Examples of different levels of severity in Childhood Apraxia of Speech (CAS)

Sharing buttons:

we consider CAS a motor speech disorder

because of the fact that the primary

difficulty is this planning and

programming of movement and that's

probably the way it's different from

other speech disorders it's important

however to remember that childhood

apraxia of speech occurs in the context

of the child learning all aspects of

language and speech so most children

that have a proxy of speech also have

other disorders maybe a language problem

and certainly a problem in learning the

rule governed system of sounds for their


the primary way though that apraxia is

different is because it involves

specifying movement parameters treatment

has to be focused on helping that child

a child acquire more accurate movement

some children do have very severe

difficulty with practice or planning

these movements and will have a very

difficult time learning to talk other

children though may have moderate to

more mild maturity difficulties and will

need less frequent or won't be in

therapy quite as long it's sort of like

coordination where it's on a continuum

where some people have very severe

problems with speech praxis and others

have very little difficulty the

following examples can show you some of

the variation in severity in childhood

apraxia the following examples are from

evaluations and are not examples of

therapy this clip shows word repetition

during an evaluation again we're not

providing therapy here but just

examining speech characteristics as he

tries to repeat notice the inaccurate

movements resulting in sound distortions

good job by up dad back o out out me me

no no hi

you should press hi huh oh my

hi mom hi my knee

oh no oh good job very good how old are

you oh good job in this next clip you

will see a child who exhibits a number

of characteristics of childhood apraxia

including groping for sound physicians

and off-target movements that distort

sounds notice how he is inconsistent

over repeated tries at the same word

toward the end of the clip notice how he

does better if he's looking at the

clinicians face day Oh dad ah no no no

ma Nana

ah ah oh

go for now say aye

oh oh oh oh ah ah ah ah ah there you go

very good say it again

ah ah look at me say AHA there you go do

it again

ah do it again huh Julian like this in

this next clip you will see more probe

testing where we are looking at the

child's ability to say the phrases on

which he has been working notice his

deliberate manner of speaking his slower

rate and the concentration he needs to

use he will need to use less

concentration as the movement accuracy

becomes more automatic with continued

practice I would turn writer I sit on my

pass ah my bed bed back

I need my Ben 10 I need my then then oh

I heard all those good sounds oh ah I

will fight i right good job

look at me over here I will have fun me

out fun let's try again I'm watching ah

yeah I will have fun they can learn how

about this one I write with my pen I

like race MA


in this clip you will see the child

naming some pictures and talking with

the clinician note that he has some

typical developmental sound errors such

as substituting T for K and D for G as

well as difficulty with the art sound

we call these Bona logic and they are

not associated with difficulty with

movement planning these errors are

consistent and that he always does them

the same way however he also exhibits

some sound distortions and slower and

more deliberate speech which is often

seen in children with childhood apraxia

many children with apraxia also make

developmental or Fona logic hey can you

tell me what these are what is what is

this a house good job what's this part

of the house

I hope oh this is the roof and this is

you look out the window good job with

this awfully good job what's this uh-oh

what's a long name for it is it a

telephone yep can you tell me that kind

of some good job this is a KCAP a t-top

that's right it is a teacup um

some yetis ammonia you had some yuckies

in your ear what happened um doctor how

did we I was click let me to pull last

night you were playing in his swimming

pool last night

then he doesn't head like that daddy hit

your foot nothin

what is Dalton Oh Dalton is that your


yeah yeah Dalton hit your foot well tell

me what you were doing

um plane and that Blue Slide playing on

the Blue Slide what was this like eat ah

ah ah good what's this one a knife and

this is a fool good job

what is this I wanna leave that time

ding aha

wagon you put sand in it can you say the

name again it's all riding with sank

with the stress a Samba we put on game

that's why we made our added touch with

it John mm-hmm