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Childhood apraxia of speech : Causes-Symptoms-Diagnosis-Treatment


 What is Childhood apraxia of speech(CAS) ?

In order for speech to occur, messages have to be compelled to go from your brain to your mouth. These messages tell the muscles however and once to maneuver to form sounds. Once a toddler has a speech disorder, the messages don't get through properly. the kid may not be ready to move their lips or tongue within the right ways in which, despite the fact that their muscles aren't weak. Sometimes, the kid may not be ready to say a lot of the least bit.

A child with CAS is aware of what they require to mention. the matter isn't however the kid thinks however however the brain tells the mouth muscles to maneuver.

What is Childhood apraxia of speech(CAS) ?
Childhood apraxia of speech

CAS is typically referred to as verbal dyspraxia or biological process brain disease. Despite the fact that the word “developmental" is employed, CAS isn't a retardant that kids outgrow. a toddler with CAS won't learn speech sounds in typical order and can not build progress while not receiving treatment. It will take loads of labor, however the child’s speech will improve.

Childhood brain disease of speech (CAS) may be a motor speech medicine (brain) condition that affects some young kids as they learn to talk. Kids with CAS recognize what they require to mention, however square measure is unable to make the words.

Childhood brain disease of speech, biological process verbal dyspraxia and biological process brain disease of speech consult with a similar condition.

Apraxia implies that you utterly lose the power to try to do one thing. Dyspraxia implies that you partly lose the power to try to do one thing with accuracy. The distinction between the 2 terms is severity, with brain disease being the foremost severe.

You will see all 3 terms interchangeably employed by completely different aid suppliers.

  1. Mouth

  2. Teeth

  3. Tongue

  4. Lips

Medical terms

  • If you’re a parent who is concerned about your child’s speech development you may want to know whether the problem is serious enough to warrant professional intervention Many young children go through periods of disfluent speech that do not indicate a developmental or learning delay However some children have difficulties with speech production that could be related to underlying health problems physical birth defects or neurological conditions such as childhood apraxia of speech (CAS)

  • Apraxia of speech a motor speech disorder characterized by impaired voluntary control over the processes required for producing spoken language It is manifested by the inability to produce sounds syllables or words despite having adequate intellectual abilities and sensory function of the organs of speech (Wordnet 3.0) Apraxia is an acquired disorder that results from injury to parts of the brain responsible for planning complex movements such as delivering instructions to muscles involved in speech production

  • Childhood brain disease of speech (CAS) is Associate in Nursing uncommon upset within which a baby has issues creating correct movements once speaking.

  • In CAS, the brain struggles to develop plans for speech movement. With this disorder, the speech muscles are not weak, however they do not perform ordinarily as a result of the brain having issues leading or coordinating the movements.

  • To speak properly, your child's brain must find out how to create plans that tell his or her speech muscles the way to move the lips, jaw and tongue in ways which end in correct sounds and words spoken with traditional speed and rhythm.

CAS is commonly treated with therapy, within which youngsters apply the proper thanks to say words, syllables and phrases with the assistance of a speech-language medical specialist.

Symptoms Childhood apraxia of speech

Children with childhood apraxia of speech (CAS) may have many speech symptoms or characteristics that vary depending on their age and the severity of their speech problems.

CAS can be associated with:

  • Delayed onset of first words

  • A limited number of spoken words

  • The ability to form only a few consonant or vowel sounds

These symptoms are usually noticed between ages 18 months and 2 years, and may indicate suspected CAS.

As children produce more speech, usually between ages 2 and 4, characteristics that likely indicate CAS include:

  • Vowel and consonant distortions

  • Separation of syllables in or between words

  • Voicing errors, such as "pie" sounding like "bye"

Many children with CAS have difficulty getting their jaws, lips and tongues to the correct positions to make a sound, and they may have difficulty moving smoothly to the next sound.

Many children with CAS also have language problems, such as reduced vocabulary or difficulty with word order.

Some symptoms are also distinctive to youngsters with CAS and may be useful to diagnose the matter. However, some symptoms of CAS are symptoms of different varieties of speech or language disorders. It's troublesome to diagnose CAS if a baby has solely symptoms that square measure found each in CAS and in different varieties of speech or language disorders.

