Does Your Child Have Childhood Apraxia of Speech (CAS)?

Childhood apraxia of speech (CAS), is also called developmental apraxia of speech (DAS) and dyspraxia. This is a motor speech disorder. Children with developmental apraxia have difficulty coordinating and sequencing their articulators (mouth, lips, jaw, tongue) to produce sounds, syllables and words. This is not at all due to muscle weakness, but rather it is due to poor communication between the brain and the muscles that are needed for speech. In other words, the area of the brain that is responsible for telling the muscles what to do and how to move to make partiuclar sounds is not fully developed or possibly damaged. In adults, apraxia of speech is caused by a stroke or other brain damage. In children the cause is not so clear.

Speech apraxia is only related to speech activities and so non-speech activities that use the same muscles such as coughing, chewing and swallowing are performed just fine.

Some Characteristics of Childhood Apraxia

• Sound errors may be inconsistent - this means that your child may be able to say /b/ in some contexts but not others. For example he might be able to say /bye/ but be unable to say /baby/ or /bed/.
• Typically this child will understand langauge better than they can speak.
  
• This child has difficulty imitating even though they may look at you and try - you may see your child groping when attempting to produce sounds or imitate sounds.
• Even though he has trouble imitating, his imitated speech will be clearer than his spontaneous speech
  
• As a parent you may hear your child say a word while playing alone, but then when asked to say it again, they can't. So when they feel "put on the spot" to say a certain word they become more anxious and the motor planning then becomes completely unaccessible.
• Longer words and phrases are more difficult to understand than shorter ones.
• Children with DAS may also have difficulty retreiving words because as a result of their difficulty retrieving the motor plans for speech, they have not organized words into a 'dictionary' in their brains during a very important time of vocabulary development.
  
  

Therapy for Children with DAS

A child with developmental apraxia of speech will not usually grow out of it on his own. His speech will improve without speech therapy, but he will continue to have speech errors and be difficult to understand as he gets older. There is not a quick fix for DAS and it often takes a couple of years of intensive therapy before a child with DAS feels that he is a successful communicator. Therapy for children with apraxia is usually pretty intensive - 2-3 times a week and focuses on combining both visual and tactile cues for best resuts. In severe cases of DAS, a picture communication system or sign language may be introduced in order to give your child a means to communicate. These communication systems will often taper off once your child becomes successful with speech.

At home it is important to give your child plenty of encouragement and praise when speech is attempted. If you know what your child is saying, it is important to say it back to him so he can hear how it sounds correctly. When you want him to try to say a sound or word after you, make sure he is looking at your mouth as you say it so you are providing him with as much visual feedback as possible. And always reward the attempt, not neccesarily the accuracy. And remember that even though he might have been able to say a word correctly once or twice or ten times, that the motor plan for that word may not always be accessible.

Once your child is seeing a speech pathologist, it is important to establish times every day to work with your child on the speech exercises that are recommended. As with anything, it is better to practice five minutes each day than once or twice a week for longer periods of time. Try to make your home practice fun and game-like to encourage greater participation.

For more information on Childhood Apraxia of Speech you may want to visit The American Speech-Language Hearing Association (ASHA).

I have found a great resource for teachers and parents on CAS (Dysraxia). This book promises to be give useful advice for helping children with DAS. It gives clear and positive answers to many questions asked by parents and teachers. For those who want a quick, simple reference on Dyspraxia, this book it ideal.