Childhood Apraxia of Speech

Childhood Apraxia of Speech (CAS) is a motor speech disorder that affects a child's ability to plan and execute the movements necessary for speech. It is a neurological condition that impacts the coordination and sequencing of the muscles involved in speech production. Children with CAS have difficulty with volitional speech production and may have inconsistent errors, such as saying the same word differently each time they attempt to say it. They may also have difficulty with the timing, rhythm, and flow of speech, and may struggle to produce certain sounds or syllables.

CAS should be diagnosed by a speech-language pathologist who is specifically trained in identifying the specific characteristics that children with Childhood Apraxia of Speech demonstrate. Children who are very unintelligible, who produce many errors, and who have made limited progress in speech therapy can benefit from a CAS evaluation. Receiving an accurate diagnosis of CAS is important due to the specific speech therapy approach that is required to best help the child.

Contact Thrive Speech, Feeding, & Myofunctional Therapy to schedule an in-person or online evaluation to determine if your child has Childhood Apraxia of Speech. Each evaluation includes an in depth analysis of your child's speech sound repertoire, patterns, and characteristics that allow the clinician to diagnose or rule out CAS. Our goal in the Childhood Apraxia of Speech evaluation is to provide an in-depth analysis of you child's speech sound repertoire and use, determine the cause of these errors, and construct a treatment plan that includes specific target words to start with that will lead to the quickest progress for your child. Our evaluations also include an comprehensive oral motor evaluation to assess if there is an orofacial myofunctional disorder affecting speech production and development.

The following are frequently asked questions about Childhood Apraxia of Speech:

What are the characteristics of CAS?

1. Limited vowel and consonant repertoire: Children with CAS may have difficulty producing a variety of speech sounds, and may be limited to using only a few sounds or combinations of sounds.
2. Inconsistent errors: Children with CAS may produce the same word or sound differently each time they attempt to say it, making it difficult to predict how they will sound.
3. Difficulty imitating speech: Children with CAS may have difficulty imitating speech sounds or sequences, and may struggle to learn new words or sounds.
4. Vowel Distortion: Children with CAS may produce specific vowels incorrectly, sometimes sounding as if they speak with an accent that is unfamiliar to parents.
5. Voicing errors: Children with CAS may produce voiceless sounds ("k, p, t") and voiced sounds ("g, b, d").
6. Groping: Children with CAS may move their mouth in several positions as they "search" for the correct position to produce a sound.
7. Single-word production better than sentences: Children with CAS may make more errors in their speech as the utterance length increases.
8. ​Difficulty with prosody: Children with CAS may have difficulty with the rhythm, intonation, and stress patterns of speech, making their speech sound flat or monotonous.
9. Syllable segregation: Children with CAS may add spaces in between syllables due to difficulty connecting sounds.

What Are the different Treatment approaches for CAS?

Speech therapy should be individualized to fit each child's needs. Due to the motoric nature of CAS, the treatment approach should involve multisensory cueing using principles of motor learning. Treatment will different depending on your child's present level of speech sound production. The following are well-known research-based speech therapy approaches for CAS:

• Dynamic Tactile and Temporal Cueing (DTTC) is a therapy approach that uses tactile and temporal cues to help children with CAS produce speech sounds and words more accurately. DTTC involves providing simultaneous tactile and verbal cues, along with temporal cues that help the child coordinate the timing and rhythm of speech movements. During DTTC, the therapist provides tactile cues to guide the child's articulators, while also tapping a rhythm on the child's body to support the timing and prosody of speech. DTTC has been shown to be effective in improving speech production and intelligibility in children with CAS.
• ReST (Rapid Syllable Transition) therapy is a treatment approach for CAS that uses nonsense words (made-up words) to help children practice producing syllables and words with increasing complexity and speed. During ReST therapy, the child attempts to produce nonsense words that are formed based on sounds that the child can already produce. The clinician provides immediate feedback on the child's accuracy and progress, allowing for individualized and intensive practice. ReST therapy can help improve the child's motor planning and sequencing skills, and has been shown to be effective in improving speech production in children with CAS.
• PROMPT therapy is a motor-based approach that uses a hierarchy of prompts to help children with Childhood Apraxia of Speech (CAS) produce speech sounds and words more accurately. The prompts are tailored to the child's individual needs and may include visual, auditory, or tactile cues, as well as physical support to guide the child's articulators into the correct positions for speech production. Prompt therapy aims to improve the child's motor planning and execution of speech movements, and can be effective in improving overall speech intelligibility.

Can any Speech therapist work with my child with CAS?

All speech language pathologists (SLPs) are licensed to work with child who have CAS. However, it is important to speak with your SLP to ensure that they are using the most effective and up-to-date practices to ensure that your child is making the most amount of progress possible.

Schedule Childhood Apraxia of Speech Evaluation Today!