Childhood Apraxia Of Speech Essay
Childhood Apraxia Of Speech Essay
Kevin C. Towery COM110-15 Research Speech Outline CHILDHOOD APRAXIA OF SPEECH General Purpose: To inform Specific Purpose: To provide information to the audience about the speech disorder known as childhood apraxia of speech. Thesis Statement: Apraxia is a rare disorder that if left untreated can persist into adulthood, causing a child to suffer years of frustration from being unable to communicate effectively. Introduction: I. Attention-getter – Who here tonight has known someone who has or has had a speech disorder? (Pause) Everyone can raise his or her hand, since you know me. II. Childhood Apraxia Of Speech Essay.
Recording a child’s speech and playing it back. ii. Repeat syllables, words, sentences, and longer utterances. c. Once speech production is improved or corrected speech therapy is ended. Conclusion I. Summary – Tonight we have discussed what childhood apraxia is, factors that may cause this disorder in children, how the condition is diagnosed, and its treatment. II. Thesis Re-statement – It is important to understand that properly treating childhood apraxia will take time, commitment, and a supportive environment to ensure that a child develops confidence in his or her ability to communicate.Thesis Statement – Apraxia is a rare disorder that if left untreated can persist into adulthood, causing a child to suffer years of frustration from being unable to communicate effectively. III. Credibility – I have read numerous articles and support websites about apraxia and I have also personally gone through four years of speech therapy for this disorder. IV. Preview of points – Tonight I am doing to discuss childhood apraxia, what the speech disorder is, what causes it, how it is diagnosed, and how it is treated. Childhood Apraxia Of Speech Essay.(Transition: To understand what causes Apraxia, we must first understand what the disorder is. ) Body: I. What is Apraxia? . For every 10,000 children 1 in 10 are affected by apraxia. (Shriberg, Aram, & Kwiatkowski, 1997a) b. Controversy around its definition, cause, treatment and diagnosis. c. Disorder attributed to deficits of the nervous system that impact the ability to sequence and say sounds, syllables, and words. d. A child knows what they want to say, but the brain can’t tell the right body parts the correct way to move in order to say it properly. e. Called by various names (slide showing various names) (Internal Transition: Just as there are varying medical definitions of apraxia, the topic of how it is caused has multiple theories. II. What causes Apraxia in children? a. The cause or causes of Apraxia are not yet known. b. Studies have determined: i. Apraxia typically affects more boys than girls. ii. Validated that it is not caused by muscular weakness or paralysis. iii. Studies involving brain imagings have not produced any evidence to support there are differences in the brain structure. c. Observations have shown that children with apraxia often have family members who have a history of communication disorders or learning disabilities. These studies suggest that there is a genetic factor that may play a role in the disorder. Internal Transition: Since apraxia is not physiologically obvious, diagnosis combines eliminating other medical conditions with evaluation by a speech pathologist. ) III. How is Apraxia diagnosed? a. Speech pathologists evaluate children for speech disorders and over half are employed in K-12 school systems (slide showing statistics). b. First a hearing test is done to evaluate if hearing loss is a possible cause. c. A certified speech pathologist evaluates coordination of their speech mechanisms. An example is moving the tongue side-to-side, smiling, frowning, etc. . The pathologist will also evaluate the coordination of muscle movements by having the child repeat strings of sounds as fast as possible. e. Speech articulation is evaluated and assessed by having the child pronounce individual sounds and combined sounds. (Internal Transition: Once a speech pathologist has diagnosed a child with apraxia, the family’s next step is treatment. ) IV. How is Apraxia treated? a. Speech therapy with focus on the planning, sequencing, and coordination of motor movements for speech production. b. Exercises are done emphasizing repetition. i. Childhood Apraxia Of Speech Essay.
It is generally true that childhood Apraxia of Speech (CAS) is a motor speech disorder that influences people’s ability to plan, produce, coordinate and sequence speech sounds. The diagnosis of this disability is challenging, especially for the children under the age of 3. Moreover, kids who are suffering from this disorder have considerable disabilities in coordination of the movements of tongue, lips and jaw that are vital in speech production. It is needless to say that CAS is not a paralysis or muscle weakness; this issue is related to problems with brain. It can be illustrated by the fact that a child clearly understands what he/ she wants to say. However, he/she may have significant difficulties in coordinating parts of their body that are responsible for speech. Furthermore, the children who have CAS are not able to produce words and phrases intelligibly or automatically, that can be observed in children with normal development. Childhood Apraxia Of Speech Essay.
