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Apraxia of speech is grouped with other conditions as a “motor speech disorder”. It varies significantly from child to child, and its severity can range from mild to severe.

Speech is one of the most intricate and complex actions in which humans can be engaged. It requires a high degree of oral- and verbal-motor coordination involving the “articulators” (i.e., lips, tongue, teeth, palate, jaw). Children with apraxia of speech have difficulty initiating and coordinating the oral- and verbal-motor movements needed for the production of speech sounds and for sequencing them into syllables, words, phrases, and sentences.

Apraxia of Speech FAQs

Some children with CAS have a history of feeding difficulties (e.g., poor coordination for sucking, chewing, and/or swallowing) and difficulty using the lips and tongue for non-speech tasks, such as puckering lips to kiss or blow bubbles, or using the tongue alone (without lip or head support) to lick an ice cream cone. Such difficulty with non-speech tasks is termed “oral apraxia”. However, the signs of oral apraxia are absent in many children with CAS.

Following are the verbal-motor difficulties experienced by most children with CAS:

  • Limited frequency and diversity of sounds, vocal play, and jargon as a baby.
  • Slow acquisition of words and of the ability to put them together into phrases.
  • Poor speech understandability due to numerous sound errors and omissions of sounds and syllables.
  • Discrepancy between receptive and expressive language skills (i.e., The understanding skills of children with CAS is usually stronger than their ability to express themselves.)
  • Inconsistency in how the child produces a sound or word (e.g., A child may say the /s/ sound correctly in the word “sun”, but then say the word “sit” as “hit”.)
  • The ability to correctly produce a sound or word spontaneously, but the inability to do so when asked to imitate the sound or word.
  • A decrease in accuracy and understandability as the utterance length and/or complexity increases (e.g., The child can say each of the words, “cow” and “boy” clearly, but says the word “cowboy” as “buckoy”.) The speech of some children with CAS sounds slurred and run together, as they attempt to express themselves in longer phrases and sentences. Such children may be able to imitate the single words “butterfly” and “beautiful”, but when spontaneously using them in a sentence, they may omit sounds and syllables, making the words difficult to understand (e.g., “The buhfie is booful.” for “The butterfly is beautiful.”)
  • A relatively poor repertoire of syllable and word shapes (e.g., The child may mainly produce consonant (C) + vowel (V) syllables, such as “boe, tee, doo” or CVCV reduplicated syllables, as in “mama”, “wawa”, “baba”).
  • The ability to produce some consonant and vowel combinations, but not others (e.g., The child can say, “kay”, “kee”, and “kie”, but not “koe” or “koo”.)
  • Distortions of vowel sounds. For children who are developing speech typically, accurate vowel acquisition is occurs early. Children with CAS often possess some vowel distortions (e.g., “tom” for “time”, “bod” for “bad”, and “ott” for “out”).
  • Difficulty sequencing sounds in words (e.g., “ticky” for “kitty”), especially when attempting to produce longer words (e.g., “cuhvanoe” for “volcano”).
  • A relatively poor repertoire of consonants and vowels (e.g., The child may only produce the consonants /p, b, m, t, d” and the weak vowels “eh” and “uh”.)
  • Unusual stress or rhythm patters. The child may sound “robotic” due to the placement of equal stress or emphasis on each syllable (e.g., “I-am-pe-tting-the-pu-ppy.”)

We make therapy for the child with CAS a fun experience using a combination of toys, games, and picture tasks. Since a great deal of speech practice is needed to help children conquer this disorder, we incorporate a lot of reinforcement and motivating tasks in our sessions.

A specific therapy program is designed for each child, depending upon her age, interests, personality, strengths, and speech needs. The primary goal of therapy for the child with CAS is to help her develop the motor control and sequencing abilities needed to produce all age-level sounds clearly and to easily and accurately sequence those sounds into words of increasing length. Each little achievement made by the child adds a great deal to her competency and confidence and makes the next step easier to attain.

