May is Apraxia Awareness Month. Check out this article to learn more about childhood apraxia of speech.
How exactly does speech “happen”? Well, speech begins with an intention to communicate. An idea is formed, and the words are put in the correct order. Each word in the desired message contains a unique, specific sequence of sounds and syllables that have to be ordered together correctly. Our brain then sends this message to the muscles of our articulators (lips, tongue, jaw, and soft palate). These muscles then execute the movements needed for speech to occur, so that the words within the message are properly pronounced. While all of this happens in a very short amount of time, this process does not always go smoothly. Children with Childhood Apraxia of Speech have difficulty learning or carrying out the complex sequenced movements that are necessary for intelligible speech. In this article we will define CAS and talk about characteristics of and treatment for this motor speech disorder.
WHAT IS CHILDHOOD APRAXIA OF SPEECH?
Apraxia is a motor speech disorder that makes it hard to speak. The most important concept within this phrase is the root word “praxis”, meaning planned movement. When a child has apraxia of speech, their messages are not sent from their brains to their mouths correctly. Children with a diagnosis of apraxia of speech generally have a good understanding of language and know what they want to say. However, they have great difficulty planning and producing the precise, refined, and specific series of movements that are necessary for intelligible speech.
Characteristics of CAS
Not all children with Childhood Apraxia of Speech present the same. However, children with CAS may show some or all of the signs below:
- Limited repertoire of vowels.
- Variability of errors.
- Errors increase with length or complexity of utterances, such as multi-syllabic or phonetically challenging words.
- Repetition of sounds in isolation may be adequate but connected speech may be more unintelligible.
- More difficulty with volitional, self-initiated utterances as compared to over-learned, automatic, or modeled utterances.
- Impaired rate/accuracy on diodochokinetic tasks (alternating movement accuracy or maximum repetition rates of same sequences).
- Disturbances in prosody including overall slow rate, timing deficits in duration of sounds and pauses between and within syllables.
- Limited vocalization, babbling or phonetic diversity during infancy.
Treatment of CAS
Speech therapy for children with apraxia may include:
- A high, intensive degree of practice and repetition.
- Visual, verbal, tactile or touch cueing to provide increased sensory information to help the control of speech movement sequences.
- Use of rhythm or pacing to help with naturalness of intonation, syllable and word stress patterns.