Targeting both speech perception and production for CAS

We think of childhood apraxia of speech (CAS) as a motor speech disorder, so it makes sense that our interventions mostly treat speech production. But what about all the children with CAS who also have language and reading weaknesses? Some evidence suggests that therapy to improve speech perception (think phonological awareness skills) can also benefit children with CAS. 

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In this study, Hume et al. used a combined perception and production treatment with six children with CAS (ages 4–7) who were making slow progress in therapy. They used a pretest–posttest design (basically six case studies)—so the study design isn’t the strongest. But we don’t have a ton of treatment studies on children with CAS, and descriptive studies can still give us ideas for our clients, so the results are still worth a look.

During individual, 50-minute sessions, an SLP led children in: (1) rhyming practice, (2) phonological awareness activities using target sounds or sound patterns, (3) speech production practice, and (4) generalization practice (using target sounds in a new context). Following 30 treatment sessions, all children improved their production of untaught words and their consistency of word productions, and five of the six children improved on tests of phonological awareness.

Again, with a nonexperimental study, we can’t say whether the treatment caused children’s progress. However, the results match findings from other studies that suggest perception practice might benefit children with CAS. If you have clients with CAS who are making slow progress in therapy and who also struggle with reading or pre-reading skills, tacking on some phonological awareness practice might be worth a try. 

Hume, S. B., Schwarz, I., & Hedrick, M. (2018). Preliminary investigation of the use of phonological awareness paired with production training in childhood apraxia of speech. Perspectives of the ASHA Special Interest Groups, 3 (SIG 16), 38–52.