First of all, your child’s speech-language pathologist will provide you with specific suggestions and activities for home practice. Consistent home practice is a big factor in helping your child overcome her difficulties. As we always suggest, make your child’s message more important than how she says it. Don’t feel the need to correct your child when she tells you something. If you do not understand the whole message, try to mentally fill in the misunderstood parts in order to get the “gist” and respond to your child accordingly.

In many cases, a parent is one of the only people who understands their child with CAS. This is extremely comforting and freeing to the child, when the rest of the world does not know what she is trying to say. At the beginning, you may need to speak for the child, but as she becomes more skillful and gains confidence when communicating with others, your role will be more supportive in nature It is so helpful to know what your child’s abilities and limitations are, and it is crucial that she not be put on the spot to say something (e.g., “Tell Grandma what we did today!”). Instead, it is helpful to ask your child choice-of-two questions that would allow for a simple single-word or short phrase response (e.g., “Did we paint or make cookies?”).

Be patient and encouraged. With therapy, home practice, and time, your child should be able to make great strides toward becoming a clear communicator. Most children we see who had CAS tend to make up for lost time, becoming little chatterboxes!

The Childhood Apraxia of Speech

The American Speech-Language-Hearing

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Crystal Scheibe

Great place, glad we found them. Been going to Medina over 2 months now and he loves Lauryn and Kyler. Wish they had more ABA therapy places available... live in Wooster and long drive everyday.

Karrie Swan LaRock

My 11 year old son has dyslexia and has made noticeable gains in working At LLA THERAPY. Katie is strong in her approach toward him and also keeps him comfortable enough to perform well. We will continue visiting both the Fairlawn and Hudson offices and recommend them highly.

Ron Monroe

My 9 year old just completed about 9 months of weekly speech sessions (due to his stuttering) with Matt Hagge at LLA and we are thrilled with the experience and results. What I thought might be a negative (what kid really wants to go to speech class?) was made very positive by Matt, and my son never hesitated or complained when we talked about class. He really enjoyed it and really took what Matt taught him to heart. His speech has been greatly improved and we definitely recommend LLA. Thank you so much!

Heather Dougherty-Pantoja

My son’s Occupational Therapist, Jess, is an amazing OT! She gives practical tips on working with my son at home and school!

Terri Apgar

I cannot say enough good things about LLA Therapy. My daughter was a client of Teal Simmons’ for approximately 2 years and was just released from speech therapy! She was diagnosed with Apraxia in 2015 and worked with Teal twice a week. Through Teal’s application of PROMPT therapy, my daughter had age-appropriate speech after one year. All of the staff we interacted with at LLA were absolutely wonderful. They really care about what they do and making sure your child achieves their goals.

Kelli Geisler Davisson

LLA Therapy has been an excellent experience for my son as well as my family! My son always asks, "When can I go see Ms. Jeannine again, is it Monday??" He has also made huge gains in only 5 months! I would highly recommend LLA and have already shared my experience with friends looking for services!

Victoria Hansford-Price

We are so grateful for our Speech Therapist Ms.Teal. We have seen a great improvement with our sons confidence and communication abilities since we have started "Prompt" therapy. What we love the most about LLA and Ms. Teal is that Kohl feels comfortable and relaxed which has played a critical role in his progress. Thank you Ms. Teal for all you have done.

Laura Lee Hogsett

They have helped in numerous ways. Speech, OT and behavioral. I've had numerous compliments on my son's progress thanks in very large part to LLA. I would recommend LLA before I recommend our local children's hospitals, though they are good, they don't have the staff that LLA does.

Amy Furukawa

We had a great experience with Matt Hagge at LLA! Our Middle School age son was becoming very conscious of his voice, which is nasal due to a cleft palate. Matt helped him to better form his sounds and project his voice in a way that makes the unavoidable nasality less noticeable.Our son is more confident and outgoing & even took on a speaking role in the church play. Matt has the perfect personality to relate with our son, and we would recommend him to anyone needing speech therapy services!

Jessica Havalotti

LLA Therapy has been an excellent experience for our daughter. I would highly recommend LLA. Miss Grace was so amazing and I can't believe how quickly our daughter showed improvement. Thank you!
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