by: Blair Gorenberg MA, CCC-SLP
It’s difficult to understand the sequence of events that must occur in the body in order for just one sound to be produced. In the blink of an eye, the brain sends messages to tell the mouth exactly how to move. These messages allow for the muscle coordination necessary to produce sounds, words, and sentences. When there is a breakdown in communication between the brain and the mouth, a child may demonstrate unusual speech patterns or may not be able to talk at all. This breakdown is called Childhood Apraxia of Speech.
What does CAS look like?
There are several hallmark signs and symptoms of childhood apraxia of speech. Here are some things to look out for:
- Producing the same word differently every time it is said. For example, saying “dog” in one sentence, then saying “gog” in the next sentence, and “dah” in the following sentence, despite trying to say “dog” in all three sentences.
- Demonstrating “groping” or various facial movements that make it look like your child is trying to say something but while struggling to coordinate the oral movements to produce an intelligible word.
- Very limited or no verbal output, especially while the child’s understanding seems to be age-appropriate
- Difficulty imitating oral-motor movements and/or sounds/words produced by someone else.
- Difficulty with fine motor skills
What causes CAS?
Often, it is unclear what caused childhood apraxia of speech. Children and adults may be diagnosed with apraxia of speech following neurological changes associated with head injury or stroke. Some genetic disorders may include apraxia of speech. However, for the majority of children who are diagnosed with childhood apraxia of speech, the origin of the disorder is unknown.
How can I help my child with CAS?
Childhood apraxia of speech can be a tricky thing to treat. The most important thing to remember when helping a child with CAS is to be patient! Practicing oral-motor movements and sound/word production can be very exhausting for a child with CAS. It’s best to review these targets in short practice sessions and allow your child time to rest when tired. Biofeedback is a helpful strategy to keep your child engaged in the session while also providing additional messages to the brain. For example, making “funny faces” at each other in the mirror will allow your child to watch your face while watching their own face and adjusting accordingly. Enrolling your child in speech therapy is incredibly beneficial and the earlier you start, the better! Early intervention in speech therapy has been shown to have dramatically increased effects. Make sure to discuss with your child’s therapist what is being worked on in the therapy room and how you can incorporate the same strategies into the home environment.
What does speech therapy look like for a child with CAS?
As with any speech or language disorder, your child’s speech therapist will use age-appropriate therapy materials and items/activities that motivate your child. Sessions may focus on breaking down movements and sounds to allow your child to focus on the basics before working up to full words, phrases, and sentences. The speech therapist will determine what feedback measures work best for your child. Feedback can include looking in the mirror, incorporating touch cues to cue the mouth where to move to produce a sound, or listening to records of his/her speech and identifying sounds/words that were produced correctly versus incorrectly.
Alternative communication methods
Communication is a basic human right so when verbal speech is not an option, alternative communication methods should be explored. These alternative methods may be a short-term solution while your child works on increasing verbal communication or they may be a long-term functional communication method for your child. Alternative methods of communication include sign language, picture exchange, communication boards, and speech-generating devices. Your child’s speech therapist will determine if an alternative communication method is appropriate for your child and can provide the necessary training for your child as well as anyone who communicates with your child (family, school staff, etc.).
The Therapy Place offers speech therapy and occupational therapy for young children who may have developmental delays or other difficulties. There’s no shame in reaching out for help! If you are concerned about your child’s speech or language development, call The Therapy Place today to schedule an evaluation with one of our speech pathologists!
References:
“Childhood Apraxia of Speech (CAS) / Developmental Verbal Dyspraxia (DVD) / Developmental Apraxia of Speech (Das).” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/17911-childhood-apraxia-of-speech.
“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/.
“Childhood Apraxia of Speech.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 July 2021, https://www.mayoclinic.org/diseases-conditions/childhood-apraxia-of-speech/symptoms-causes/syc-20352045.
“Home.” Apraxia Kids, 21 Mar. 2022, https://www.apraxia-kids.org/.
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