Childhood Apraxia Of Speech (CAS)

Childhood apraxia of speech, also known as CAS, is a motor speech disorder. The disorder is a result of miscommunication between the signals of the brain and parts of the mouth and jaw. The jaw, lips, tongue, and other parts of the mouth do not move normally when producing words. For example, children with CAS may not be able to pronounce every syllable structure process in a word. For example, the word tomato may be pronounced as mato, or toma. In such cases, children may drop the first or the last syllable of a word. However, they won’t be consistent with types of deletions. Parents or teachers may notice various problems with speech because children with CAS do not have just one speech disorder. Rather, they will have multiple disorders
that are present at different times. If children have CAS, they may have trouble with a variety of symptoms. They may not try to speak as early as other children, or they may have trouble imitating the speech of others. Many other symptoms are possible as well, so diagnosing CAS can be problematic. Not much research exists, so diagnosis and treatment are often difficult. In most cases, when children demonstrate speech that is inconsistent in terms of the type of errors, then CAS is diagnosed. To treat this type of disorder, therapy must take place frequently and intensively. The actual type of therapy used depends on the evaluation of each child because every child with CAS is different. Childhood apraxia of speech, also known as CAS, is a motor speech disorder that is affected by abnormalities in the planning and programming area of the brain or verbal trait deficiencies.
As a result, the brain does not not tell an affected child’s lips, jaw, tongue, or other body parts used in speech how to move correctly (Jacks, Marquardt, & Davis, 2005; Grigos, Moss, & Lu, 2013; Highman, Hennessey, Leitão, & Piek, 2013). Therefore, the child has a number of problems pronouncing sounds and syllables. Syllable deletion and initial and final consonant deletion are all primary symptoms of CAS. Such deletions are more prevalent in children with CAS than with any other speech disorders children may have. Syllable problems include issues with deleting certain syllables in words as in the following example: potato is pronounced tado. Also, more than with any other disorder, an initial and final consonant is deleted: boat becomes oat or bo (Jacks, Marquardt, & Davis,
2005).
The speech of children with CAS is usually very difficult to understand.
This disorder is highly complicated and is caused by errors in motor processing. According to ASHA, therapy is very difficult due to difficulty with diagnosis: symptoms of CAS may vary with each child, so progress in therapy takes longer to achieve. The clinician must assess each articulator—lips, jaw, tongue, etc.—in order figure out the fundamental speech production. When a child’s speech errors are extremely variable and inconsistent, the clinician can then diagnose a child with CAS. The child may exhibit problems with speech that include difficulty with the number of sound inventories, production of sound sequences, commission of vowel errors, imitation of speech, ease with prosody, and struggling with the formation of articulators to produce the correct sound (Grigos & Kolenda, 2009). Other symptoms of this disorder may include deficiencies in speech perception and with expressive language and phonological awareness. A child may also experience problems with literacy-related skills. The root of this disorder is located in the brain centers that are involved in planning and programming of speech motor performance. Some of the symptoms of CAS remain longer than in other children with speech disorders or delays. While the vocabulary size and speech skill are not directly related to each other in these children, it could still be due to their intelligibility in their speech (Velleman,
2011).
With CAS, since the processing and programming of speech movements are disabled, treatment plans are varied among different clinicians, but the main goal is the same: to watch and analyze the movement of the speech articulators. In order to do so most effectively, a motion capture system could help clinicians study the production of movement of different articulators with various tasks (Grigos, Moss, & Lu, 2013). In any case, the clinician must treat a child with CAS differently than one with delayed speech development. Both disorders may present with similar symptoms; however, each case will result in different outcomes. Researchers are not sure about which movement of the speech articulators is specifically a sign or a symptom of CAS. Therefore, greater emphasis should be placed on finding opportunities for more effective social interaction with speech. Research should focus more intently on how a child’s speech develops over time. As a result, therapy would become a more effective tool for clinicians to help these children communicate more successfully with their family members and peers. For example, Clinicians will then have more control over the diagnosis if they have a clearer understanding of the actual disorder when it is not confused with others (Grigos, Moss, & Lu, 2013).
Because so many gaps exist in the definitive diagnosis of CAS and because limited research has been completed, treating CAS can prove to be a very complicated process (Velleman, 2011). Treatment used in this article was mainly on creating phonemic awareness, connecting graphemes to phonemes, and providing opportunities for targeted speech production practice. Because each child with CAS presents with unique symptoms and speech goals, each treatment plan much be specifically written for him or her. In some cases, phonological awareness intervention is utilized to emphasize the manipulation of speech parts and performance rather than on solely auditory-based activities. However, it is possible to make progress in some children with CAS. The lack of research and treatment options causes problems as clinicians try to treat childhood apraxia as opposed to adult apraxia. Because childhood apraxia differs dramatically from adult apraxia, the focus of therapy must be more tailored to a child’s development of literacy skills (Moriarty & Gillon, 2005). One such focused type of therapy involves principles of motor learning, a type of therapy that helps with the development of various learned motor skills (Ballard, Robin, McCabe & McDonald, 2010). In order for each child with CAS to be diagnosed and treated in the best way, more focused research must be done to help clinicians work more effectively.