Childhood Apraxia of Speech

Question 1

What is Childhood Apraxia of Speech (CAS)?

Answer 1

A motor-planning disorder affecting the articulatory and prosodic parameters of speech. The child will have great difficulty with fine, rapid, and voluntary movements necessary to produce speech

Question 2

What are Nelson’s findings in regard to CAS?

Answer 2

-Differential diagnosis of CAS from dysarthria
In CAS, children can use oral motor systems adequately for reflexive acts just not for speech
-NOT muscle weakness
-difficulty planning speech movements
-many intelligible as teens
-persistent language-processing problems
-may have disorders of reading and spelling

Question 3

What are the general principles of treatment for CAS?

Answer 3

• Give them initial success!
• Don’t focus on individual sounds, work on movement patterns and sequence of sounds (syllables) ie- not articulation but moving between phonemes
• Treat more commonly occurring sounds
• May start with vowel errors if those are dominant
• Get away from auditory discrimination
• Start with early-developing, visible, stimulable sounds
• Start with voiceless sounds, move to voiced
• Train sounds first in word-initial position
• Take lots of short breaks (this is hard for them!)
• Drills (repeated trials of same movement- muscle memory)
• Practice each target several times before moving on
• Select core vocab of meaningful words
• Teach child to speak slowly
• Use carrier phrases

Question 4

What are specific treatment approaches for CAS?

Answer 4

-Always use a multimodality approach (touch, look, feel, hear)
-Total communication!
1. Phonetic Placement Techniques- Give explicit instructions for how to do placement. Use diagrams, pictures, get physical (tongue depressors, etc.)
2. Prompt- requires certification, etc. But you can use modified prompts- multimodal, kinesthetic = movement
PROMPT approach by Hayden good for children with severely involved disorders.
3. Shaping/Progressive Assimilation- use what they have, use non-speech gestures
4. Contrastive Stress Drills- using big stress to contrast with other parts of a phrase, differentiating what is important in the message