CAS

Question 1

What is CAS also called?

Answer 1

Childhood apraxia of speech (CAS) also called developmental apraxia of speech (DAS)

Question 2

What is CAS?

Answer 2

Motor programming disorder of neurogenic origin

Question 3

What does CAS affect?

Answer 3

Affects articulatory and prosodic parameters of speech production

Question 4

A child with CAS has difficulty with what?

Answer 4

Child has great difficulty with fine, rapid, voluntary movements of speech.

Question 5

By adolescence:

Answer 5

most children with CAS are intelligible

Question 6

Children with CAS have persistent what?

Answer 6

Persistent language processing problems

Question 7

Children with CAS may have disorder of what?

Answer 7

May have disorders of reading and spelling

Question 8

Treatment for CAS children may be:

Answer 8

• Tx: sequential organization; simple to complex speech tasks
• We can progress from CV or VC combinations -> CVC->CCVC ->syllable shapes ->words ->phrases -> sentences ->conversational speech

Question 9

General principles of CAS treatment:

Answer 9

1. children may have experienced failure, need initial success in treatment
2. Don’t focus on individual sound productions; focus on movement patterns and sequence of sounds (syllables)
3. treat more frequently-occurring sounds
4. Treatment may start with vowel errors if these are dominant.
5. Initial treatment targets: stimulable, early-developing, visible sounds
6. treat sounds in order of increase phonetic difficulty (ex: begin with vowels, end with affricates)
7. Start with voiceless sounds, progress to voiced sounds
8. treat sounds first in word-initial position
9. have short breaks; these kids get tired
10. do repeated trials (program muscle memory)
11. select a core vocab of meaningful words for initial treatment
12. Make sure child speaks slowly
13. Use a variety of carrier phrases (ex: “here is ___” “I want ____”

Question 10

What is Multimodality approach?

Answer 10

-For children with severe CAS, may need sign lang or augmentative communication

Question 11

Phonetic Placement Techniques to Elicit Sound Production:

Answer 11

• Detailed descriptions of “how to”
• Diagrams, pictures
• Get in there and get physical! Use tongue depressors, cotton swabs, mirrors

Question 12

Prompt:

Answer 12

• Prompts for Restructuring Oral Musculature Phonetic Targets
• Uses kinesthetic, touch pressure, and proprioceptive cues (proprioception: sense of how our bodies are positioned)
• SLP puts her fingers on child’s face and neck to prompt place and manner of production
• These movements may be used in isolation and eventually to chain sounds together into words
• Deborah Hayden
• Used in various countries around the world
• Offers training and certification workshops
• Especially effective for severely involved child (CAS, cerebral palsy, dysarthria (TBI))

Question 13

Shaping/Progressive Assimilation:

Answer 13

• To get a child to produce a sound, use non-speech gestures or sounds that are not affected
• For example, if child cannot produce /v/, she may be asked to bite her lower lip, turn on her voice, and breathe out

Question 14

Contrastive Stress Drills:

Answer 14

-Work especially well to teach stress and rhythm of spoken language as well as promote better articulation
-Example for /k/:
SLP: Is your name Ben?
Child: No, my name is Ken.
SLP: Is his name Ken?
Child: No, my name is Ken.

Question 15

Remember…

Answer 15

• CAS treatment takes years

- Child quickly lose gains if not constantly reinforced!