Childhood apraxia of speech Flashcards
What is CAS?
A rare neurological childhood speech sound disorder with primary difficulty in the planning and production of movements underlying speech
What % of children have CAS according to Dodd’s Subtype Classification (1995)?
3%
What is the impact of CAS on sound repertoire?
limited C and V repertoire
What is the impact of CAS on speech?
- Frequent omission errors
- High incidence of vowel errors
- Increased errors on longer units
- Inconsistent errors on consonants and vowels in repeated productions of syllables and words (say 3 times - consistent or inconsistent)
- Inappropriate prosody
- Lengthened and disrupted coarticulatory transitions between sounds and syllables (especially with clusters)
What is the impact of CAS on motor movements?
- Associated mild motor difficulties
- Reduced diadochokinetic rates
- Impaired volitional movements
- Groping
What is the impact of CAS on language?
- Co-morbid expressive language difficulties
- Relatively unimpaired receptive abilities
What is the response to therapy?
slow response to therapy
CWCAS have __ of the following on __ or more tasks:
4 of the following on 3 or more tasks:
1. Vowel distortions
2. Difficulty achieving initial articulatory configurations
3. Equal stress or lexical stress errors
4. Distorted substitutions
5. Syllable segregation
6. Groping
7. Intrusive schwa
8. Voicing errors
9. Slow rate
10.Slow DDK
11.Increased difficulty with polysyllabic words
What are the causes of CAS?
- Neurological impairment (e.g. trauma, infection, stroke), with neurobehavioural disorders of known or unknown origin (e.g. a genetic or metabolic disorders like Down Syndrome or Galactosemia), or as an idiopathic (i.e. cause unknown) neurogenic speech sound disorder.
What is praxis?
Movement
What happens with motor maturation?
- speed control
- force
- precision
- direction
- coord of movement
How does praxis develop?
First, it requires the experience of motor movement and understanding its results, which includes gaining control over movements and being able to consciously control them if necessary. Praxis also involves action in space, implying the need for spatial perception. The relationship between action, sensation, and perception is also key. Lastly, praxis involves modifying a movement pattern based on sensory feedback to ensure it is effective in space.
How does motor speech develop?
- Production of a range of language-appropriate vowels and consonants i.e. range of movements in space
- At an appropriate speed with app transitions
- Precisely to preserve mutual intelligibility
- Sufficiently consistently
- At segmental (v/c/words) level
- At suprasegmental (prosody, loudness, stress, pitch, resonance etc) level
If lacking praxis?
Impaired ability to:
- Learn general schemes about classes of motor actions
- To use appropriate perceptual cues within the environment
- To organise and integrate info from the body
- solve problems and adapt behaviour
- analyse task demands and components
- prepare for upcoming actions
What is developmental co-ordination disorder?
- Performance in daily activities
that require motor coordination
substantially below that
expected - The motor disturbance
significantly interferes with
academic achievement or ADL - Onset of symptoms is in the
early developmental period. - motor skills deficits are not
better explained by intellectual
disability or visual impairment
and are not attributable to a
neurological condition affecting
movement (e.g. cerebral
palsy).
