Childhood apraxia of speech (CAS) affects a child's ability to produce sounds and syllables precisely and consistently, and to produce words and sentences with accuracy and correct speech rhythm. It is quite different from the more common developmental Speech Sound Disorder, because it involves a component of motor planning deficit that is not present in Speech Sound Disorders. This means that for children with CAS, they know what they would like to say but there is a breakdown in the ability to program or plan the fine and rapid movements required to accurately produce speech.
Three particular core features of CAS include:
(1) inconsistent error production on both consonants and vowels across repeated productions of syllables or words;
(2) lengthened and impaired transitions between sounds and syllables;
(3) inappropriate prosody
Now that we know what it is and how to identify Childhood Apraxia of Speech, what is the most current research evidence out for effective treatment?
Description of the intervention
Therapeutic approaches for CAS can be grouped into the following three areas.
(1) Motor‐based approaches. These therapies are based on principles of motor learning for example, traditional articulation‐based drill therapy, the Nuffield Dyspraxia Programme, the Rapid Syllable Transitions Treatment, rate control therapy, the PROMPT System (Prompts for Restructuring Oral MuscularPhonetic Targets), to name a few.
(2) Linguistic approaches. Linguistic therapies address language impairments that can co‐occur in children with CAS. Examples of linguistic approaches include programmes to address phonological speech production or awareness.
(3) Multi‐modal communication approaches. These approaches seek to support verbal communication. Methods can address specific communication messages or features, such as Aided AAC (augmentative and alternative communication) Modelling, or use of technological devices.
From my experience, the three different approaches as listed above all have its merits. As a trained PROMPT clinician, I have found it the most beneficial to first start with the motor-based approach in order to determine if the child is ready to try new sounds and is stimulable for shaping of his/her muscles to produce functional words. From there, a linguisitic approach can be coupled with it as well.
Read more about Childhood Apraxia of Speech here.
Reference
Morgan, A., Murray, E., Liegeois, F. (2017, August). Interventions for childhood apraxia of speech.https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006278.pub3/information#authors