Childhood apraxia of speech

Question 1

Introduction

Answer 1

• CAS also called developmental apraxia of speech (DAS)
• MOTOR PROGRAMMING disorder of NEUROGENIC origin
• affect articulatory and prosodic parameters of speech production
• ch has great difficulty with fine, rapid voluntary movements of speech

Question 2

intro continued…

Answer 2

• by ADOLESCENCE, most ch w/ cas are INTELLIGIBLE
• persistent lang processing probs.
• may have disorder of reading and spelling

Question 3

in general

Answer 3

• treatment: 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 4

general principles of treatment

Answer 4

1. ch may have experienced failure; need INTIAL SUCCESS in treatment
2. don’t focus on idiv sound productions; focus on movement patterns and sequence of sound (syllables)
3. treat more frequently – occurring sounds

Question 5

general princ. of tx. continued (4-7)

Answer 5

4. treatment may start with vowel if these are dominant
5. initial tx targets: stimulable (give model they can imitate it), early developing, visible sounds
6. treat sounds in order of increase phonetic difficulty (e.g., begin with vowels , end with affricates)
7. start with voiceless sounds, progress to voiced sounds

Question 6

general princ. of tx. continued (8-13)

Answer 6

8. treatment sounds first in WORD-INITIAL position
9. have short breaks; these kids get tired
10. do repeated trails (program muscle memory)
11. select a CORE VOCAB of meaningful words for initial treatment
12. ,make sure ch speaks slowly
13. use variety of carrier phrases (e.g., “here is ___”
    “i want ___)

Question 7

specific treatments approaches

Answer 7

• multimodality approach

- for ch. w/ SEVERE caS may need sign languagh or augmentative communication

Question 8

phonetic placement techniques to elicit sound production

Answer 8

• detailed descriptions of “how to”
• diagrams, pictures
• get in there and GET PHYSICAL! use tongue depressors, cotton swabs, mirrors

Question 9

prompt

Answer 9

• prompts for restricting oral musculature phonetic targets
• uses KINESTHETIC , touch pressure, and proprioceptive cues (proprioception: sense of how our bodies are positioned)
• SLP puts her fingers on ch 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

Question 10

prompt cont…

Answer 10

• Deborah hayden
• used in various countries around the world
• offers training and certification workshops
• esp. effective for SEVERELY INVOLVED ch (cas, cerebral palsy , dysarthria [TBI])

Question 11

Shaping/ progressive assimilation

Answer 11

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

Question 12

contrastive stress drills

Answer 12

-work esp well to teach stress and rhythm of spoken lang as well as promote better articulation

Question 13

remember

Answer 13

• cas treatment takes YEARS

- ch quickly LOSE GAINS if not constantly reinforced