For some children with childhood apraxia of speech (CAS), difficulties will persist during their school year, and therapy goals and techniques may be influenced by expectations for participation in the classroom.
When a student reaches school age, reduced intelligibility may have a negative impact on their ability to participate in the classroom or interact with peers. While the core aspects of treatment will remain the same, adjustments in goals and targets may be necessary to maximize the student’s ability to communicate in that setting.
Strategies for School-Aged Children with CAS
When working with this age group, these eight strategies can help you focus your interventions to increase buy-in from your students and motivate them to keep practicing for better results:
- Maintain key elements of motor-based treatment, as appropriate. Focus on movement and thoughtful incorporation of principles of motor learning, such as intensity and type of practice1—for example, random versus blocked.
- Students who are older and more verbal may benefit from structured practice for prosody, using an intervention such as Rapid Syllable Transition (ReST).2 Transfer of prosody skills can be addressed by practicing with classroom reading materials using varied intonation.
- Curriculum may influence choice of targets. The student can begin working on challenging words or phrases before they will be used by the teacher and classmates. Working on a few highly relevant words to establish accurate productions can facilitate the student’s participation when the vocabulary is used in the classroom.
- The student’s interests may also influence choice of targets, encouraging motivation for practice. Being able to talk about current “hot” topics can both support willingness to practice and potentially facilitate interactions with peers who have similar interests.
- It may be appropriate to address goals in a small group format. This might look like playing a simple game with one to two peers who also have speech goals, with support for providing feedback to each other in a natural context.
- Provide strategies to help the student to work on production of challenging words or phrases on their own. For example, you can teach the student how to break a multisyllabic word into syllables and then practice reassembling it with smooth coarticulation.
- Give careful attention to skills in phonological awareness, language processing, and verbal expression, and incorporate activities to support skills in these areas as needed. Some students are identified on school entry as having a question of ADHD or other learning disabilities.
- We know that students with CAS are at risk for later academic difficulties.3 Be proactive about monitoring for subtle language problems or behavioral signs of other learning problems.
When children with CAS reach school age, SLPs providing intervention need to be especially aware of providing support beyond work on speech intelligibility. Given the risk for additional academic and learning difficulties, support for academically related skills should be incorporated into intervention, with referrals to other specialists if additional needs are identified.
Learn more about the specifics of working with students with CAS in my MedBridge course, “Childhood Apraxia of Speech: Treatment of School-Age Children.”
- Maas, E., Gildersleeve-Neumann, C., Jakielski, K. J., Kovacs, N., Stoeckel, R., Vradelis, H., & Welsh, M. (2019). Bang for your buck: A single-case experimental design study of practice amount and distribution in treatment for childhood apraxia of speech. Journal of Speech, Language, and Hearing Research, 62(9): 3160–3182.
- Ballard, K. J., Robin, D. A., McCabe, P., & McDonald, J. (2010). A treatment for dysprosody in studenthood apraxia of speech. Journal of Speech, Language, and Hearing Research, 53(5), 1227–45.
- Miller, G. J., Lewis, B., Benchek, P., Freebairn, L., Tag, J., Budge, K., & Iyengar, S. K., et al. (2019). Reading outcomes for individuals with histories of suspected studenthood apraxia of speech. American Journal of Speech-Language Pathology, 28(4), 1432–1447.