Generally childhood apraxia of speech can be observed in conditions such as neurological impairment, complex neurodevelopment, and idiopathic speech disorder. The first one, neurological development can be caused by injury, disease, or infections. It can be seen before or after birth; moreover, it can cause fatal development. The presence of complications in the brain can be evident in a positive result on the magnetic resonance imaging scan of a child’s brain. The second condition or the complex neurodevelopment disorder can be a reason for the development of children apraxia. This category includes the following disorders that coexist with CAS: Galactosemia, Chromosome translocations, Autism, and Fragile X. The third issue, idiopathic speech disorder is a sickness with undefined reasons. This last condition is fully related to childhood apraxia of speech; since children with this disorder have not been diagnosed as having serious neurological abnormalities (Kumin, 2007).
There are two types of this disorder: acquired apraxia of speech and developmental apraxia of speech. The former is a disorder that can be caused by a stroke, tumor, head injury, or other diseases influencing the brain. It can be observed at any age, both in children and grown-ups. The latter may result from muscle weakness that affects speech production or language ability. Childhood Apraxia Of Speech Essay. Developmental apraxia (DAS) of speech is a disorder that is present form the birth of a child. Scholars often refer to this disability as the mental one; since it significantly influences mostly boys than girls. DAS is a delay of a flow of words that is usually slower than normal.
Additionally, it is necessary to discuss the symptoms of childhood apraxia of speech. It is vital to point out that the signs mentioned below may not be present in every child. In this case, it is important to have the child examined by a speech-language pathologist, who can professionally make a diagnosis, find out whether it is CAS or not, and provide a good treatment. The most evident symptoms of childhood apraxia of speech can be classified into two groups that are observed in very young and older children. Firstly, a small kid may not babble as healthy infant and be combining the sounds incorrectly, making big pauses between them. Moreover, these children can have a delay of development of the first words. Secondly, older children can make sound errors resulting not from the lack of immaturity. Furthermore, a child can pronounce the words monotonously, laying the stress on incorrect syllables. Older children with CAS can choke when trying to pronounce a long word or to coordinate their jaw, lips, or tongue. It is often obvious if a child with CAS is under nervous tension. It is quite evident when children are suffering from childhood apraxia of speech, because they are confusing word order and recalling unnecessary sounds.
Another point which is worth mentioning here is the treatment of children with CAS. An appropriate motor therapy for children with CAS is different from the treatment that is used for children who have other language disorders. One of the main areas that the attention should be paid to in order to coordinate the speech of a child with CAS concerns the sequencing for the movements from shorter to longer syllables. Childhood Apraxia Of Speech Essay. While doing this exercise, it is necessary to add new syllables one by one, so that the word will not be too complicated to pronounce. A good idea is to apply a prosodic approach; for instance, melodic therapy can significantly help to strengthen the child’s muscular organs of speech. Furthermore, a child should constantly practice speech by getting feedback in tactile and visualized methods. For example, the kid can look in the mirror while pronouncing the words. In this case, the mirror will act as a feedback from audience or the listener, controlling the movement sequences (National Institutes of Health, 2002).
If parents have the suspicion that their child is suffering from CAS; it is vital to seek help of a speech-language pathologist, who can choose the appropriate method of treating this sickness. Moreover, the family members should also remember that treatment of CAS is a long and intensive program, which can last for an extended period of time. In this case, mutual support and patience are essential. No doubt, putting a pressure on a person with CAS will considerably impair this disorder and lead to its undesirable development.
With a very young child, they may not coo or babble during infancy, produce first words late and lack some sounds, only produce a few different consonant and vowel sounds, have difficulty combining sounds, avoid using difficult sounds by replacing or deleting them, and experience eating problems. In older children, common signs are that they can comprehend language much easier than they can produce it, struggle more with language production when anxious, are hard to understand, sound choppy and monotonous, seem to grope to produce certain sounds, and have difficulty imitating speech, though they are more fluid and clear with imitation than with spontaneous production. At any age, a child may portray delayed language development, issues with expressive language, fine motor impairments, hypersensitivity, hyposensitivity, and difficulty learning to write (“Childhood Apraxia,” 2011). Other reported possible symptoms of CAS include extended reliance on nonverbal communication and omission of consonant sounds in the initial and final positions of words (“Apraxia: Symptoms, Causes,” n.d.). CAS is one of the most difficult disorders to diagnose. Childhood Apraxia Of Speech Essay. Many speech pathologists are worried that it is commonly over diagnosed and misdiagnosed (“Apraxia: Speech Therapy,” 2011). It is not known how many children actually have CAS, but it appears to be on the rise. Certain factors, such as increased awareness of CAS by professionals and families, evaluation and identification
Childhood Apraxia of speech is a motor speech disorder. Communication disorders impact the way child function not only in the areas of speech and language but in many other areas of the brain. Apraxia of speech is a neurological disorder that is very rare. Children with this disorder have trouble with sounds, syllables and words. CAS, Apraxia affects the movement of the tongue, lips, jaw and palate that is necessary for speech. Childhood Apraxia of Speech is also sometimes known as Developmental Apraxia of Speech, Verbal Dyspraxia or Developmental Apraxia of Speech. Edeal and Neumann said that a child with CAS demonstrates difficulty programming, combining, and sequencing the motor movements needed for volitional speech. This speech disorder is hard to treat.
