The Root Causes of Childhood Apraxia of Speech: Why They Matter and How to Find Them
- Tori Starling
- 5 minutes ago
- 9 min read
What Does “Root Cause” Really Mean?
When you first hear the diagnosis of Childhood Apraxia of Speech, overwhelm, confusion, and fear often sets in. Most parents are told the same thing: it’s a neurological motor speech disorder, the cause is unknown, and frequent, intense speech therapy is required.
But as a mom who has walked this road with my own child, I know there’s more to the story. The truth is, there is a root cause(s) for symptoms and there are reasons the brain isn’t coordinating speech the way it should.
I always say symptoms are like the check engine light coming on in your car. When this happens, do you put a piece of duct tape over the light, go a little slower, and hope for the best? Or, do you take your car into the mechanic to see what’s going on under the hood?
Finding the root cause means asking why the symptom is happening in the first place. And that question changes everything.
Why Root Causes Matter with Apraxia
Imagine a vase with a small crack. When you patch it without addressing why it cracked in the first place, you’re just covering up the symptom. The underlying structure is still weak, so pressure builds and new cracks eventually form. This is what happens when we ignore root causes.
Root causes matter because:
They affect the whole child, not just their speech.
Apraxia rarely exists alone. If we only treat speech, we miss the bigger picture.
By finding and addressing root causes, we can reduce the total burden on the brain and body, which may improve results in speech therapy.
Comorbid Conditions and Apraxia of Speech
According to the non-profit group Apraxia Kids, “Childhood Apraxia of Speech only occurs in roughly 1% of the population and more often than not, other issues are also diagnosed at some point including autism spectrum disorders, fine and gross motor difficulties, learning disorders, literacy difficulties, and hearing loss.” (1)
Building on that statement, a 2023 study analyzed 375 kids with Childhood Apraxia of Speech with an average age of four years and nine months old. Out of the 375, only one child had no comorbidities! The study states, “Comorbidity appears to be the rule, rather than the exception, for children with CAS.” (2)
A few interesting facts from this study are:
Average number of comorbid conditions was 8.4.
Average number of “communication-related comorbidities” was 5.6.
Top 4 common comorbidities: expressive language problems, receptive language delay, articulation deficit, and non-speech oral apraxia.
It was especially insightful that this study included seven pages of comorbidities. The numbers you see here are the numerical findings out of 375 children. Conditions that I found of interest from a holistic, whole child perspective were:
feeding difficulties (124)
vision problems (64)
ADHD (63)
tonsillectomy (42)
sleep disturbance (39)
behavior problems (38)
autism (32)
GI problems (29)
anxiety (22)
sleep apnea (12)
allergies (8)
dyslexia (8)
iron deficiency (7)
asthma (6)
Keep in mind, these are current conditions, not ones that may spring up in the future or ones they may have had in the past.
Imagine how much more comprehensive a treatment plan could be if all children with apraxia of speech were given a full work up that included their comprehensive symptoms and diagnoses.
For an even greater understanding of their condition, testing for things like nutritional deficiencies, food allergies and sensitivities, genetic vulnerabilities, impairments in detoxification, and total load could be exceptionally beneficial in determining root cause and putting together their whole body puzzle.
Lessons From History: When the Root Cause Was Missed
Looking back, there are examples of how medicine has misunderstood root causes:
1.) Pellagra: Once believed to be an infectious disease, it was later discovered that it was caused by a niacin (vitamin B3) deficiency due to a diet high in corn and not enough nutrients. Symptoms included diarrhea, dementia, skin issues (dermatitis), and in severe cases, depression, confusion, anxiety, and hallucinations.
