Childhood Apraxia of Speech (CAS) is known by many names. Apraxia, Developmental Verbal Apraxia, Childhood Verbal Apraxia, and Developmental Apraxia of Speech are just a few of the names; however, CAS is the current preferred term for the severe speech disorder.
Childhood Apraxia of Speech affects 2-3 children per 1000. There is no universal criteria list used to diagnose the disorder like there is with Autism or ADHD. And there are no chromosomal abnormalities like Down Syndrome or Apert Syndrome. Recently there has been a gene linked to the disorder; however, far more research is required in the area of genetics.
How it is Diagnosed
There are several standardized measures used to diagnose Childhood Apraxia of Speech. This has lead to over-diagnosis. The Childhood Apraxia of Speech Association of North America is currently working on guidelines for Speech Language Pathologists for diagnosis and treatment of the disorder, which should help.
I try to learn as much as I can in regards to the treatment and diagnosis of CAS. It is one of my areas of expertise in which I provide therapy and am often called in to provide a second opinion or training to a treating therapist.
So What is Childhood Apraxia of Speech?
To put it simply, the structures of the mouth are adequate yet the message is not getting from the brain to the mouth to produce clear speech.
Some characteristics of CAS include, but are not limited to, vowel distortion, more sound errors with longer sentences, and inconsistent sound errors. Children with this severe speech disorder are extremely difficult to understand and may or may not develop clear speech as adults. Similar characteristics may be seen in other severe speech disorders as well, making diagnosis difficult.
Appropriate Speech-Language Therapy is Key
Good, appropriate speech-language therapy is key in helping children with CAS learn to produce intelligible speech. Multiple short therapy sessions have proven to be most effective. The more a sound is produced in therapy the faster the progress as the skill must be learned and become automatic.
There is no one “right” therapy however there is a “wrong” therapy. If you have a child with CAS (or any other severe speech disorder) beware of oral-motor therapy that is used to teach clear speech.
Oral motor therapy is therapy that does not involve speech production while moving the mouth. To improve speech, speech must be worked on. As a feeding therapist I often use oral motor therapy to help with chewing, swallowing, and drooling. However, while effective with feeding, there is no research proving that these exercises will improve speech.
Childhood Apraxia of Speech remains a challenge for speech language pathologists, parents of children with the disorder and the children themselves. While research is underway we are only at the beginning of understanding this severe and complex disorder.
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