(Shriberg et al., 2003) found only a 55% agreement between clinicians on 35 speech
sounds in the differentiation between CAS and non-CAS groups. Furthermore, many children
with CAS have co-occuring disorders and different compensatory behaviors (Strand, 2001).
Despite the conflicting studies, there is a consensus among researchers that children with CAS
will show deficits in one or more of the following areas: nonspeech motor behaviors, motor
speech behaviors, metalinguistic awareness, language, prosody, and literacy.
Children with CAS exhibit a variety of characteristics depending on the stage of
development. Young children with the disorder may not babble or coo during infancy. These
children typically have delayed speech development
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Although all
children have difficulty with phonotactic speech errors, consonant harmony, and final consonant
deletion in the first 12–18 months of life, these issues persist past the age of 3 in children with
CAS (ASHA, n.d.).
Older children with CAS make inconsistent sound errors that are not due to immaturity. It
is common for children with CAS to display vowel distortions, initial consonant deletions,
consonant substitutions, and schwa additions to consonant clusters. Their expressive language
skills are significantly poorer than their receptive language skills. They also have difficulty
imitating speech and may appear to have difficulty with motor coordination when formulating
sounds. Children with CAS also have difficulty expressing themselves when anxious and
struggle more with longer phrases than shorter ones. Other possible characteristics of CAS
include groping behaviors, inappropriate prosody, word confusion, difficulty with word recall,
fine motor coordination and movement difficulty, hypersensitive or hyposensitive mouths, and
literacy issues. (ASHA, n.d.).
Assessment
Since the diagnostic criteria for CAS are not firmly established, the challenge