Speech Sounds Disorders
CAS occurs when there are issues with a child's motor planning affecting their ability to produce sounds accurately. The diagnostic criteria can be controversial, as a child does not have to have all possible features to be diagnosed with CAS.
Signs and Symptoms
ASHA's 3 primary features of CAS:
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Inconsistent errors on the production of vowels and consonants on repeated productions
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Lengthened or disrupted transitions between speech sounds
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Inappropriate prosody (word/phrase stress, rhythm, intonation)
Other features of CAS:
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Distorts or changes consonants and/or vowels
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Short words/phrases are easier to understand than longer words/phrases
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General motor difficulty
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Producing voiceless sounds (such as "p, t, k, f, s" etc.) as voiced sound (such as "b, d, g, v, z")
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A limited number of consonants and vowels that the child can produce
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Difficulty coordinating movements oral structures from one sound to the next
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Difficulty imitating words
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Groping movement of facial structures during speech
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Slow rate of speech
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Deletion of initial and/or final sounds in words
Childhood Apraxia of Speech
Assessment
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If you are concerned that your child/student may have CAS, it is important to refer them to a speech-language pathologist for a screening and/or comprehensive evaluation.​
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The speech-language pathologist may use formal and/or informal assessment methods to determine if CAS is present.
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Parents and teachers participate in the evaluation process through interviews, checklists, surveys, etc.
Formal Assessments that may be used include:
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(Note: the most common assessments are listed, but others may be used depending on the Speech Language Pathologist's professional selection)
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CAS Specific:​
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Verbal Motor Production Assessment for Children (VMPAC)
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Dynamic Evaluation of Motor Speech Skill (DEMSS)
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The Orofacial Praxis Test - Kaufman Speech Praxis Test for Children (KSPT)
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Madison Speech Assessment Protocol (MSAP)
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Articulation/Phonology:​
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Goldman Fristoe Test of Articulation (GFTA)​
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Khan-Lewis Phonological Analysis (KLPA)
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Clinical Assessment of Articulation and Phonology (CAAP)
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Diagnostic Evaluation of Articulation and Phonology (DEAP)​
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Oral Motor:
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Oral Speech Mechanism Screening Examination (OSMSE)​
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Language:
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Clinical Evaluation of Language Fundamentals (CELF)​
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Comprehensive Assessment of Spoken Language (CASL)
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Oral and Written Language Scales (OWLS)
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Informal Assessments include:
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Observations
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Oral Motor Imitation Exercises
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Determining if the client can imitate movements of the lips, tongue, and jaw ​
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Stimulability Testing
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Determining if the client can produce sounds correctly provided supports and models​
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Parent and Teacher Interviews
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Checklists
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Spontaneous Speech Sample
Treatment
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If you are concerned that your child/student has CAS, treatment for his or her speech impairments will be provided by a speech-language pathologist.
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The child may be seen in a school, clinic, or home setting.
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The speech-language pathologist will work with you and the client to develop goals for his or her communication.
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Parents and teachers can help support the child during the therapy process by consulting with the speech-language pathologist on supports for the classroom and home environment.
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The speech-language pathologist will collaborate with the caregivers and teachers to provide them with appropriate guidance and support that may result in the most effective treatment for the child.
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If there are concerns or questions about the therapy process, it is important to consult the speech-language pathologist to ensure that the child is receiving the support that he or she needs.
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The speech-language pathologist will provide direct therapy to the child, selecting the most appropriate, evidence-based treatment approach.
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The approach may vary from therapist to therapist as the selection of a treatment approach is based on the needs of the child and professional opinion of the speech-language pathologist.
Some common treatment approaches used with CAS include:
Note: Common treatment are listed, but others may be used depending on the Speech Language Pathologist's professional selection)
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Traditional Articulation Therapy
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Prompts for Restructuring Oral-Muscular Phonetic Targets
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Rapid Syllable Transition Training
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Kaufman Speech to Language
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Phonological Awareness Intervention
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Core Vocabulary
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Nuffield Dyspraxia Programme
Blogs/Websites
Facebook Groups
Apraxia Kids: Official Support Group
Childhood Apraxia of Speech Support
Childhood Apraxia of Speech Parent Support Group
NWO Apraxia Support
The Apraxia Foundation: Hearing All Voices (Evidence Based Support Group)
APRAXIA AWARENESS
Apraxia Momma Bear Parent Support
YouTube
Definitions and Descriptions of Childhood Apraxia of Speech (CAS)
Childhood Apraxia of Speech - WHAT is it?
REFERENCES
American Speech-Language-Hearing Association. (2021). Childhood apraxia of speech. ASHA. https://www.asha.org/public/speech/disorders/childhood-apraxia-of-speech/
American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech [Position Statement]. Available from www.asha.org/policy.
Apraxia Kids. (2021). New to apraxia. Apraxia Kids. https://www.apraxia-kids.org/
Gubiani, M. B., Pagliarin, K. C., & Keske-Soares, M. (2015). Tools for the assessment of childhood apraxia of speech. Sociedade Brasileira de Fonoaudiologia, 27, 610-615.​
Mayo Clinic. (2021). Childhood apraxia of speech. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/childhood-apraxia-of-speech/symptoms-causes/syc-20352045
Murray, E., McCabe, P., & Ballard, K. (2014). A systematic review of treatment outcomes for children with childhood apraxia of speech. American Journal of Speech-Language Pathology, 23, 486-504.
Murray, E., McCabe, P., Heard, R., & Ballard, K. (2015). Differential diagnosis of children with suspected childhood apraxia of speech. Journal of Speech, Language, and Hearing Research, 58, 43-60.