The mental component of this condition often resulted in a diagnosis of insanity and admission into a mental asylum. Between 1906 and 1940, there were three million cases in America, with 100,000 of those resulting in death. By the 1950’s, the case of pellagra was solved, although it is sometimes seen today in malabsorption, alcoholism, and malnutrition. (3)
2.) Scurvy: For years, sailors died from what was thought to be a mysterious illness, when actually, they had a severe vitamin C deficiency. Symptoms included fatigue, bleeding gums, joint pain, slow-healing wounds, and heart problems. It was eventually discovered that giving the sailors lemons cured their symptoms. (4)
3.) Rickets: During the Industrial Revolution, this illness affected European children who spent most of their time indoors. It was later discovered that the symptoms of this illness like soft bones, bowed legs, bone pain, weak muscles, dental issues, and growth problems were caused from a vitamin D deficiency. (5)
My Son’s Apraxia of Speech Root Causes
When I began this journey with my son’s apraxia, I quickly realized speech therapy was necessary, but it was not enough. His progress was slow, and he had other symptoms that didn’t make sense. Once I started supporting his root causes, things shifted. Yes, his speech improved, but so did everything else. His physical symptoms and sensory issues slowly faded away, and his ability to learn clicked into place. Addressing root causes gave him a stronger foundation to build on. It’s also been beneficial to understand his vulnerabilities as he’s continued to grow and develop.
Our integrative MD gave my son the following root cause diagnoses for his apraxia of speech:
Nutritional Deficiencies: Testing showed that he was low in vitamins A, C, E, B2, B6, B7, B9, B12, CoQ10, magnesium, and zinc. All of these are essential for brain and nervous system health.
Antioxidant Deficiencies: Since he didn’t have antioxidants to neutralize his out-of-control free radicals, oxidative stress resulted.This caused inflammation, and mitochondrial damage and dysfunction.
Poor Methylation: Genetic vulnerabilities, high total load, and a host of other problems led to a body that wasn’t detoxing well.
Fat Deficiency and Trouble Metabolizing Fats: Not only was he deficient in healthy fats, but his body was having a hard time breaking down and processing fats. This was a massive problem because essential fatty acids and other healthy fats are vital for brain health.
His deficiency of fat-soluble vitamin E fits in here as well. Some of the symptoms of E deficiency that made sense in regards to his apraxia of speech were: muscle weakness, oxidative stress, coordination problems, and nerves not transmitting signals correctly. Fat malabsorption and lack of pancreatic enzymes are possible causes of this deficiency.
Poor Gut Health: Allergies, gluten and dairy sensitivities, and leaky gut created all sorts of problems. Because the gut is integral for the health of the body, when it’s not working well, every system—including the brain and speech—can be affected. Gut issues can also lead to problems with nutrient absorption and assimilation.
The Energetic Body
One piece that often gets overlooked in the conversation about root causes is the energetic body. Just as electricity powers your home, the body’s energetic system powers its biological functions. Energy flows along the internal meridian network and sometimes blockages can occur. Just like a traffic jam on the highway, when the road is closed and traffic is detoured. These blockages and imbalances in energy can cause the body to struggle to function at its best.
Let’s look at the 2015 study, “Clinical study of post-stroke apraxia treated with scalp electric acupuncture.” A total of 60 adults with post-stroke apraxia of speech participated and they were divided into two groups of 30. One group received speech rehab only, and the other group received speech rehab plus scalp electric acupuncture. After four weeks of treatment, for those who only had speech rehab, 16 out of 30 improved. For those who had speech rehab and acupuncture, 30 out of 30 improved.
The conclusion of the study states, “The scalp electrical acupuncture combined with speech rehab training obviously improves speech apraxia in stroke patients so that the speech disorder can be relieved. The efficacy is better than that in simple rehabilitation training.” (7)
When my son was younger, I added acupuncture into his care plan—not as a replacement for nutrition, therapy, or medical support, but as another layer to tackle apraxia from all angles.
As a side note, I’ve spent the past ten years looking for an energy medicine modality that checks all my boxes. I wanted to find something that was easy, pain-free, accurate, affordable, and accessible from anywhere in the United States. I decided on Energy4Life’s Bioenergetics Wellness System, which is designed to uncover and address energetic imbalances. I look forward to exploring the possibilities of this type of technology with the apraxia kids.
How to Determine What Your Child’s Unique Root Causes Are
Root causes reveal themselves through a mix of detective work, observation, intuition, and testing. Some of the ways to uncover them include:
1.) Symptoms: Physical symptoms are clues that help you understand what is going on in the body. This includes things like: eczema, constipation, diarrhea, stomach aches, ear infections, dark circles under the eyes, low muscle tone, food reactions, asthma, sensory issues, fatigue, mood swings, trouble sleeping, coordination issues, and more.
