Completing a Dynamic Assessment for Childhood Apraxia of Speech (CAS)

​What is Childhood Apraxia of Speech?

"CAS is a neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g., abnormal reflexes, abnormal tone)..." (ASHA, 2007a, Definitions of CAS section, para. 1)

What to look for…
 10 Core Characteristics of CAS:

1.) Inconsistent errors on consonants and vowels in repeated productions of syllables or words
2.) Lengthened and disrupted co-articulatory transitions between sounds and syllables and difficulty with initial artic configurations
3.) Inappropriate prosody, especially in the realization of lexical and phrasal stress (robotic sounding, difficulty with intonation, rhythm, lack of variation in pitch or ability to control or decipher loudness)
4.) Consonant distortions
5.) Vowel errors – substitutions and distortions
5.) Groping
7.) Intrusive Schwa
8.) Brief or inappropriate pauses
9.) Slow rate of speech and increased difficulty with multi-syllable words
10.) Voicing errors
(ASHA; 2007; Davis, Jacks & Marquardt, 2005; Iuzzuni-Siegel et al, 2015; Shriberg and Strand, 2014)

A dynamic assessment is essential for a differential diagnosis of CAS!

Where to begin...
Assessment

• Begin with case history/developmental history including hearing test  
• Assess Neuromuscular Condition  - looking into symmetry, muscle tone, reflexes, strength, gait
• Structural Functional Examination​  - looking at the structures of the oral mechanism - are they functioning appropriately?  Include looking into Non-Speech Oral Motor Movements, single and sequentially.  Look if weakness is present, rule out dysarthria.
• Physiological Parameters - including looking at respiration, phonation, pitch/loudness and vocal quality

Motor Speech Evaluation
Determines motor planning ability for speech

• Determine vowel and consonant repertoire  
• Examine ability to sequence sounds and syllable shapes in various contexts (we're looking at movement!)
• Be dynamic - assess children in imitation and spontaneously, determine what types of cues and how much support is necessary to facilitate speech production - attempt slowing down production and simultaneous production 
• Assess targets multiple times - noting accuracy, consistency and prosody​

Continuation of Assessment

• Use Other Available Assessments/Screeners
• Speech Sound Assessment
• Phonological Assessment
• Language assessments

For a more thorough assessment checklist, checkout my Teachers Pay Teachers store at 

www.teacherspayteachers.com/Product/Dynamic-Assessment-for-Childhood-Apraxia-of-Speech-Checklist-4438888