active researcher for a review of current research followed by practical information for diagnosing and treating children who have Autism Spectrum Disorder and CAS.

Download Presentation Handouts Here

Additional Resources

Comorbidity: Sensory Processing Disorder

Sensory processing disorder (SPD) can be a stand-alone diagnosis, but can also be a common comorbid diagnosis with CAS. Sensory processing disorder exists when sensory signals don’t get organized into appropriate responses and a child’s daily routines and activities can be disrupted as a result. Children with sensory differences often have atypical reactions to typical experiences – either by over-responding or under-responding to sensory input, or craving sensory input altogether. It’s a very diverse diagnosis and if it interferes with your kiddos daily life, an accurate diagnosis can lead to a helpful treatment plan.

Comorbidity: Epilepsy

Epilepsy is a neurological condition defined as recurrent seizures. A person can have one seizure (perhaps related to illness, fever, injury, etc.) and not necessarily be diagnosed with epilepsy. Being diagnosed with epilepsy means that your brain shows seizure activity often, which leads to recurrent seizures.


Links to Give to Your Child’s SLP

Apraxia Kids Professional Supports
slp kit parent portal

Books About Having CAS and Other Speech Disorders

Click below to view our list of children’s books about having CAS and other speech disorders and for socio-emotional health as well as books for parents and professionals about CAS.

Additional Downloadable and Printable Resources

Click on the resources below to download or order information that helps to explain CAS.

Available Services for Children with Disabilities

Most states have websites with information in that state on services available for parents of children with disabilities. The one below in Massachusetts provides parent training and information to help families with children with disabilities from birth to adulthood in the areas of education, transitions, and family engagement among others. Parents should search for sites in their state.

Federation for Children with Special Needs