Evidence Based Practices in Treating Childhood Apraxia of Speech
Among all the approaches used in treating CAS, two approaches are found to be the most effective with evidence. They are, Motor Programming and Linguistic Approach.
I) Motor Programming Approach
The Motor programming approach has the following principles to it, which has made it stand out and the most effective as compared to the others.
a) Frequent Practice: CAS is a motor planning disorder, and therefore, a lot of practice is required for children to be able to produce the targeted sounds consistently and effectively with clarity. Repeated practice is key to success.
b) Accurate speech movement and feedback: Say for example, you’re trying to work on the sound “ta” and the child says “tha” instead, then you need to give the child an appropriate feedback; so that he would be able to correct the “tha” to “ta” and to produce the right sound.
Accurate speech movement feedback which has emphasis on the right placement of articulators are crucial. I encourage the feedback to be given much positively. For example, rather than saying it’s not “tha” its “ta” you can say “yes you’ve tried it right, now for the next trial, try to put your tongue above and behind your teeth and say “ta”. This is likely to give you more success rate because you’re building up the child’s confidence and letting him know that he’s right. Even better if you offer multi-sensory feedback.
c) Use a variety of sensory Inputs: Use visual, auditory, as well as tactile input so that you will be able to help the child produce the targeted speech sound with far better ease, rather than only depending on auditory stimuli.
d) Considerations for Practice: Duration, intensity and frequency of therapy sessions are a major part of success. The duration can be limited between 30 minute to 40 minute sessions, as prolonged duration can be overwhelming or the child may feel bored. The session ought to be well planned, so that they are intense and meaningful. As for frequency a minimum of three sessions per week is recommended. If parents and therapists are available for more sessions, it could be most fruitful.
These are the 4 principles of the Motor programming approach.
II) Linguistic Approach
The other approach with most evidence is the Linguistic Approach by Shelly Velleman, which emphasizes on the
Founder, Director at Dimensions
Speech Langauge Pathologits