Childhood Apraxia of Speech (CAS) is a complex and variable motor based speech disorder which emerges in early childhood, marked by inconsistent and imprecise motor executions.
Although there are not any formal guidelines for diagnosing CAS, as it is a variable disorder and features change over time, there are three key features that SLP’s look for to identify such a disruption in a child’s motor planning:
• Inconsistent
Speech Sound errors in repeated productions of syllables and words
• Disrupted
and/or lengthened co-articulatory transitions between sounds and syllables, as
well as impaired prosody (or rhythm of speech)
• Inconsistent
errors in repetition of the same target. (This is the strongest
indicator of CAS)
Children with CAS tend to also have impairments in
non-speech motor movements. They also tend to present with vowel and sound
ordering errors, while experiencing groping.
A diagnosis of CAS is reached via an assessment in
observation of the child’s speech production skills, prosody, and expressive
language and non-speech skills. Such an assessment may include:
• A
sound discrimination task (have children listen to, and discriminate phonemes)
• Syllable
repetition and alternating production task (such as asking the child to repeat:
“pu-tuh-kuh” several times)
• Sound
imitation task: Children with CAS have significant difficulty imitate
sounds.Obtain a speech sample of utterances of greater length and complexity.
• Administer
a standardized Articulation Test, such as the GFTA (Goldman Fristoe Test of
Articulation) to evaluate all sounds in varying word positions.
Chatterboxes’
SLP’s are trained in a specialized form of ‘hands on’ speech therapy, known as
PROMPT© therapy. The PROMPT© System stands for ‘Prompts for Restructuring
Oral Muscular Phonetic Targets’.
WHAT: PROMPT©
is a dynamic tactile method of treatment for motor speech disorders which is
based on touch pressure, kinesthetic and proprioceptive cues.
WHY: PROMPT© helps to reshape
individual and connected articulatory phonemes and sequences (coarticulation).
WHO: During
this approach, the clinician helps to manually guide articulators to produce specific
sounds or words that seem to be problematic.
HOW: This is a hands-on approach. The
SLP uses her hands to cue and stimulate articulatory movement, at the same time
helping the child to limit unnecessary movements
The
below series of photographs demonstrate the touch cues that may be applied
during a typical PROMPT© therapy session by the Speech-Language Pathologist.
Please note: such kinesthetic cues may be provided by the SLP to aid the child
in eliciting a single sound, such as “ah.” In addition, combinations of tactile
cues may be used to aid in elicitation of sound combination, single words,
short phrases, and even sentences. More
information about PROMPT can be obtained via www.thepromptinstitute.com
The
PROMPT photograph demonstration is as follows:
