Childhood Apraxia of Speech (CAS) is considered a childhood motor speech disorder which is “characterized by deficits in sequencing the movements required for speech production” (Teverovsky. Bickel, & Feldman, 2007). CAS can occur due to a co-occurring neurological disorder or it may be associated with neurogenic speech sound disorder that has no known cause. The features associated with a diagnosis of CAS are what it is usually distinguished by.
According to ASHA (2014), there are many signs and symptoms that indicate a child has CAS. It is found that these children commonly display these characteristics in order to be diagnosed. These characteristics include: “inconsistent errors in vowel and consonant production in repeated production of syllables and words, lengthened transitions between sounds and syllable and inappropriate prosody” (ASHA, 2014). These functional areas have been consistent deficits associated with CAS and are also involved in planning and programming of speech. These features are not considered to be the only associated characteristics with a diagnosis of CAS. These children may also experience co-occurring phonological and language problems.
The impairment of inconsistency and precision of the motor speech movements is what is to be considered the core problem for a child with CAS. The features that are included in CAS have not been considered by ASHA (2014) to be the only diagnostic features of CAS as not all signs and symptoms are seen in every child. No sites of lesion in the brain have been identified to be the cause of CAS. The diagnosis of CAS is considered to be without the presence of oral motor weakness (Daniel, 2009) It is also important to note that a child with CAS may experience other disorders simultaneously. It is common to find Dysarthria, a motor speech disorder involving weakened muscles of the face, to co-occur with CAS.
There are many methods that can be used to treat CAS. Previously indicated, CAS is considered to be a problem with a child’s motor planning or programming and therefore often the approach that is taken should be motor based. Integral stimulation therapy is one motor based treatment that is often used. Integral stimulation uses cognitive motor learning principles and combines them with cueing strategies for repeated practice of motor tasks (ASHA, 2013). There are different methods that this treatment can be applied and there are several studied that research the effects of this treatment on children with CAS.
Integral stimulation is a hierarchical treatment program that was developed by Rosenbek to help treat apraxic speakers (Daniel, 2009). This treatment is now used for children with CAS, after originally being developed for acquired apraxia of speech and was more geared towards adults (Edeal, 2008). There are 8 steps for a clinician to use when implementing this method. The first step is the “watch me and do what I do” technique. This is when the therapist will provide a visual as...