Childhood Apraxia & Speech Therapy Centre provides comprehensive intervention specific to motor speech disorders including Childhood Apraxia of Speech (CAS). We use up-to-date, evidenced-based methods including the Principles of Motor Learning theory to treat motor speech, suspected CAS and CAS, which is the primary passion of our Centre.
You may have been told in early intervention or other speech therapy that your child is showing signs of “motor speech difficulties” or “motor speech disorder.” This may or may not include CAS. Not all children with motor speech disorders have apraxia; apraxia is one kind of motor speech disorder. We can help ascertain whether your child is demonstrating motor speech disorder – not otherwise specified (i.e. not apraxia) or motor speech disorder – childhood apraxia of speech (i.e. CAS). Differentiating the two can be complicated, but we can help!
If your child is not yet talking, you might also be wondering about CAS. Determining what’s behind a child who is not yet speaking can be challenging, but we can help. While we know only 3 – 5% of preschool children with a speech difficulty will indeed have CAS, we also know that early, intensive and appropriate apraxia therapy is the best and most effective treatment.
In Ontario, Speech-Language Pathologists (SLP) cannot diagnose Childhood Apraxia of Speech. Diagnosis is the responsibility of a medical doctor, however they do so often with the support of an SLP. While this can be confusing or frustrating for families, Childhood Apraxia & Speech Therapy Centre can help guide you through your journey and provide support along the way; whether you need documentation for your medical doctor, clarity around who to speak to, how to access more or better apraxia therapy, resources to support you and/or your child at home or in other environments, or to connect with other families experiencing the same difficulties, we can help.
Warning Signs for Childhood Apraxia of Speech
Some or all the following may be present in a child with CAS:
- Struggle to speak or difficulty being understood when speaking
- Quiet infancy/lack of babbling
- Limited repertoire of sounds, often vowel errors
- Inconsistent errors
- Understanding language is much easier than expressing/using language
- Difficulty imitating speech and sounds
- Groping or silent oral movements when trying to speak
- Hyper or hyposensitivity in the mouth (textures, foods, tooth brushing)
- Longer speech utterances are more difficult to produce
- An ease with overlearned, automatic utterances (e.g. mommy, all done)
At Childhood Apraxia & Speech Therapy Centre we employ the following treatments specific to apraxia therapy:
- Implementation of the Principles of Motor Learning (PML)
- Dynamic Temporal & Tactile Cueing (DTTC)
- Kaufman Speech to Language (K-SLP) approach
- Multi-Sensory Approach to CAS by David Hammer
- PROMPT approach to CAS
For a complete listing of CAS-related professional development that Brooke has both undertaken and provided, please click here.
The American Speech-Language and Hearing Association has published both a Technical Report and Position Statement on Childhood Apraxia of Speech. These documents are available to the public. Below is a brief statement taken from their public information document on current best practices in treatment. At Childhood Apraxia & Speech Therapy Centre we subscribe to this same philosophy.
“Research shows the children with CAS have more success when they receive frequent (3-5 times per week) and intensive treatment. Children seen alone for treatment tend to do better than children seen in groups. As the child improves, they may need treatment less often, and group therapy may be a better alternative.
The focus of intervention for CAS is on improving the planning, sequencing, and coordination of muscle movements for speech production. Isolated exercises designed to “strengthen” the oral muscles will not help with speech. CAS is a disorder of speech coordination, not strength.
To improve speech, the child must practice speech. However, getting feedback from a number of senses, such as tactile “touch” cues and visual cues (e.g., watching him/herself in the mirror) as well as auditory feedback, is often helpful. With this multi-sensory feedback, the child can more readily repeat syllables, words, sentences and longer utterances to improve muscle coordination and sequencing for speech.
Some clients may be taught to use sign language or an augmentative and alternative communication system (e.g., a portable computer that writes and/or produces speech) if the apraxia makes speaking very difficult. Once speech production is improved, the need for these systems may lessen, but they can be used to support speech or move the child more quickly to higher levels of language complexity.
Practice at home is very important. Families will often be given assignments to help the child progress and allow the child to use new strategies outside of the treatment room, and to assure optimal progress in therapy.
One of the most important things for the family to remember is that treatment of apraxia of speech takes time and commitment. Children with CAS need a supportive environment that helps them feel successful with communication. For children who also receive other services, such as physical or occupational therapy, families and professionals need to schedule services in a way that does not make the child too tired and unable to make the best use of therapy time.
ASHA Information for the Public > Speech, Language and Swallowing > Disorders and Diseases > CAS