Moderate CAS Therapy – Child Apraxia Treatment

Therapy for Moderate CAS

Your child’s needs determine the appropriate treatment and your child’s needs will change over time. This means that at the beginning of treatment your child may benefit from a therapy approach for moderate-severe CAS, such as DTTC and NDP3, but as the deficit in motor planning/programming decreases, they may benefit from other approaches designed for milder severity levels, such as ReST or IPA. At some point, your child may no longer need motor-based therapy, but may still have other concerns, such as language, that can be addressed in traditional speech and language therapy.

What will therapy look like?

Therapy for your child should be individualized to meet your child’s needs. However, there are some common features you should see for a child with moderate CAS. Remember, if your child is just starting their therapy journey, their therapy might initially look like therapy for severe CAS, but should progress to therapy for mild CAS as they make progress and their deficit in motor planning/programming decreases. Therapy for moderate CAS usually includes things like:

Prosody
Prosody includes the rhythm, rate, smoothness and inflection of speech and is often disrupted for children with CAS, which can make their speech seem "flat" or lack emotion. Therefore, you should see this targeted in therapy. The speech-language pathologist should be helping your child to say words, phrases and sentences in lots of different ways - as a question, with varying emotions, slower or quicker, with different pauses. For example, Let's eat, Grandpa. Let's eat Grandpa! Let's eat Grandpa?
Augmentative and Alternative Communication (AAC)
Your child should be learning how to communicate, which includes speech but also other forms of communication, like gestures, signs, pictures or a device. These other forms of communication are called AAC. Even though your child may be talking, the SLP will probably also be working with your child on AAC so that they have a consistent, reliable way to communicate or to use as a "back-up" in situations in which others don't understand your child's speech. Using AAC will help your child to express their wants and needs, increase their language, and decrease frustration and anxiety.
Carrier Phrases
Carrier phrases refer to sentences that start the same way but can be completed with a variety of different words, making them useful in many situations. Carrier phrases include things like "I want," "I see," and "I put." For example, "I want juice," "I want a turn," "I want to go." When practicing these sentences, the goal is for your child's voice to sound "normal" good inflection (not flat or monotone), normal rate (not slow,) and smooth (not choppy).
Language
Many children with CAS have expressive language deficits that affect their grammar. You should see your child working on language goals like using personal pronouns (such as I, me, my, you) correctly.
New Movements Patterns for Words
Your child will probably be working to learn new movement patterns for words and phrases. You'll see these worked on with lots of repetition during therapy, so your child will be practicing each word or phrases dozens of times during a session.
Functional Speech and Phrases
Your child should be practicing using their speech in a variety of situations, including with their friends.
Complete Sentences
You should see your child working to use short sentences that are not missing any words (grammatically correct) and functional. Your child should also be working on emphasizing different words to express different meanings or emotions (e.g. I do it? Versus I do it! Or I do it versus I do it). Other phrases might include: leave me alone, stop it, what's that?