Multisyllabic Words in Apraxia Speech Therapy
Updated: Aug 25
In this article we will discuss:
What is Childhood Apraxia of Speech?
Childhood apraxia of speech (CAS) is a neurological speech disorder. Children with CAS have difficulties positioning their tongue, lips, and jaw to make intelligible speech sounds. It affects the part of the brain that controls motor planning which results in difficulty programming and planning speech movements.
The child’s speech is difficult to understand due to trouble putting speech sounds together. Longer phrases, sentences, or words are even more difficult for the child to say. This is because of the additional motor planning required which causes more errors. In addition, the child may be able to produce a sound or word correctly one time. However, they are not able to say it correctly the next time.
Children with CAS can benefit from speech therapy
Speech characteristics of childhood apraxia of speech
Just like any other speech sound disorder, children with CAS have criteria. The characteristics that can be evident that may be present include:
Inconsistent errors on consonants and vowels in repeated productions of syllables or words. This means that a child produces the same sound in a word differently (i.e. “op” for “pop”).
Lengthened and disrupted co-articulatory transitions between sounds and syllables. A child produces choppy or disconnected speech due to trouble transitioning between sounds or words.
Inappropriate prosody, especially in the realization of lexical or phrasal stress. A child may sound robotic, have incorrect phrasing, or stress the wrong words or syllables.
Increased errors with utterance length and/or complexity. Children with childhood apraxia of speech may have a hard time producing longer sentences or multisyllabic words.
How can speech therapy help?
Childhood apraxia of speech requires specific evidence-based treatments that are unique to their specific needs. Therefore, a differential diagnosis between apraxia of speech and speech sound delays or disorders is crucial to ensure the best therapy solutions for each child. Consulting a qualified speech-language pathologist who has experience diagnosing or treating apraxia that will accurately assess a child’s speech and language abilities is a must!
If you are suspecting your child has childhood apraxia of speech, consult a speech-language pathologist for a formal diagnosis. A good differential diagnosis will lead to a better therapy plan and outcomes. For speech therapists, early intervention is key to maximizing your child’s potential. Apraxia of speech treatment can be very beneficial the earlier it starts!
Treatment for Children with Apraxia
Therapy for your child should be individualized to meet your child’s specific needs. However, there are some common features you should see in a child with CAS. Remember, if your child is just starting their therapy journey, their therapy might initially look like therapy for severe CAS. But they should progress to therapy for mild CAS as they make progress and their deficit in motor planning/programming decreases. Therapy for mild CAS usually includes the ff.:
Prosody includes the rhythm, rate, smoothness, and inflection of speech.
It is often disrupted for children with CAS. Their speech may seem “robotic” or lack emotion. Therefore, you should see this targeted in apraxia speech therapy early intervention. The speech-language pathologist will be helping your child say words, phrases, and sentences in lots of different ways. May it be as a question, with varying emotions, slower or quicker, or with different pauses. This can help them produce naturally sounding conversations and express their thoughts with emotions.
Multisyllabic words, or words that are three syllables or longer, are often difficult for children with childhood apraxia of speech.
When the speech-language pathologist is working on these words with your child, the goal should be for the words to be produced smoothly, at a normal rate and rhythm or stress – not choppy, monotone, or super slow. There are different tips & strategies to improve the production of multisyllabic words. These includes:
Clap out the syllables of words as you say them. Say them nice and slow so your child has time to clap with you. This gives them auditory and visual cues as to how many syllables they need to produce. It can also cue them to produce more syllables than one. It can also help them plan motor skills better.
Tap out syllables using body parts such as head, shoulders, knees, and toes. Touch a different body part for each syllable. Physical cues can help a child get physical feedback as to how to produce words and sentences.
Move a part of your body such as your head or shake an arm for each syllable.
Tap on a table, drum, or another item while producing words with multiple syllables. Again go slow so your child can hear the syllables and tap to them.
Use items with 3 – 4 dots on them for your child to touch while saying each syllable of the word. This strategy can also be used to decrease speaking rate, by tapping on a circle for each word in a sentence. A pacing board teaches a child to slow down and segment each syllable or word in a sentence.
Having your child sort items with your help can increase awareness and production of multisyllabic words. All you need is 3 or 4 baskets or buckets and random items with 2 – 4 syllables. Label each basket with 2, 3, or 4. Then provide your child an example. For instance, I found an airplane. The airplane has two syllables, this goes in the 2 buckets. Continue taking turns finding items and putting them in the bucket that represents the number of syllables.
Many children with CAS have expressive language deficits that affect their grammar.
As your child’s ability to motor plan for speech improves, they should be using longer and longer sentences. The SLP should be helping them to do this, including working on the right prosody so that your child’s speech sounds smooth and interesting (has normal inflection).
You should see your child working on language goals like using pronouns (such as she, he, it, her, him) or using past tense verbs (action words) correctly.
If your child is not yet producing all of their speech sounds (vowels and consonants) correctly, they should be learning a new movement to produce new sounds.
If you are suspecting your child has childhood apraxia of speech, don’t hesitate to chat with a professional. At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.
Frequently Asked Questions
Why are multisyllabic words so difficult for children with apraxia?
Apraxia of speech affects the brain's ability to plan and sequence the precise movements needed for speech. Longer words require more complex motor planning, which means more opportunities for errors. As syllable count increases, children with apraxia often struggle with stress patterns, sequencing, and consistency, making multisyllabic words a significant but important therapy target.
At what point in therapy should multisyllabic words be introduced?
Most speech-language pathologists introduce multisyllabic words gradually, after a child demonstrates some consistency with single and two-syllable words. The goal is to build motor patterns in a structured hierarchy. Rushing into longer words too soon can reinforce errors, so your child's therapist will guide the right timing based on their individual progress.
What techniques do therapists use to help with multisyllabic words in apraxia therapy?
Common strategies include repeated practice with high-frequency words, using rhythmic tapping or clapping to mark syllables, and applying the principles of Dynamic Temporal and Tactile Cueing (DTTC). Therapists also focus on correct stress placement, since apraxia often disrupts natural word rhythm. Practice should be consistent, frequent, and tailored to the child's current motor speech level.
How often should a child with apraxia practice multisyllabic words at home?
Short, frequent practice sessions are more effective than one long session per week. Aim for 10 to 15 minutes of focused practice daily using words your therapist has already introduced in sessions. Home practice reinforces the motor patterns being built in therapy. Ask your child's speech-language pathologist for a specific home program with target words and cueing strategies.
How can I find a qualified speech therapist who specializes in apraxia without waiting months for an appointment?
Finding specialized apraxia support quickly can feel overwhelming, but Better Speech connects families with licensed speech-language pathologists who have experience treating apraxia, including work on multisyllabic words. Better Speech offers online therapy with no waitlists and accepts most major insurance plans, so your child can start making progress sooner rather than later.
About the Author
Aycen Zambuto
I’m a seasoned educator in speech therapy with over six years of experience helping people navigate challenges in communication. Throughout this time, I’ve found joy in guiding individuals through a variety of therapeutic journeys, from toddlers with apraxia to seniors with dysphonia.
I’m passionate about demystifying this complex world of speech therapy and helping readers around the globe achieve clear and effective communication. When I’m not writing about speech, you’ll often find me reading, traveling or spending time with friends and family.
