Children's Perspective of CAS Therapy
Article Summary & Clinical Implications
How do children feel about apraxia therapy?
Most evidence-based treatment methods for childhood apraxia of speech (CAS) involve motor-based treatment characterized by a significant amount of drill. Some clinicians and parents may worry that expecting children to participate in intense drill could be stressful and even cause the child to view therapy negatively.
Recently, a team of researchers explored the experience of children with CAS who participated in treatment research studies and received intense, motor-based drill for 45-60 minutes per session. Their results were published in the journal Child Language Teaching and Therapy, 2025.
The Research Study
The study conducted by McCormick, et. al. involved thirty children (age 3:9 – 8:7) enrolled in two separate CAS treatment studies using Dynamic Tactile and Temporal Cueing (DTTC). After completing the study which involved a total of 24 hours of treatment, children shared their perspectives about therapy through drawing pictures, describing their drawings, and using emojis to answer direct questions.
The drawings and responses demonstrated that even very young children were able to describe their speech therapy experiences. Following analysis of drawings, descriptions, and answers to direct questions, the study authors reported the following:
- When asked about their feelings about speech therapy, most children described positive experiences (62.5% pointed to the emoji for “happy”, 16.67% pointed to the emoji for “middle”; and 8.33% pointed to the emoji for “sad”).
- Children’s drawings and descriptions provided insights about focal points of the children’s experiences. Place (the therapy setting), transitions (to
and from therapy and within the session) and people were common focal
points.
Clinical Implications
There are two potential clinical implications from this study:
-
Using innovate methods (such as drawing and use of emojis) can help clinicians and parents understand the perspective of children who are undergoing treatment
Clinicians can use these methods for periodic “check-ins” with children about how they are feeling about therapy. A simple chart with 5 or 6 emojis could potentially help children express feelings without resorting to undesirable behaviors. -
The therapy environment and therapeutic relationship with the child are important.
Places and people were focal points for many children in the study. Minimizing environmental distractions might help the child focus on the clinician’s face for modeling and cues. Allowing children to give input in things like treatment target words and reinforcements might help the child feel like a partner with the clinician.
This research was funded by a grant from The Once Upon A Time Foundation/Child Apraxia Treatment