CAS may go beyond speech

Childhood apraxia of speech (CAS) can present some of the most challenging “speech-only” cases. But have you ever had a parent ask you if their child needs more than just speech therapy? For example, have they, or you, ever noticed that their child with CAS also seems a little clumsier than a typical child?

Turns out, in a sample of children ages 3–15 with CAS, 49% also met the criteria for developmental coordination disorder (DCD), compared to 5–6% of the general population. Developmental coordination disorder presents as a difficulty of acquisition and execution of coordinated motor skills. These motor impairments can significantly impact a child’s ability to perform daily acts of living, including academics, self-care, and leisure activities. Symptoms may include an unsteady walk, difficulty acquiring motor skills like tying shoes or using scissors, and frequent dropping or running into objects.   

While it makes sense that children with motor planning difficulties for speech may also have general motor difficulties, SLPs have an advocacy role to play here. We need to be aware that children with CAS may need additional support from OT or PT, and that CAS and DCD can be successfully managed from a young age if addressed early and in a collaborative manner.

Duchow et al. encourage SLPs treating children with CAS to engage in interdisciplinary evaluation and treatment, as difficulties with both communication and motor skills significantly impact academic achievement and social participation. The authors encourage SLPs to utilize the Developmental Coordination Disorder Questionnaire (free!) to screen for the disorder in children ages 5–15 (There is a preschool version available for $50). If you don’t regularly work with OT or PT, appropriate referrals should be made.

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Editor’s Note: Never heard of developmental coordination disorder (DCD)? I hadn’t either! So, of course after reading this article, we had to dig a bit deeper. First, the disorder goes by other names, (e.g. global apraxia; developmental dyspraxia), though DCD seems to be the more current term. To learn more about DCD, I’d highly recommend these articles: this recent one is definitely the most thorough; this is a commentary on that article. Then this and this are also good. Long story short—after reading the research and emailing several PTs and OTs, it seems like this disorder is much more commonly diagnosed in Europe and Canada, and tends to be a bit difficult to get insurance coverage for in the U.S. But we encourage you to discuss this and collaborate with local colleagues—because it definitely looks like there’s more and more research being done, and it will very likely come up in your clinical practice sooner or later! ~ Meredith Harold, PhD, CCC-SLP

 

Duchow, H., Lindsay. A., Roth, K., Schell, S., Allen, D., & Boliek, C.A. (2019). The co-occurrence of possible developmental coordination disorder and suspected childhood apraxia of speech. Canadian Journal of Speech-Language Pathology and Audiology.