Treatment of Childhood Apraxia of Speech – Key Vocabulary

Vocabulary flashcards summarizing essential terms, symptoms, assessments, treatments, and motor-learning principles related to Childhood Apraxia of Speech (CAS).

Childhood Apraxia of Speech (CAS)

A motor speech disorder involving breakdowns in planning, sequencing, and programming the movements required for speech.

Prevalence of CAS

Estimated to occur in roughly 5–10 % of children with speech-sound disorders.

Motor Systems Involved in Speech

Respiration, phonation, resonation, and articulation—all of which must be coordinated for intelligible speech.

Resonatory/Phonatory Symptoms of CAS

Voicing errors, vocalization on inhalation, subtle hyper-/hypo-nasality, nasal emission, and atypical stress or phrasing.

Oral-Motor Symptoms of CAS

Saliva pooling or drooling, silent or audible groping, jaw–tongue disintegration, slowed or inaccurate diadochokinesis, and poor sequencing of nonspeech oral tasks.

Segmental Errors (CAS)

Omissions, prolongations, vowel distortions, high substitution rate, transpositions, extra syllables, non-phonemic productions, and blend errors.

Lexical–Prosodic Characteristics (CAS)

Loss of previously produced words, initiation difficulty, greater accuracy in automatic speech, lower intelligibility with longer utterances, and rhyming/sound–letter association deficits.

Early Developmental Red Flags

Late or absent babble, delayed first word, increased drooling, low fine-motor scores at 24 months, with receptive language typically intact.

ASHA Core Feature 1

Inconsistent errors on consonants and vowels across repeated productions.

ASHA Core Feature 2

Lengthened or disrupted coarticulatory transitions between sounds and syllables.

ASHA Core Feature 3

Inappropriate prosody, especially with lexical or phrasal stress.

Differential Diagnosis: CAS vs Phonological Disorder

CAS shows motor involvement, deficient prosody, sequencing errors, vowel substitutions, and variable errors; phonological disorder does not.

Screening Test for Developmental Apraxia of Speech-2

A standardized tool used to screen children for possible CAS features.

Kaufman Speech Praxis Test

An assessment that evaluates a child’s ability to plan and sequence oral-motor movements for speech.

The Apraxia Profile

A preschool and school-age assessment designed to profile behaviors associated with CAS.

Treatment Focus for CAS

Improving motor planning and programming through production-based, motor-learning-driven therapy.

Kaufman Speech Praxis Kit

A treatment program using a phonological simplification hierarchy to shape accurate productions.

PROMPT Therapy

A tactile-kinesthetic approach using specific cues to facilitate jaw dynamics and articulatory movements.

Rapid Syllable Transition Treatment (ReST)

An evidence-based therapy targeting prosody and rapid transitions between syllables in polysyllabic words.

Melodic Intonation Therapy (Adapted)

A prosody-focused technique originally for adults, modified to help children with CAS use melody and rhythm to improve speech.

Motor Learning Principles

Guidelines stating that high-quality practice, optimal feedback, variability, and multimodal cueing drive skill acquisition.

Practice Scheduling

Mass practice (longer, less frequent) aids acquisition; distributed practice (shorter, more frequent) strengthens retention and generalization.

Blocked Practice

Repetition of the same motor pattern to build initial mastery but with limited generalization.

Random Practice

Varied motor patterns each trial, enhancing generalization and motor memory.

Recommended Repetition Dosage

At least 50, preferably 100+ accurate repetitions per stimulus within a 15-minute session.

Multimodal Cueing

Using visual, tactile, kinesthetic, and auditory cues consistently across therapists to support accurate productions.

Rate and Prosody Manipulation

Purposefully slowing speech and modifying volume, pitch, and rhythm to increase accuracy and model correct stress patterns.

Integral Stimulation Hierarchy

Progression from simultaneous production to immediate imitation, delayed imitation, and finally spontaneous speech ('watch me, listen to me, say it with me').

Knowledge of Results (KR)

Feedback indicating correctness of an attempt (e.g., 'That was missing your /s/').

Knowledge of Performance (KP)

Feedback explaining why an attempt was inaccurate (e.g., 'Put your teeth on your lip for /f/').

Home and School Involvement

Regular, structured practice outside therapy that directly correlates with improved outcomes in CAS.

Mirror Neuron System

Neural mechanism activated by observing actions, leveraged in therapy by encouraging children to watch accurate speech movements.

FOXP2 Gene

A genetic factor linked to speech and language disorders, including some cases of CAS.

Oral-Motor Exercises and CAS

Activities lacking evidence of efficacy for improving CAS because the disorder is in planning, not strength or range of motion.

Prognostic Influences

Factors such as etiology, severity, cognition, therapy intensity, and family support that affect CAS treatment outcomes.