Diagnosis And Treatment Of Childhood Apraxia Of Speech

Diagnosis of CAS:

Oral-motor Assessment:

• Looking for signs of weakness in muscles in the lips, jaw and tongue (Dysarthria) CAS patients do not have this sign.
• Checking the level of coordination of movements of the mouth by making him imitate non speech actions like – moving tongue as per direction, smiling, frowning or puckering lips etc.
• Examining the coordination of muscle movements for speech while the child is performing tasks. He is made to utter repetitive sound like ‘puh-tuh-kuh’ as fast as possible.
• Testing for abilities in the child’s skill of daily activities like ‘licking a lollipop’ or pretending activities to lick a lollipop.

Intonation (rise and fall of the voice pitch) Assessment:

• Checking if the child is making appropriate stress on syllables and words in a sentence.
• Evaluating a child’s pitch and pauses to show different expressions like questions, exclamations or statements.
• Examining placings of pauses like between words and phrases.

Pronunciation Of Sounds Assessment:

• Evaluating vowel sounds and consonant sounds.
• Listening to individual sounds and combinations.
• Looking for understandability of the child’s speech by others who are not closely related to the child.

A speech and Language pathologist also checks for the expressive and receptive language abilities in the child.

Audiology Assessment:
An audiologist performs hearing evaluation tests to check for hearing loss affecting child’s speech.

Treatments for CAS:

Early detection and early start of the treatment is most necessary. Several research studies states that receiving frequent treatments i.e.- 3-5 times a week is very successful. Children shows better results when treated alone instead of groups. Once improvement is seen, treatments are required less often. And then group treatment patterns may be used.

The focus should be pointed to improving the planning, sequencing and coordinating muscle movements to produce speech. Exercises are designed to strengthen the oral muscles. But this would be of no help as CAS is about establishing coordination to produce speech.

Practising speech is extremely important. Feedback methods may be employed like – acting in front of mirror (visual methods), playing self recorded sounds (auditory methods). These are very helpful. Frequent repetitions of syllables, words, phrases, sentences can improve muscle coordination and ability of sequencing for speech.

Sign language or communication systems may be used. Family support is a must. Speech Therapists will educate the parents also.