Tests and diagnosisBy Mayo Clinic staff
To evaluate your child's condition, your child's speech-language pathologist will review your child's symptoms and medical history, conduct an examination of the muscles used for speech, and examine how your child produces speech sounds, words and phrases.
Your child's speech-language pathologist will also assess your child's language skills, such as his or her vocabulary, sentence structure and ability to understand speech.
Several tests will help determine if childhood apraxia of speech (CAS) is present and rule out or identify other problems that may be affecting your child's ability to speak. The specific tasks conducted during the evaluation will depend on your child's age, ability to cooperate and the severity of the speech problem.
Diagnosis of CAS isn't based on any single test or observation. It depends on the pattern of problems that are seen.
It's important to identify whether your child shows symptoms of CAS, because CAS is treated differently from other speech disorders. Children with CAS also may have other communication problems.
It can sometimes be difficult to diagnose CAS, especially when a child speaks very little or has difficulty interacting with the speech-language pathologist.
Your child's speech-language pathologist may determine that CAS may be present. However, your child's speech-language pathologist may not be able to definitely diagnose CAS.
Your child's speech-language pathologist often may be able to determine an appropriate treatment approach for your child, even if the diagnosis is initially uncertain.
Tests may 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 pathologist will examine your child's lips, tongue, jaw and palate for structural problems, such as tongue-tie or a cleft palate, or other problems, such as low muscle tone. Low muscle tone usually isn't associated with CAS, but it may be a sign of other conditions.
Your child's speech-language pathologist will observe how your child moves his or her lips, tongue and jaw in activities such as blowing, smiling, and kissing.
Speech evaluation. Your child's ability to say sounds, words and sentences will be observed during play or other activities.
Your child may be asked to name pictures to see if he or she has difficulty making specific sounds or speaking certain words or syllables.
Your child's speech-language pathologist may evaluate your child's coordination and smoothness of movement in speech during speech tasks. To evaluate your child's coordination of movement in speech, your child may asked to repeat syllables such as "pa-ta-ka" or say words such as "buttercup."
If your child can produce sentences, your child's speech-language pathologist will observe your child's melody and rhythm of speech, such as how he or she stresses syllables and words.
Your child's speech-language pathologist may help your child be more accurate by providing cues, such as saying the word or sound more slowly or providing touch cues to his or her face.
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