Children with CAS may show in coordination in many different areas like problems with manual dexterity, oral motor dysfunction, below average intelligence or academic difficulties (Teverovsky, Bickel & Feldman 2009). The thing that characterizes Apraxia of speech is the errors of consonants and vowels (ASHA 2007). Due to the testing that is needed for CAS they find in many children there are other problems associated with CAS they need attention to so they put them in rehabilitation and evaluations. Velleman and Curro give three diagnostic criteria for CAS which is inconsistent errors on consonants and vowels in repeated productions of syllables or words. Lengthened and disrupted coarticulatory transitions between sounds and syllables. Childhood Apraxia Of Speech Essay. Lastly, inappropriate prosody especially in the realization of lexical or phrasal stress. Most of the time children are diagnosed by the age of five years old.
Teverovsky say the International Classification of Functioning is a comprehensive, systematic and scientifically-based classification system for describing function irrespective of the underlying health conditions. This is known as the ICF. This was created to see how health related conditions affect the lives of people by the World Health Organization. The ICF can be used on individuals but also on a population of people. The ICF has recently been used as a tool for describing the functional problems associated with communication disorders (Teverovsky, Bickel & Feldman 2009). The ICF has now come out with a version for children called the ICF- Children and Youth. The version was released in 2004 but the final version was published in 2007. The children’s version was focused on describing how younger children function at home and in school.
The ICF has three major domains of functioning: body functions and structures, activities and participation. The environment, personal factors, and health related conditions have an impact on the domains. The ICF has a list of codes that describe the body functions, daily activities, individual participation and the environmental factors that can have an impact. The activity section is used mostly for habilitation and education. The participation section is for social integration and community life. The environmental section is for the interaction of functional abilities. For children with CAS studies show that children have functional problems in multiple domains (Teverovsky, Bickel & Feldman 2009). Using the ICF is useful for identifying areas or needs and targeting outcomes of therapy. The International Classification of Functioning has been helpful in describing functional profiles of children with other clinical conditions (Teverovsky, Bickel, & Feldman 2009). The ICF was designed careful to keep from being biases at all.
ASHA has identified three differential signs for CAS. Inconsistent vowels and consonant errors in repeated productions of words and syllables, inappropriate prosody, difficulty with articulatory sequencing resulting lengthened and disrupted transitions between words and syllables (Edeal & Nuemann 2011). Most agree that CAS is the core of motor planning and programming. There have been many approaches to find a treatment for explored for Childhood Apraxia of Speech. Childhood Apraxia Of Speech Essay. When treating a motor learning disorder it is necessary for constant evaluation by a doctor. When therapy is provided to a patient with CAS one of the most important things is to set long term improvement in speech. Generalization is a key component of learning and is achieved by the four main tenets of motor learning into therapy. The four main tenets are precursors to learning, conditions of practice, feedback and influence of rate (Edeal & Neumann 2011).
Precursors to learning the concepts established with the client before treatment begins. Informing the client of goals and starting to establish trust between each other. Conditions of practice include blocked versus random practice, mass versus distributed practice and variability of practice (Edeal & Neumann 2011). In blocked versus random practice blocked practice has one target in practice at a time in random there is more than one target practiced. Mass versus distributed practice, mass practice in a long session for fewer days, like a 60 minute session once a week. Distributed are shorter sessions but more days a week for example 20 minute sessions 3 days a week. Practice variability asking the patient to practice targets set for him or her outside of treatment. There are two types of feedback intrinsic and extrinsic. Extrinsic feedback includes knowledge of results and performance. Intrinsic feedback comes from the assessment of the client or patient’s performance. The rate of speech has an influence on learning. Rate reduction decreases the metal load on the client (Edeal & Nuemann 2011).
