Understanding Childhood Apraxia of Speech
According to the American Speech-Language-Hearing Association (ASHA), Childhood Apraxia of Speech, or CAS, is defined as a motor speech disorder that may also be referred to as “verbal dyspraxia” or “developmental apraxia”. CAS is commonly misinterpreted as a disorder resulting from muscle weakness, though this is untrue—it is characterized by a disruption in the planning and programming of speech sounds and sequencing connected speech, where the muscles used for speech are unimpaired and functioning. For the majority of verbal communicators, their brain generates a message in the Broca’s area. The Broca’s area then sends a signal to the motor cortex which sends a message to your motor neurons. This tells your speech muscles how to move to be able to communicate your thoughts out loud to others.
For individuals with CAS, there is an interruption in the signal between the motor cortex and the muscles used for speech, and the output of speech does not go as planned.
How does this differ from an articulation or phonological disorder?
While articulation and phonological processes are consistent, meaning that the child makes the same error every time and you can track a pattern, individuals with Childhood Apraxia of Speech will have inconsistent errors. For example, the child might say “fish”, “fifth”, or “fip”, etc. while playing a fishing game and attempting to say “fish”. In addition, the child may present with vowel distortions which are not typically seen in articulation/phonological disorders. This may sound like “bonny” instead of “bunny”. Lastly, the child may not put the stress on the correct syllable (“bun-NY” instead of “BUN-ny”). All of these characteristics are commonly seen in children with Childhood Apraxia of Speech.
Who can help?
Treating CAS is within the scope of Speech-Language Pathologists and Speech-Language Pathology Assistants, although it is important to find a provider who is well-trained in motor speech disorders specifically, as articulation/phonology interventions will not be effective.
What treatments are effective?
There are many treatments for CAS, and some are more effective than others, depending on how the child’s apraxia presents. Stimulability, Motor Entrainment Treatment, Integral Stimulability/Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition Treatment (ReST), and Prompts for Restructuring Oral Musculature Phonetic Targets (PROMPT) are among some of the treatments for CAS. At Grow with Words, our therapists choose one or a combination of treatment strategies that work best for that individual. One of the treatments we like to utilize is Motor Entrainment Treatment. Jenya Iuzzini-Seigel, assistant professor of Speech Pathology and Audiology at Marquette University and Director of the Communication, Movement, and Learning Lab, leads the research in Motor Entrainment and its application to Childhood Apraxia of Speech. She explains this theory using the phenomenon of walking. When you are walking, your legs are doing the work, and your arms decide to join in and help out simultaneously. This is motor entrainment. In speech, we use big motor movements (gross motor movements) to assist our speech motor movements (as mentioned in a previous blog post) to produce the desired output! For example, the child can hop in the hallway or bounce on a stability ball to assist their motor speech planning. This helps children sequence their sounds and their planning and programming of speech improves!
Have more questions about Apraxia, treatments, or therapies we offer? Contact us for a free 15-minute consultation. We would be happy to speak with you!
References:
“Childhood Apraxia of Speech.” American Speech-Language-Hearing Association, American Speech-Language-Hearing Association, https://www.asha.org/public/speech/disorders/childhood-apraxia-of-speech/
Iuzzini-Seigel, J., Thompson, A., Hasseldeck, B., & Nesbitt, C. (November, 2018). Motor entrainment treatment for CAS: Talking while moving. Poster presentation at the annual convention of the American Speech, Language, and Hearing Association, Boston, MA.