Apraxia.docx

Julia HartChildhood Apraxia of Speech (CAS)

I. Defining characteristics of apraxia:-Apraxia of speech is a neurological, motor speech disorder. Apraxia is not due to weakness or paralysis of muscles. -Children with apraxia know what they want to say, but their brains struggle with the motor planning needed for sound production. -Children with apraxia may have trouble saying sounds, syllables, or words.-Very young children with CAS may not babble or coo as infants, say their first words late, may produce limited consonant or vowel sounds, and may have long pauses between sounds.-Older children with CAS make inconsistent errors in articulation, have incorrect prosody, may appear to grope for certain sounds when saying words and may require multiple attempts to pronounce a word. Children with CAS tend to experience greater difficulty with multisyllabic words and longer phrases.

II. Etiology:-In most cases, the cause of apraxia is unknown. CAS is sometimes referred to as developmental apraxia and is present from birth.-Acquired apraxia, which typically occurs in adults, can be the result of a genetic syndrome, stroke, or brain injury. Acquired apraxia may sometimes resolve with treatment for the underlying medical condition, but children with CAS require treatment from an speech and language pathologist.

III. Diagnosis:-A hearing screening should be completed to rule out hearing loss as the cause of a childs speech/language delays.-A speech and language pathologist (SLP) will conduct an evaluation to determine if a child has apraxia of speech. Most cases of CAS are diagnosed by SLPs. In some cases, CAS is diagnosed by medical professionals. -An SLP will check for weakness in the mouth/speech muscles, which could be a sign of dysarthria, rather than apraxia.

IV. Effects on Development and Learning:-Speech-motor disorders may contribute to difficulties in reading, writing, and spelling.-Children with CAS generally have age-appropriate receptive language skills.-Poor literacy outcomes can be a related to childhood apraxia. Some studies have shown that children with CAS have poor phonological processing which leads to reading and spelling deficits.-Difficulties with pronunciation may lead to struggles segmenting words, which is essential for reading and spelling. -Children with CAS may have difficulties with social relationships, as well as academically. They may struggle to communicate with peers.

V. General Prognosis:-Children with CAS may undergo years of speech therapy. Typically more than 9 years. It is recommended that children receive services 3-5 times per week, initially. -Children with CAS may improve in articulation of targeted phonemes, but tend to have difficulties with producing novel or complex words.-Continued work with an SLP is necessary for children with CAS. CAS will not resolve on its own. -For children who struggle greatly with speech, a communication device or sign language may be used to facilitate communication and ease frustration. Generally these devices become obsolete as childrens speech improves.

VI. Resources and References:American Speech-Language-Hearing Association http://www.asha.org/public/speech/disorders/ChildhoodApraxia.htmLewis, B. A., Freebairn, L. A., Hansen, A. J., Iyengar, S. K., & Taylor, H. G. (2004). School-age follow-up of children with childhood apraxia of speech. Language, Speech & Hearing Services in Schools, 35(2), 122-140.National Institute on Deafness and Other Communication Disorders (NIDCD) http://www.nidcd.nih.gov/health/voice/pages/apraxia.aspxShriberg, L. D., & Aram, D. M. (1997). Developmental apraxia of speech: I. Descriptive and theoretical perspectives.Journal Of Speech, Language & Hearing Research, 40(2), 273.Teverovsky, E., Bickel, J., & Feldman, H. M. (2009). Functional characteristics of children diagnosed with Childhood Apraxia of Speech. Disability & Rehabilitation, 31(2), 94-102.