Childhood Apraxia of Speech
Childhood Apraxia of Speech (CAS) is a neurological childhood speech sound disorder. The speech muscles and brain are fine, however the difficulty is with getting the message from the brain to the speech muscles in order to say sounds, words and sentences.
What is Childhood Apraxia of Speech?
Childhood Apraxia of Speech (CAS) is a neurological childhood (paediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g. abnormal reflexes, abnormal tone). The core impairment in planning and/or programming of movement sequences results in errors in speech sound production and prosody (ASHA, 2007b, Definitions of CAS section).
The speech muscles and brain are fine, however the difficulty is with getting the message from the brain to the speech muscles in order to say sounds, words and sentences. This results in inconsistent sound errors, difficulty combining sounds into syllables and words in a smooth manner, and problems with prosody. These are not due to muscle weakness, but impaired motor planning and programming.
Assessment and diagnosis
Comprehensive dynamic assessment is recommended when differentiating CAS from other speech disorders.
Please refer to the assessment section on this website to learn more about assessment into CAS.
Evidence-based treatments for CAS
Dynamic Temporal and Tactile Cueing (DTTC)
A motor-based approach where the clinician shapes accurate speech movements using modelling, tactile and timing cues, gradually fading support as skills grow.
Rapid Syllable Transition Training (ReST)
Uses practice of made-up multisyllable words to target smooth transitions between sounds and syllables, along with prosody.
Integrated Phonological Awareness Training (IPA)
Combines phonological awareness activities with speech production practice within the one program.
Nuffield Dyspraxia Program Third Edition (NDP3)
A structured program that builds speech step by step, from single sounds through to syllables, words and longer utterances.
CAS treatment evidence shows that therapy 4 times a week in blocks of 12-16 sessions (Murray et al, 2015) is recommended. A minimum of two sessions a week has been shown to work clinically (e.g. Namasivayam et al, 2015; Thomas et al, 2014).
Click to view: Evidence Summary: Childhood Apraxia of Speech, January 2024
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