Childhood Apraxia of Speech (CAS)

 Every child has the right to a voice. 

Childhood Apraxia of Speech (CAS) can make it really hard for a child to speak and to be understood by others. About one third of the children I work with each week have CAS. They range from the age of 3 years to 17 years; they are each unique in their own way. 

So, this month, let's talk about CAS. 

What is CAS?
CAS is a motor-speech disorder where a child has difficulty connecting speech messages from their brain to their oral articulators (lips, tongue and jaw). This disruption between the brain and mouth can make it really hard for a child to speak - even though they know exactly what they want to say.  

CAS is often also referred to as ‘Verbal Dyspraxia’.

 
How is CAS Diagnosed?
A Speech Language Therapist can diagnose CAS.
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There is no standardized test for CAS, at this stage. However, during a Speech Assessment testing for CAS, a Speech Language Therapist will usually look into your child’s:

1. Oral-motor skills (e.g. the strength and range of movement of their lips, tongue and jaw)
2. Sound production in isolation vs. in words
3. Use of stress / emphasis on sounds in a word
4. Automatic speech (e.g. counting to 10) vs. spontaneous speech
5. Sequence sounds in alternating productions (e.g. p-t-k-p-t-k)
6. Overall ability to be understood
7. Language ability
8. Speaking background information

There is a general consensus among Speech Language Therapists about several characteristics that are associated with CAS. Some of these include:

• Inconsistent speech production
• Speech that is difficult to understand
• Clearer automatic speech and imitated speech than spontaneous speech
• Atypical prosody
• Physical groping
• Vowel distortions

 
What Treatment is Available?
Scientific evidence shows that Speech Therapy is effective for CAS.
Speech Therapy should address both short-term and long-term improvements in your child’s communication.
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1.Short-Term Objectives:

If your child is non-verbal, or very hard to understand, it is very important that they are given / taught an alternative method to communicate while they work on their verbal skills. Alternative means for communication can include (but are not limited to) sign language, picture boards or using an Applications on a tablet. These alternative means for communication will act as your child’s voice while they work on developing their verbal skills. These alternative means to communicate are also likely to reduce frustration which your child may experience because of not being able to communicate verbally.
 
2.Long-Term Objectives:

Long-term objectives usually involve a focus on your child's motor-speech / verbal skills.

Scientific studies have found that children with Apraxia usually respond well to:

• Frequent repetition of words and phrases
• Consistent and regular practice
• Shorter, but intensive practice sessions 
• Tactile prompts, verbal cues and visual cues used during speech practice 
• Speech Therapy starting earlier in life; this is likely to result in better speech outcomes

I have seen many children with Apraxia make wonderful progress with the PROMPT Method. You can read more about the PROMPT Method here.
 
I want to end this post by saying, no matter how old your child may be, please do not give up hope on their ability to speak, or to learn to communicate with others meaningfully by using an alternative communication method. I have been blessed to witness children saying their first words well into their teenage years... I have also been part of the journey of teenagers finding their voice through an App. Nothing is more rewarding than helping children find their own voice. 
 
Speak soon,
The Expat Speechie

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