Thursday, February 28, 2013

7 Common Myths of Childhood Apraxia of Speech (CAS)

By Melanie Feller, M.A., CCC-SLP

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Proper diagnosis of a language concern is crucial to effective and appropriate treatment. Childhood apraxia of speech (aka developmental apraxia of speech/dyspraxia/verbal apraxia) is frequently both over, and under-diagnosed. Ineffective and inefficient treatment can result.
Childhood apraxia of speech (CAS) is a difficulty coordinating and planning out the production of sounds. It is a disorder of motor planning. The child knows what he or she wants to say, but can’t get his or her mouth to do what the brain wants.
Specific signs of CAS include, but are not limited to:
  • Limited babbling/sentence production: In younger children, they may not babble much and sequencing of sounds may be limited. The older child may produce shorter sentences
  • Groping: The child may have obvious difficulty putting sounds together. Groping may be noted, meaning that the child may move his mouth around in an attempt to find the correct place in which to make the desired sound.
  • Difficulty with spontaneous speech: The child may have difficulty initiating speech, not because of lack of desire, but because of difficulty producing the sounds and “getting started”. The child may also simplify words.
  • Difficulty with accurate imitation: The child with CAS may not imitate sounds or movements accurately. The child with CAS will have difficulty imitating oral posture (i.e. round lips, blow a kiss), and may have difficulty imitating sounds..
7 Common Myths of CAS
  • An expressive language delay (insufficient language at the child’s age) must mean the child has CAS.
  • CAS is life-long, and the child will never speak properly as a result
  • CAS results from oral muscle weakness.
  • A wait-and-see approach is a good option.
  • Any speech pathologist can treat CAS.
  • CAS requires hundreds of dollars spent on special programs and special therapy materials.
  • One session per week is sufficient for a child diagnosed with CAS
Myth 1: An expressive language delay must mean a child has CAS.
An expressive language delay and CAS are NOT the same thing. An expressive language delay means that the child is demonstrating verbal behaviors similar to that of a child at a younger age. The child with CAS is demonstrating verbal behaviors that are not considered appropriate at any age. Just because the child isn’t speaking sufficiently for his or her age doesn’t mean he or she has CAS.

Myth 2: CAS is life-long, and my child will never speak properly as a result.
While there are children who continue to demonstrate minor speech issues, as well as those that are more significantly affected, the majority of children with CAS go on to lead lives with average speech abilities. A diagnosis of CAS is not an indication that the child will not be able to communicate effectively as he ages.

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