Most of the focus for this disorder has been on determining the specific features that characterize it. One treatment combines a core vocabulary treatment with stimulability training. The treatment focuses on increasing the number of stimulable sounds a child can produce. A treatment protocol was designed which targeted enhancement of stimulability by teaching sounds (Forrest 2010). By breaking the word into syllables and then teaching the word to the child in sounds and syllables it is the best way for children to produce words. Childhood Apraxia Of Speech Essay.The stimulability and vocabulary treatment hold promise for treating children with Childhood Apraxia of Speech.
In Speech language pathology, motor learning principles have been found effective in treatment research for individuals with acquired Apraxia of Speech ( Edeal & Neumann 2011). Hierarchies are used for many different things. In speech therapy it is used by beginning with the easiest speech targets and moving to more challenging targets. It has been modified to target motor deficits specifically seen is Childhood Apraxia of Speech. A child with Childhood Apraxia of Speech is more likely to show more progress in frequent shorter sessions, then longer less frequent sessions.
DTTC is based on integral stimulation therapy and motor learning principles (Edeal & Neumann 2011). Speech targets are practiced at the syllable, word, phrase, or sentence level. Depending on the achievement level patients can move up and down in success also from session to session. Studies have shown that integral stimulation is a successful and effective treatment for children with Childhood Apraxia of Speech though more studies are needed to show the benefits of the treatment (Edeal & Neumann 2011). DTTC uses visual tactics for a child seeing things give them a better understanding. DTTC uses cues to help the child only when the child is struggling and is necessary otherwise the cues are down.
Treatment intensity is critical for motor learning. This treatment increases the likelihood that desired change in behavior or situation will occur (Duhon, Mesmar, Atkins, Greguson & Olinger 2009). This treatment can be one-to-one or in small groups. The different areas include duration, frequency, number of episodes, and form of treatment. Treatment intensity is most affective with shorter treatment sessions over a longer period of time to promote motor learning. Childhood Apraxia Of Speech Essay. Though in this treatment there is a possibility that it can decrease the performance and learning in the patient. For motor task, intensity in the form of mass practice conditions may be effective for initial performance but detrimental to learning, with shorter treatment sessions distributed over a longer time frame more likely to promote motor learning (Edeal & Nuemann 2011).
In the lexical route correct reading of familiar words can be achieved. The lexical route implies good language skills. Children that have a language or speech disorder tend to have trouble with reading also and begin to fail at it. Examining possible contributions of and interactions among all underlying linguistic and cognitive factors in such children is an important area of research (Zaretsky, Velleman & Curro 2010).
In the phonological route requires the reading non-words or unfamiliar words. This allows the child to transfer the abstract awareness of smaller linguistic units like syllables, onsets, rimes, and phonemes onto more concrete visual representations (Zaretsky, Velleman &
Curro 2010). This helps the children with speech disorders because they are at a higher risk for reading deficits. When using the phonological route children establish cognitive skills. Cleft palate and Dysarthia literacy difficulties should not be accompanied by Childhood Apraxia of Speech. Treatment for CAS should start with children before or at kindergarten level. Childhood Apraxia Of Speech Essay.
There are many different symptoms for CAS ranging in the age of children also. Though, some children may not show little to any symptoms at all. No children are the same so every child will show different symptoms to Childhood Apraxia of Speech. In a very young child there are many different symptoms (ASHA.org). When you child is an infant if the infant is not babbling or making noises. First words are not on time and don’t sounds correct. They don’t have many different consonant and vowel sounds. The infant has a problem combining sounds in words or a long pause in between words. May have issues eating. The infant replaces difficult sounds with easier ones or ignores the difficult sounds.
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In older children there are many different symptoms in children also. Not every child is the same so many of these symptoms will change in each child. If the child is making inconsistent sound errors, that do not result from immaturity. The child can understand the language he or she speaks much better than he or she can talk. He or she has difficulty imitating speech. If the child appears to be groping, when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement (ASHA.org). If he or she has difficulty saying longer phrases then shorter ones more clearly. When your child is anxious and their speech becomes more difficult to understand. When the child is hard to understand and people who don’t know the child cannot understand him at all.
Childhood Apraxia of Speech is usually accompanied by functional problems. Children with CAS show impairments in language as well as speech. Childhood Apraxia Of Speech Essay. The speech and language components are independent. The First national CAS conference for parents and family member was held in Pittsburgh, Pennsylvania in 2004. For a child with Childhood Apraxia of Speech it is important to identify functional domains for further planning comprehensive evaluations, therapies, and long term follow ups with a doctor.
Childhood Apraxia of Speech also known as CAS is a very serious communication disorder found early in children. CAS effects the brain though the brain knows what it is trying to say it cannot put it in words for others to hear. There are many different treatments for Childhood Apraxia of Speech. Though it is found early in children it also is a part of other functional disorders.
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