What is Childhood Apraxia of Speech?
Childhood Apraxia of Speech (CAS) is a speech-sound disorder that is related to difficulties with the planning and programming aspects of speech output. It is unrelated to any muscle weakness.
Often times, parents may report that “My child is hard to understand” or “No one understands my child.” Additionally, many children who are diagnosed with CAS develop as late talkers. Parents may find that “my child said a word once, but not again.” It also may appear like your child is trying to say something, but is not able to get it out (groping).
What causes Childhood Apraxia of Speech?
CAS is a motor speech disorder. This means that it is related to a neurological difficulty because the brain is having difficulty creating plans and executing them for speech movement. In typical speech, our brain has to create a message and then send it to our mouth to produce it. In CAS, it is not that a child is “thinking wrong” or has a low IQ, just that the message their brain is sending is being skewed on the way to the mouth. Because CAS is neurological, it cannot be “grown out of” and requires speech therapy for consistent progress.
Signs and Symptoms of CAS
Are you thinking, “Does my kid have apraxia?" Check out these signs and symptoms below for CAS, but remember that no two-kids are the same. The best way to get more information is to meet with a speech-language pathologist.
- Late talkers: delayed onset of your child’s first words and subsequent words
- Limited number of words your child can say
- Often times, you may find your child says a word once but then seemingly never again.
- Inconsistent word productions
- If your child says a word differently each time she says it
- Example: For monkey, your child may say “muh-key”, “kee-kee”, “muh-kuh”, “kuh-kee” each time they try to label it.
- Groping
- If your child seems to be trying to say something, but no speech is coming out, this is called groping.
- Vowel Errors
- Differences in automatic versus voluntary speech
- Your child may say everyday phrases, like hello, good morning, love you, consistently and accurately, but have difficulty with all other forms of verbal communication, like labeling a picture, retelling a story, etc.
- Decreased sound inventory
- Stress Errors
- Example: For the word banana, we typically say it as “buh-NAH-nuh”, a stress error may be a child saying it as “BUH-nah-nuh” or “buh-nah-NUH”
- Voicing Errors
- Example: Saying “pie” for ‘bye’
Speech Therapy for Childhood Apraxia of Speech (CAS)
Individualized and intensive speech therapy is vital for treating CAS. Many children with CAS strongly benefit from multiple repetitions and repeated practice of carefully selected speech words/targets by a speech therapy (SLP), which means intensive therapy along with practicing at home for carryover is key for great progress.
PROMPT Therapy
PROMPT therapy (Prompts for Restructuring Oral Muscular Phonetic Targets) is a specialized therapy that requires trained therapists to utilize this technique. It relies on tactile-based cues, which means using specific hand gestures and movements on a child’s face to support accurate production of a speech sound or word. Molly Brown is a trained therapist and experienced in PROMPT and uses techniques from this program along with others to promote an-all inclusive therapeutic approach with children with CAS.
DTTC Therapy
DTTC (Dynamic Temporal and Tactile Cueing) is another specialized therapy that is often used with children with CAS. This form of treatment follows the principles of motor learning to treat CAS. Through this therapeutic approach, the child and SLP follow a hierarchy of very-supported speech therapy, fading to independent production. At first, the therapist will have the child say a targeted word simultaneously with the therapist, this will eventually fade to having the child say a targeted word or phrase by themselves. Molly Brown is trained and experienced in using DTTC with children with CAS and other speech sound disorders.
AAC Devices
AAC (Augmentative and Alternative Communication) are different ways to allow your child to communicate with you than verbally. This can include low-tech AAC like picture boards and high-tech AAC like iPads, apps, and specialized devices. Research shows that children with CAS strongly benefit from using AAC along with receiving specialized speech therapy.
Which approach is right for my kid with childhood apraxia of speech?
There is no one right approach for treating CAS. Here at MollyBSLP, find that using all approaches together leads to the best success. No child is the same, some kids may benefit more from hands-on tactile cues, while others may be distressed from others touching their face and benefit more from DTTC and following the principles of motor learning.
What words will you work on with my child?
Our number one importance of treating childhood apraxia of speech is functional goals and progress. We want to target words and phrases that are relevant to your child. If your kid loves dinosaurs, then we will work on words related to that interest, whereas if another child does not like dinosaurs, but does love playing kitchen, then that will guide our treatment. We follow a very family-centered speech therapy approach with Childhood Apraxia of Speech.
Finding a speech therapist for childhood apraxia of speech near me
Are you looking for a speech therapist who is experienced in working with children with CAS? Maybe you are just looking for a consult to see if your child may have CAS or not? We know it can be stressful when you don’t know what is wrong with your child or what to do, let us help. Molly Brown provides speech therapy via virtual speech therapy in New York and Virginia.