Clinicians' Perspectives on Diagnosing and Treating Childhood Apraxia of Speech in Children Under 3 Years Old.

PURPOSE: Childhood apraxia of speech (CAS) is a pediatric speech sound disorder with genetic and neurological underpinnings, implying its presence at birth. While early identification and intervention offer clear benefits, clinicians' perspectives on early diagnosis of CAS remain unclear. This study examined speech-language pathologists' (SLPs') knowledge, beliefs, and clinical decision making regarding CAS in children under 3 years old. METHOD: A novel survey was distributed to SLPs working with children under 3 years old (N = 298). Respondents shared demographic information, CAS training and knowledge, diagnostic opinions and practices, and, in a subset, clinical decision making. Data were analyzed using z tests for proportions, logistic regression, and descriptive statistics. RESULTS: Forty percent of early intervention SLPs believed CAS cannot be diagnosed before the age of 3 years, and 52% would not disclose a diagnosis to caregivers of children in this age group. Continuing education on CAS was the only significant predictor of accurate early diagnostic beliefs; years of experience, setting, and general CAS knowledge were not. Among SLPs who did diagnose and treat CAS in children under 3 years old, most used caregiver coaching and play-based models. Highly structured, clinician-directed interventions were relatively underused, despite strong evidence for them. CONCLUSIONS: Findings reveal gaps in early intervention SLPs' knowledge and practices related to CAS. Hesitation to diagnose or disclose CAS in young children may delay appropriate intervention. Results highlight the need for better alignment between research and clinical practice to support early identification and treatment of CAS. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.30781640.