I completed the Advanced Apraxia Training in Chicago this fall and I'm sharing the top ten facts I think every SLP should know about the assessment and treatment of Apraxia of Speech! These are foundational facts that I hope will help you determine what you know, what you don't know, and what you want to know more about!
I laid this blog post out in simple bullet points so it is easy to read and digest (and I link a HUGE blog post with loads more detailed info at the end of this blog).
Apraxia of Speech Meaning :
Childhood Apraxia of Speech is a label for a subset of children with Speech Sound Disorders - not a medical diagnosis. As such, SLPs are the most qualified professional to assess, diagnose, and treat CAS.
Apraxia is a disorder of movement. As a results, our goals, cues, and feedback should be movement focused - not sound focused.
Apraxia of Speech Signs:
There are many apraxia of speech characteristics that are present in CAS, but not discriminative of CAS. The following characteristics are discriminative: difficulty moving from one articulatory configuration to another groping, presence of vowel distortions, distorted consonants/consonant substitutions, intrusive schwa, sound addition, prosodic errors & inconsistent voicing errors.
Apraxia of Speech Assessment and Diagnosis:
A Dynamic Motor Speech Assessment, such as the DEMSS, is important in diagnosing CAS, as it provides information about the ability to sequence accurate movement.
Apraxia of Speech Goals
In CAS treatment, goals should focus on movement gestures - not sounds. You want to use a variety of word shapes, consonants, and vowels. This means you DO not work up a complexity hierarchy! For example, you can work on CV, VC, CVC, CVCV at the same time! You don’t ‘master’ one word shape before you move up to the next one.
Apraxia of Speech Treatment
Do not target approximations. This establishes an incorrect motor plan. This means you would not choose words that have sounds the child is not stimulable for. You want to choose words that are responsive to cueing. For a list of words and cards, check out my Real Life Apraxia Photo Cards.
Motor planning begins at the syllable level. Think about the shape and tension of your lips on the ‘b’ when you’re about to say ‘bee’ vs ‘boy”! You’re already planning for the vowel!!
Variability of practice is important! You want to vary the types of frequency of feedback. Both Knowledge of Performance (specific information about what was wrong/right about the movement) and Knowledge of Results (general feedback, cut as not quite or that was right) are important!
Do not use oral motor exercises. To help a child improve their speech, you want to work on speech.
DTTC is one evidence based approach for treating CAS. You can learn more about it here.
This is definitely not meant to be a comprehensive list of everything there is know about CAS! These are just quick facts that are important to know and help you guide your practice.
Want to learn more about Childhood Apraxia of Speech?
Check out this Blog: Top Resources and References for Apraxia of Speech.
This speech therapy blog post is LOADED with references, handouts, blogs, books, podcasts and more about CAS.
Interested in more play based therapy ideas, access to freebies (like the ones below) and special offers? Make sure to get on my email list (link below!)!