Some characteristics, sometimes called markers, help distinguish CAS from other types of speech disorders. Those particularly associated with CAS include:

  • Difficulty moving smoothly from one sound, syllable or word to another

  • Groping movements with the jaw, lips or tongue to make the correct movement for speech sounds

  • Vowel distortions, such as attempting to use the correct vowel, but saying it incorrectly

  • Using the wrong stress in a word, such as pronouncing "banana" as "BUH-nan-uh" instead of "buh-NAN-uh"

  • Using equal emphasis on all syllables, such as saying "BUH-NAN-UH"

  • Separation of syllables, such as putting a pause or gap between syllables

  • Inconsistency, such as making different errors when trying to say the same word a second time

  • Difficulty imitating simple words

  • Inconsistent voicing errors, such as saying "down" instead of "town"

Other characteristics are seen in most children with speech or language problems and aren't helpful in distinguishing CAS. Characteristics seen both in children with CAS and in children with other types of speech or language disorders include:

  • Babbling less or making fewer vocal sounds than is typical between the ages of 7 to 12 months old

  • Speaking first words late (after ages 12 to 18 months old)

  • Using a limited number of consonants and vowels

  • Frequently leaving out (omitting) sounds

  • Using speech that is difficult to understand speech

Other speech disorders sometimes confused with

Some linguistic unit disorders usually get confused with CAS as a result of a number of the characteristics could overlap. These linguistic unit disorders embrace articulation disorders, synchronic linguistics disorders and defects of speech.

A child UN agency has the hassle of learning a way to build specific sounds, however does not have the hassle of designing or coordinating the movements to talk, could have associated articulation or synchronic linguistics disorder. Articulation and synchronic linguistics disorders are more common than CAS.

Articulation or phonological speech errors may include:

  • Substituting sounds, such as saying "fum" instead of "thumb," "wabbit" instead of "rabbit" or "tup" instead of "cup"

  • Leaving out (omitting) final consonants, such as saying "duh" instead of "duck" or "uh" instead of "up"

  • Stopping the airstream, such as saying "tun" instead of "sun" or "doo" instead of "zoo"

  • Simplifying sound combinations, such as saying "ting" instead of "string" or "fog" instead of "frog"

Dysarthria could be a motor speech defect that's because of weakness, fitfulness or inability to manage the speech muscles. Creating speech sounds is tough as a result of the speech muscles cannot move as quickly or as powerfully as traditional speech muscles. individuals with defects of speech might also have a husky, soft or perhaps strained voice, or thick or slow speech.

Dysarthria is commonly easier to spot than CAS. However, once defect of speech is caused by injury to bound areas of the brain that have an effect on coordination, it may be tough to see the variations between CAS and defect of speech.

Causes Childhood apraxia of speech

Childhood brain disease of speech happens thanks to issue programming the movements required for articulation (speech) to occur. The precise cause is unknown.

Children WHO have CAS might have interruptions in bound nerve pathways in their brains. These nerve pathways are answerable for coming up with the movements that are necessary for speech. In youngsters WHO have CAS, the messages from their brain to the elements of their mouth used for speech aren't being sent properly.

Weakness or dysfunction of the muscles concerned in speech, as well as those of the lips, jaw and tongue, aren't a reason for CAS.

In some cases, CAS is the result of associate degree non inheritable brain injury, sort of a stroke, that causes pathway interruptions in an exceedingly person’s brain.

There is conjointly proof that genetic conditions will result in a CAS designation. Studies show that a mutation of the FOXP2 sequence ends up in a severe sort of CAS, at the side of alternative neurodevelopmental conditions like syndrome, attention-deficit/hyperactivity disorder and brain disorder. analysis is in progress to pinpoint the direct reason for CAS.

Childhood brain disease of speech (CAS) incorporates a range of doable causes, however in several cases a cause cannot be determined. Doctors typically do not observe a tangle within the brain of a baby with CAS.

CAS is also the result of brain (neurological) conditions or injury, like a stroke, infections or traumatic brain injury.

CAS may additionally occur as an indication of a hereditary disease, syndrome or metabolic condition. For instance, CAS happens a lot of times in youngsters with inborn error of metabolism.

CAS is usually mentioned as an organic process of brain disease. However, youngsters with CAS do not essentially grow out of CAS as they develop. In several youngsters with delayed speech or organic process disorders, youngsters follow usual patterns in development of speech and sounds, however they develop a lot slower than usual.

Children with CAS do not create typical organic process sound errors. They have therapy to create more progress.

Risk factors Childhood apraxia of speech

Abnormalities within the FOXP2 factor seem to extend the danger of childhood brain disorder of speech (CAS) and alternative speech and language disorders. The FOXP2 factor is also concerned in how sure nerves and pathways within the brain develop. Researchers still study however abnormalities within the FOXP2 factor might have an effect on motor coordination and speech and language process within the brain.