2.) Total Load Assessment: Picture your child’s body as a bucket and when the bucket is full of stressors, symptoms occur. Things that fill up a child’s bucket include: processed food, sweets, eating foods they are allergic or sensitive to, pesticides, antibiotics, medications, chemical-laden household & personal care products, heavy screen time, emotional stressors, and more.
3.) Medical History: Birth trauma, frequent sickness, antibiotic use, pharmaceuticals or supplements that the mother took during pregnancy and at delivery, are a few examples of puzzle pieces here.
4.) Major Stress Events: Severe illness, surgery, mold exposure, vaccine reactions, or family crisis are examples of things that can trigger symptoms in children already vulnerable.
5.) Lab Testing: Gut microbiome testing, nutritional deficiency testing, Organic Acids Test (OAT), and basic lab work can provide concrete data about what’s going on inside your child’s body.
6.) Genetic Testing: This is useful for insight into MTHFR, food allergies and sensitivities, and other genetic markers associated with some cases of apraxia.
In Closing
There is no one-size-fits-all path for this unique speech disorder that ranges from mild to severe communication challenges and symptoms.
It’s also important to keep in mind that sometimes root cause(s) can be identified, but if the symptom burden is too high and the underlying pathology runs deep, it may be harder— or even impossible—to erase every challenge. In these cases, the goal is progress, not perfection.
Root cause work isn’t a magic pill and it’s not an overnight solution. But it is powerful because it addresses the why, not just the what.
Consider this analogy: If a fish is swimming in a dirty tank and gets sick, what would do? Would you give the fish medicine or try to nurse it back to health? Or, would you first try to change the water to see if that would make a difference? Root cause is about changing the water.
Addressing apraxia’s root causes supports not only today’s speech issues, but also other symptoms and future potential health challenges. It’s about looking at the whole child, and creating the healthiest possible foundation for the brain and body function at its best.
When I work with a mom, I get a full list of symptoms that the child has experienced in the past plus ones they currently have. The purpose is to track before and after results, and also to give me clues as to what’s going on inside of the body. In other words, the “symptom” is not the focus; “root cause” is the focus.
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If you enjoyed reading or listening to this, subscribe to the blog so you don’t miss next month’s article: “Digging Deeper Into Root Causes: Medical and Stress Triggers for Childhood Apraxia of Speech.” This will be a deeper dive into the medical history and stress events noted in the section, “How to Determine What Your Child’s Unique Root Causes Are.” I'll also go into the reasons why I think my son's root causes were triggered to begin with.
If you would like to learn more about the holistic apraxia process, please click here to get started.
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Sources:
(1)“Co-Occurring Disorders,” by Apraxia Kids. https://www.apraxia-kids.org/virtual-education-series/comorbidity-2/
(2)“Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review,” by Chenausky, Baas, Stoeckel, Brown, Green, Runke, Schimmenti, Clark. Journal of Speech, Language, & Hearing Research. Volume 66, Number 3. February 16, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10205100/
(3) “The unwavering doctor who unraveled a medical mystery,” by Sarah Schmitz and Eve Lowenstein. International Journal of Women’s Dermatology. Volume 5, Issue 2. June 2019. https://www.sciencedirect.com/science/article/pii/S2352647518300406?via=ihub
(4) “James Lind: The man who helped to cure scurvy with lemons,” by Marcus White. BBC News, October 4, 2016. https://www.bbc.com/news/uk-england-37320399
(5) Nutritional rickets: Historic overview and plan for worldwide eradication,” by Roger Bouillon and Leen Antonio. The Journal of Steroid Biochemistry and Molecular Biology. Volume 198, April 2020. https://www.sciencedirect.com/science/article/abs/pii/S0960076019304364
(6) Vitamin E Deficiency, by Tyler Kemnic and Meghan Coleman. StatPearls [Internet] July 4, 2023.
(7) [Clinical study of post-stroke speech apraxia treated with scalp electric acupuncture under anatomic orientation and rehabilitation training] by Yujuan Jiang, Yuxia Yang, Rong Xiang, E Chang, Yanchun Zhang, Bingfang Zuo, Qianwei Zhang. July 2015. https://pubmed.ncbi.nlm.nih.gov/26521575/