What is Childhood Apraxia of Speech?
Childhood apraxia of speech (CAS) is classified as a motor speech disorder, meaning there is a problem with communication between the brain and mouth.
This disorder can sometimes be referred to as developmental apraxia of speech, or developmental verbal dyspraxia. However, apraxia is not developmental because children do not grow out of it. This is a lifelong condition that needs treatment in order to improve.
Diagnosing Apraxia
Apraxia is diagnosed between the ages of 2 and 4. Since apraxia can look like other language disorders, it might not be apparent that it is the correct diagnosis, especially if a child is starting speech therapy at a younger age (age 2). The cause of apraxia is widely unknown. There are some contributing factors such as brain injury or genetic factors, however, often there is no discernable cause.
The clearest indicator of apraxia is that a child will have trouble with the movements required to make consistent, correct sounds and speech. Apraxia is not a problem with the oral muscles. In fact, before diagnosing apraxia, other factors should be looked at, such as muscle tone or hearing problems, both of which can affect a child’s speech.
Apraxia must be diagnosed by a speech-language pathologist (SLP), but common signs include:
· Trouble pronouncing words
· Language delay
· Inconsistent mistakes on sounds, syllables, vowels, consonants, and consonant-vowel combinations
· Applying stress in the wrong place
· Trouble pronouncing longer words and with transitions between words
· Off-target movements (such as wrong mouth position)
· Movements that distort sound
What differentiates apraxia from other language disorders is that it is an impairment of speech motor movement. However, it often occurs alongside other impairments such as language delay, fine motor skills, and trouble with reading, writing, and spelling.
An example of apraxia would be if a child is inconsistent when repeating the same word. So, if a child is asked to say the word “hi,” they may say “bye,” or “pie,” or not fully finish the word, such as saying “ha.” Typically, in each repetition, the child would say the word slightly differently.
Treatment
Apraxia can be treated by an SLP who will help teach a child how to plan the oral movements to produce sound. The frequency of treatment depends on the severity of a child’s apraxia, but it is most effectively treated when interventions occur at least twice a week.
Treatment can include a combination of motor programming, linguistic, and rhythmic interventions.
· Motor programming interventions include the repetitive exercise of proper speech movements.
· Linguistic interventions focus on speech function and the rules and sounds of language.
· Rhythmic interventions involve using songs, rhymes, and chants in a fun way to help with memorization
All interventions can incorporate a multisensory approach, meaning that a child’s other senses will be involved. This can be through visual, sensory, or tactile cues, such as gestures or tapping to help prompt a certain oral movement.
Depending on the severity of a child’s apraxia, other methods of communication can be utilized, such as sign language, picture boards, or computers/tablets (Augmentative and Alternative Communication or AAC).
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“Childhood Apraxia of Speech,” American Speech-Language-Hearing Association, accessed 15 June 2022, https://www.asha.org/public/speech/disorders/childhood-apraxia-of-speech/.
“Childhood Apraxia of Speech (Practice Portal),” American Speech-Language-Hearing Association, accessed 15 June 2022, www.asha.org/Practice-Portal/Clinical-Topics/Childhood-Apraxia-of-Speech/.
“What Kind of Help will my Child Need?” Apraxia Kids, accessed 15 June 2022, https://www.apraxia-kids.org/apraxia_kids_library/what-kind-of-help-will-my-child-need/