Complications Childhood apraxia of speech

Many youngsters with childhood brain disorder of speech (CAS) produce other issues that have an effect on their ability to speak. These issues are not because of CAS, however they'll be seen in conjunction with CAS.

Symptoms or issues that area unit typically gift in conjunction with CAS include:

  • Delayed language, like issue understanding speech, reduced vocabulary, or issue victimization correct descriptive linguistics once putt words along during a phrase or sentence

  • Delays in intellectual and motor development and problems with reading, spelling and writing

  • Difficulties with gross and fine motor movement skills or coordination

  • Hypersensitivity, in which the child may not like some textures in clothing or the texture of certain foods, or the child may not like tooth brushing

Prevention Childhood apraxia of speech

Diagnosing Associate in Nursing treating childhood brain disease of speech at an early stage might scale back the danger of long persistence of the matter. If your kid experiences speech issues, it is a sensible plan to own a speech-language specialist to measure your kid as presently as you notice any speech issues.

Diagnosis Childhood apraxia of speech

To evaluate your child's condition, your child's speech-language specialist can review your child's symptoms and anamnesis, conduct AN examination of the muscles used for speech, and examine however your kid produces speech sounds, words and phrases.

Your child's speech-language specialist also will assess your child's language skills, like his or her vocabulary, phrase structure and talent to know speech.

Diagnosis of CAS is not supported by any single take a look at or observation. It depends on the pattern of issues that area units see. The precise tests conducted throughout the analysis can rely upon your child's age, ability to collaborate and also the severity of the speech downside.

It will generally be troublesome to diagnose CAS, particularly once a toddler speaks little or has problems interacting with the speech-language specialist.

It's important to spot whether or not your kid shows symptoms of CAS, as a result of CAS is treated otherwise from alternative speech disorders. Your kid's speech-language specialist is also ready to confirm AN acceptable treatment approach for your child, although the designation is at first unsure.

Tests could include:

  • Hearing tests. Your doctor may order hearing tests to determine if hearing problems could be contributing to your child's speech problems.

  • Oral-motor assessment. Your child's speech-language specialist can examine your child's lips, tongue, jaw and roof of the mouth for structural issues, like deprivation or a congenital disorder, or different issues, like low muscular tonus. Low muscular tonus typically is not related to CAS, however it should be a symbol of different conditions.
    Your kid's speech-language specialist can observe however your child moves his or her lips, tongue and jaw in activities like processing, smiling and arousal. 

  • Speech evaluation. Your child's ability to form sounds, words and sentences are going to be discovered throughout play or alternative activities.
    Your kid is also asked to call photos to visualize if he or she has a problem creating specific sounds or speaking bound words or syllables.
    Your child's speech-language specialist could appraise your child's coordination and smoothness of movement in speech throughout speech tasks. to gauge your child's coordination of movement in speech, your kid is also asked to repeat syllables like "pa-ta-ka'' or say words like "buttercup."
    If your kid will manufacture sentences, your child's speech-language specialist can observe your child's melody and rhythm of speech, like however he or she stresses syllables and words.
    Your kid's speech-language specialist could help your child be a lot more correct by providing cues, like expressing the word or sound a lot of slowly or providing bit cues to his or her face. 

Treatment Childhood apraxia of speech

Treatment for brain disease of speech ought to be intensive and should last many years reckoning on the severity of your child’s disorder.

Multiple repetitions and recurrent observe of sound sequences, words and phrases throughout medical care

The use of visual prompting to indicate however speech sounds area unit created as sequences of sounds area unit combined into words

Co-production, or having the kid say the word at constant time because the SLP or caregiver

If your kid solely encompasses a restricted variety of words in his vocabulary, medical care can at first specialize in up his useful communication skills. It's vital for your kid to possess positive experiences with communication. If manufacturing words is simply too tough for your kid at first, positive interactions could also be achieved through different modes of communication, like language, image communication boards and voice output communication devices. victimization of different modes of communication whereas performing on utterance has been found to market verbal skills and reduce frustration in youngsters whereas communication.

Speech-language pathologists could treat childhood brain disease of speech (CAS) with several therapies. 

Speech therapy

Your child's speech-language medical specialist can typically offer medical aid that focuses on active syllables, words and phrases.

When CAS is comparatively severe, your kid might have frequent therapy, 3 to 5 times every week. As your kid improves, the frequency of therapy is also reduced.

Children with CAS usually get pleasure from individual medical aid. Individual medical aid permits your kid to own longer to follow speech throughout every session.

It's important that youngsters with CAS get a major quantity of follow spoken language words and phrases throughout every therapy session. Learning to mention words or phrases takes youngsters with CAS time and follow.

