Childhood Apraxia Of Speech
It is estimated that 1 to 2 in each 1,000 children, most often boys, have Childhood Apraxia of Speech (CAS).
A child with CAS has a persistent severe speech disorder that affects the ability to produce and develop intelligible speech. It is neurologically based involving motor programming and planning. A child with CAS has difficulty voluntarily producing and sequencing the movements needed for clear speech.
Current terms used to describe CAS include: Developmental Verbal Apraxia (DVA), Developmental Verbal Dyspraxia (DVD) and Apraxia of Speech (AOS). Researchers differ in names and specific characteristics that are present for diagnosis.
Oral-Motor movements for speech and/or non-speech tasks are often difficult for a child with CAS. Typically, automatic use of the oral musculature for eating is adequate, although difficulties may be present in very young children. In a very young child a parent or care taker might observe:
- Messy eating
- Open mouth chew
- Drooling
- Lack of tongue movement elevated and/or lateralized
- Stuffing the mouth or taking large bites of food
- Swallowing food with minimal chewing
- Holding food in the mouth until it “melts”
- Lack of a mature rotary chew
The oral motor characteristics of CAS seen in individual children may change over time with maturation and intervention.
Speech characteristics of a child with CAS vary from one researcher to another just as they differ in their use of terms. In 2002 the Childhood Apraxia of Speech Association of North America CASANA brought together 25 leading researchers of childhood apraxia, along with knowledgeable parents and clinicians. The speech characteristics the agreed upon include:
- The presence of vowel errors. Vowels may be less differentiated and may include distortions.
- A decrease in the accuracy of articulation with increased length, rate, and complexity.
- Prosody disturbances including: overall slow rate, timing deficits in the duration of sounds and pauses between and with syllables contributing to the perception of excess and/or equal stress, “choppy” and monotone speech.
- Inconsistent or unusual articulation error patterns.
- Increased difficulty with self-initiated speech as compared with automatic or practiced speech.
- Impaired accuracy of sounds or speech making alternating movements repeating same sequences such as “ma, ma, ma” and multiple sound/phoneme sequences such as “puh, tuh, kuh.”
- There may be an impaired movement in non-speech voluntary movements such as rounding the lips or blowing (oral apraxia).
- An observable physical struggle to achieve a position of the tongue or lips may be observed when trying to imitate sounds or words. This may be observable at some point in treatment and not necessarily during the evaluation.
For more information on childhood apraxia for children please read:
- Apraxia Uncovered: Seven Stages Of Phoneme Development - Book & Audio Set
- Becoming Verbal With Childhood Apraxia: New Insights on Piaget for Today's Therapy
- The Big Book of Exclamations-A childrens book designed to promote speech sound development for late talkers and children with apraxia, autism, speech and ... other developmental disabilities
- The Source for Childhood Apraxia of Speech
