Cyndi Epplin Shares Information on Childhood Apraxia of Speech

Childhood Apraxia of Speech is a speech disorder that if undetected has long lasting effects that are difficult to
overcome. Getting help early is a definite plus when your child is diagnosed with Apraxia of Speech. While it
may not be pleasant to admit your child has a problem, it is always better to face the problem head on and get
help from a qualified Speech Language Pathologist. The worst thing you can do is not get the help your child
deserves. This article by Kanika Khara gives you some of the symptoms to look for when determining what may
be a speech problem and some treatment options that will benefit you in making decisions on how to proceed
with therapy. I hope this article is helpful. Cyndi Epplin

Children suffering from Childhood Apraxia of Speech (CAS) have problems in speaking sounds, syllables
and words. This is not due to muscle weakness or paralysis, but it's the brain that has problems in
planning the movement of the body parts like lips, jaw, tongue, etc., which are needed for speech. The
child knows what he wants to say, but his brain has difficulty in coordinating the muscle movements
necessary to speak those words. In most cases the cause is unknown. However, genetic disorders or
syndromes and strokes or brain injuries can be some possible causes of CAS.

Signs and Symptoms of Childhood Apraxia of Speech

The signs and symptoms of CAS may not be same in all children. It is essential to get your child evaluated
by a speech-language pathologist (SLP) who has knowledge of CAS. But some common symptoms which
can be observed are:

A Very Young Child

 Does not babble as an infant.

 You can hear only few different consonant and vowel sounds.
 There can be problems relating to sounds, like taking a long pause between sounds.
 Replacing difficult sounds with easier ones to simplify words or sometimes deleting difficult
sounds.

An Older Child

 Makes inconsistent sound errors and has difficulty in saying longer words than shorter ones.
 Difficulty in imitating speech, but imitated speech is more clear than spontaneous speech.
 May appear to be fumbling while attempting to produce sounds or to coordinate the lips,
tongue and jaw for purposeful movement.
 Speech can be hard to understand for an unknown listener, especially when the child is anxious.

Some Other Symptoms

  Weakness of the lips, jaw and tongue.
 Delayed language development and other expressive language problems, like word order
confusions and word recall.
 Hypersensitive or hyposensitive in their mouths, i.e. may not like to brush their teeth, eat
crunchy food, and unable to identify an object in their mouth through touch.
 May have problems while learning to read, spell and write.

How is Childhood Apraxia of Speech Diagnosed?

An audiologist should perform a hearing evaluation to eliminate hearing loss as a possible cause of the
child's speech difficulties. This evaluation will assess the child's oral-motor abilities, speech sound
development and melody of speech. This assessment involves:

 Checking for Dysarthria, i.e. signs of weakness or low muscle tone in the lips, jaw and tongue.
 Seeing how well the child can coordinate the movement of the mouth - like moving the tongue
from side to side, smiling, frowning and puckering the lips.
 Assessing the coordination and sequencing of muscle movements for speech, while the child is
performing tasks at Diadochokinetic rate, that requires the child to repeat strings of sounds as
fast as possible.
 Evaluating rote abilities by testing the child's skills in real-life situations like licking a lollipop, and
comparing this to skills in non-functional situations like pretending to lick a lollipop.
 Examining whether the child can use pitch and pauses to mark different types of sentences (e.g.
questions vs. statements) and portions of the sentence (e.g. to pause between phrases and not
in the middle of them).
 Assessing the child's receptive, expressive language and literacy skills.

What Treatments are Available for Childhood Apraxia of Speech?

The focus of treatment is on improving the planning, sequencing, and coordination of mouth muscle
movements for speech. Isolated exercises are designed to strengthen the oral muscles along with
speech production. The child must practice speech and should be given feedback from a number of
senses, such as tactile and visual cues (e.g. watching him in the mirror) as well as auditory feedback.
With these feedbacks, the child will find it much easier to repeat syllables, words, sentences and longer
utterances to amend muscle coordination and sequencing for speech. Some kids may be taught to use
sign language or an augmentative and alternative communication system, i.e. a portable computer that
writes or produces speech. But as the speech production improves, the need for these systems may
lessen. Parents are often given speech therapy related exercises to contribute in their child's progress
and allow them to use new strategies outside the treatment room. This helps a long way in treating this
disorder.

Childhood apraxia of speech can be referred to as 'development apraxia', which has no cure, but with
appropriate intensive intervention, significant progress can be made. The family should remember that
the treatment takes time and commitment, and the child needs a supportive environment that makes
him feel comfortable with the speech. Article by Kanika Khara