Because youngsters with CAS have difficulties designing movements for speech, therapy usually focuses your child's attention to the sound and feel of speech movements.

Speech-language pathologists could use differing kinds of cues in therapy. As an example, your kid's speech-language medical specialist could raise your child to pay attention rigorously and watch him or her type the target word or phrase along with his or her mouth.

Your child's speech-language medical specialist could conjointly bite your child's face as he or she makes sounds or syllables. As an example, your kid's speech-language medical specialist could use his or her hands to assist your child spherical his or her lips to mention "oo."

No single therapy approach has been shown to be simplest for treating CAS. But, some vital general principles of therapy for CAS include:

  • Speech drills. Your child's speech-language therapist will focus on speech drills, such as asking your child to say words or phrases many times during a therapy session.

  • Sound and movement exercises. Your kid is going to be asked to concentrate on the speech-language diagnostician and to observe his or her mouth as he or she says the target word or phrase. By looking at the speech-language pathologist's mouth, your kid additionally sees the movements that go at the side of the sounds. 

  • Speaking practice. Your child will most likely practice syllables, words or phrases, rather than isolated sounds, during speech therapy. Children with CAS need practice making the movements from one sound to another.

  • Vowel practice. Because several kids with CAS distort vowel sounds, your kid's speech-language diagnostician might select words for your child to follow that contain vowels in several varieties of syllables. For instance, your kid is also asked to mention "hi," "mine," and "bite," or "out," "down," and "house." 

  • Paced learning. If your child has severe CAS, your child's speech-language pathologist may use a small set of practice words at first, and gradually increase the number of words for practice as your child improves.

Speech practice at home

Because speech application is extremely necessary, your child's speech-language diagnostician might encourage you to be concerned in your child's speech application reception.

Your kid's speech-language diagnostician might provide you with words and phrases to apply together with your child's reception that he or she has learned in therapy. Every home preparation will be short, like 5 minutes long, and you'll apply together with your kid twice daily.

Children additionally ought to apply words and phrases in real-life things. produce things wherever it'll be acceptable for your kid to mention the word or phrase ad lib. As an example, raise your kid to mention "Hi, Mom" anytime mama enters an area. Active words or phrases in real-life things can build it easier for your kid to mention the applied words mechanically.

Alternative communication methods

If your kid encompasses a severe defect of speech and cannot effectively communicate, various communication strategies will be terribly useful.

Alternative communication strategies could embody singing or natural gestures, like informing or simulating eating or drinking. As an example, your kid might use signs to say he or she desires a cookie. generally electronic devices, like electronic tablets, will be useful in communication.

It's typically necessary to use various communication strategies early. victimization these strategies could facilitate your kid being annoyed once attempting to speak. it should additionally facilitate your kid to develop language skills like vocabulary and also the ability to place words along in sentences.

As speech improves, these ways and devices could now not be necessary.

Therapies for coexisting problems

Many youngsters with CAS even have delays in their language development, and that they may have medical care to deal with their language difficulties.

Children with CAS United Nations agency have fine and gross motor movement difficulties in their arms or legs may have physical or physical therapy.

If a baby with CAS has another medical condition, then effective treatment for that condition could also be vital to raising the child's speech.

Treatments that aren't helpful for CAS

Some treatments are not useful in raising the speech of youngsters with CAS. As an example, there's no proof to indicate that exercises to strengthen speech muscles can facilitate improved speech in youngsters with CAS.

More Information

  • Childhood apraxia of speech (CAS): What it is, how it is diagnosed and treated, and what parents can do

  • Examples of CAS treatment

Is childhood apraxia of speech permanent?

Speech-language pathologists and doctors cannot predict whether childhood apraxia of speech will be permanent or entirely recover But experts do know that children with childhood apraxia of speech are more likely to get better than adults who develop the disorder Experts believe this is because the brain continues to change adapt and grow through adolescence into adulthood While some children diagnosed with childhood apraxia of speech have a very hard time speaking others have mild difficulties and can learn compensatory strategies for overcoming articulation errors (such as substituting “b” for “d”) which can improve their ability to communicate until they.

What helps apraxia at home?

Children who have apraxia should learn new skills at home before working on them in therapy The following are some suggestions for helping your child develop new skills at home: 1. Model the desired behaviors to help demonstrate what is expected For example you can model how to hold a cup or spoon using correct eating techniques You can also use visuals and other sensory cues to teach your child how things should look or feel when they're done correctly 2. Provide one-step directions that include just one action at a time so patients don't become overwhelmed with the task's complexity Examples of these types of directions could.

