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Apraxia

Apraxia of Speech (AOS), or Childhood Apraxia of Speech (CAS), is a neurological speech sound disorder in which the movements of speech are inconsistent and imprecise. Apraxia may occur in conjunction with other disorders, or on its own. The core impairment is difficulty planning movement sequences of speech, resulting in errors of speech sound production and prosody.

Symptoms

Apraxia of speech can be difficult to diagnose. However, there are three key deficits in the planning and programming of movements for speech which support a diagnosis:

  • Inconsistent errors on consonants and vowels in repeated productions of syllables or words (trouble imitating sounds, or saying something a different way each time).

  • Lengthened and disrupted transitions between sounds and syllables - speaking slowly.

  • Inappropriate prosody ("melody" of speech), especially in the way words or phrases are stressed.

Speech may also be effortful to produce, or the individual may not be able to speak at all.​

Treatment

Treatment goals for apraxia focus on facilitating overall communication and language skills by:

  • Increasing speech production and intelligibility.

  • Motor programming approaches — use motor learning via many repetitions of speech movements to help the individual accurately, consistently, and automatically make sounds.

  • Linguistic approaches — teach individuals how to make speech sounds within words and sentences.

  • Rhythmic (prosodic) approaches - using intonation patterns (melody, rhythm, and stress) to improve functional speech production.

  • When necessary, using AAC.

Motor speech disorders require repetitive planning, programming, and production practice; therefore, intensive and individualized treatment of childhood apraxia is often necessary. To the extent possible, treatment takes place in naturalistic environments, is provided in a culturally appropriate manner, and involves as many important people in the child's life as possible to facilitate carryover and generalization of skills. Involving caregivers in treatment helps them understand and practice goals with the child outside the treatment setting.​

American Speech-Language-Hearing Association (n.d.). Childhood Apraxia of Speech (Practice Portal). Retrieved Jan, 18th, 2023, from www.asha.org/Practice-Portal/Clinical-Topics/Childhood-Apraxia-of-Speech/.

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