Can a toddler overcome apraxia?

Apraxia is a developmental speech disorder in which a child has difficulty forming the words and sounds necessary for clear consistent speaking It's one of the most common reasons for children to receive an initial evaluation for speech or language disorders Speech-language pathologists can treat preschool-aged children with apraxia using approaches such as Picture Exchange Communication System (PECS).

How do you teach a child with apraxia to speak?

Many children with apraxia of speech have some degree of normal functioning in their motor and oral-motor systems However they may have difficulty coordinating the muscles required to plan the movements that create speech sounds The first step in treating this disorder is to identify its underlying cause A consult with an otolaryngologist can help determine whether a child has apraxia or another motor speech disorder Motor speech disorders are addressed using a variety of approaches depending on the specific diagnosis and severity level.

Lifestyle and home remedies

You and your family will work along with your kid reception to enhance his or her speech and language skills. Home follows, additionally to your child's therapy sessions, might facilitate your child's progress.

Encourage and support your kid as he or she practices speech and language skills. Your support will facilitate your kid feeling that he or she is doing well and up.

If your kid is collaborating in physical or physiatrics, further as therapy, schedule differing types of medical care at numerous times so your kid does not become too tired from medical care.

Coping and support

It is tough to own a toddler WHO has issues with human activity. There square measure variety of support teams accessible for fogeys of youngsters with childhood encephalopathy of speech. Support teams could provide an area for you to search out {people WHO|people that|folks that|those that|those who} perceive your scenario and who will share similar experiences.

To learn regarding support teams in your space, see the encephalopathy youngsters web site.

  1. Child medical and psychological care

Preparing for your appointment

Your kid is probably going to begin by seeing a doctor trained within the general care and treatment kids|of youngsters|of kids} (pediatrician) or a doctor trained in treating children with medicine conditions (pediatric neurologist). Your kid can then be named a specialist in speech and language conditions (speech-language pathologist).

Because appointments have restricted time, and since there are typically heaps of speaking concerns, it is a sensible plan to be ready for your child's appointment. Here's some data to assist you and your kid prepare, and what to expect from your child's doctor and speech-language specialist.

What you can do

  • Write down any symptoms your child is experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

  • Bring a list of all medications, vitamins or supplements that your child is taking.

  • Write down questions to ask your child's doctor and speech-language pathologist.

  • Bring a copy of a recent progress report and individual education plan from your child's speech-language pathologist if your child has previously been seen by 

a speech-language diagnostician.

Your time along with your child's doctor or speech-language diagnostician is restricted, thus making ready a listing of queries before time can assist you create the foremost of it slow along. For childhood brain disorder of speech (CAS), some basic inquiries to raise the speech-language diagnostician include:

  • Does my child have CAS, or any other speech or language problems?

  • What is CAS?

  • How is CAS different from other types of speech disorders?

  • Is my child's condition going to improve?

  • What treatments are available, and which do you recommend?

  • What can I do at home to help my child?

  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

In addition to the questions that you've prepared to ask your child's doctor or speech-language pathologist, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your child's speech-language pathologist

Your child's speech-language pathologist is likely to ask you a number of questions. Being ready to answer them may allow more time to ask questions about your child's diagnosis and recommended treatment. Your child's speech-language pathologist may ask:

  • When did you first have concerns about your child's speech development?

  • Did your child babble? For example, did your child produce cooing sounds and then produce syllables, such as "ba-ba-ba" or "da-da-da"? If so, when did that start?

  • When did your child say his or her first word?

  • When did your child have five words in his or her vocabulary that he or she would use frequently?

  • How many words does your child currently have in his or her vocabulary that would be understandable to most people?

  • In what other ways does your child communicate? For example, does your child point, make gestures, make signs or act things out?

  • Has anyone in your family had speech or language difficulties?

  • Has your child had ear infections? How many ear infections has he or she had?

  • When was your child's hearing tested? Was any hearing loss detected?

General summary

  1. Childhood apraxia of speech can be treated by a qualified SLP but the treatment program depends greatly on the severity of the disorder .The first phase is to break down words into phonetic segments so that the child can learn how to use his muscles and what muscle groups are required to produce speech sounds In this stage therapy focuses on developing and practicing correct muscle movement patterns for producing individual sounds Prior knowledge of correct movements does not exist in children who were previously non-verbal or minimally verbal due to childhood apraxia of speech Therefore it is important that therapists have extensive.

Childhood apraxia of speech : Causes-Symptoms-Diagnosis-Treatment

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