Treatments and drugsBy Mayo Clinic staff
Speech-language pathologists may treat childhood apraxia of speech (CAS) with many therapies.
Because there isn't evidence to show that medications effectively treat CAS, speech therapy is the primary treatment for CAS.
Your child's speech-language pathologist will usually provide therapy that focuses on practicing syllables, words and phrases. When CAS is relatively severe, your child may need frequent speech therapy, three to five times a week. As your child improves, the frequency of speech therapy may be reduced.
Children with CAS generally benefit from individual therapy. Individual therapy allows your child to have more time to practice speech during each session.
It's important that children with CAS get a significant amount of practice saying words and phrases during each speech therapy session. Learning to say words or phrases takes children with CAS time and practice.
Because children with CAS have difficulties planning movements for speech, speech therapy often focuses your child's attention to the sound and feel of speech movements.
Speech-language pathologists may use different types of cues in speech therapy. For example, your child's speech-language pathologist may ask your child to listen carefully and watch him or her form the target word or phrase with his or her mouth.
Your child's speech-language pathologist also may touch your child's face as he or she makes certain sounds or syllables. For example, your child's speech-language pathologist may use his or her hands to help your child round his or her lips to say "oo."
No single speech therapy approach has been shown to be most effective for treating CAS, but some important general principles of speech therapy for CAS include:
- 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.
- Your child will be asked to listen to the speech-language pathologist and to watch his or her mouth as he or she says the target word or phrase. By watching the speech-language pathologist's mouth, your child also sees the movements that go along with the sounds.
- 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.
- Because many children with CAS distort vowel sounds, your child's speech-language pathologist may choose words for your child to practice that contain vowels in different types of syllables. For example, your child may be asked to say "hi," "mine" and "bite," or "out," "down" and "house."
- 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 practice is very important, your child's speech-language pathologist may encourage you to be involved in your child's speech practice at home.
Your child's speech-language pathologist may give you words and phrases to practice with your child at home that he or she has learned in speech therapy. Each home practice session can be short, such as five minutes in length, and you may practice with your child twice a day.
Children also need to practice words and phrases in real-life situations. Create situations where it will be appropriate for your child to say the word or phrase spontaneously. For example, ask your child to say "Hi, Mom" each time mom enters a room. Practicing words or phrases in real-life situations will make it easier for your child to say the practice words automatically.
Alternative communication methods
If your child has a severe speech disorder and can't effectively communicate, alternative communication methods can be very helpful.
Alternative communication methods may include sign language or natural gestures, such as pointing or pretending to eat or drink. For example, your child could use signs to communicate he or she wants a cookie. Sometimes electronic devices, such as electronic tablets, can be helpful in communication.
It's often important to use alternative communication methods early. Using these methods may help your child become less frustrated when trying to communicate. It may also help your child to develop language skills such as vocabulary and the ability to put words together in sentences.
As speech improves, these strategies and devices may no longer be necessary.
Therapies for coexisting problems
Many children with CAS also have delays in their language development, and they may need therapy to address their language difficulties.
Children with CAS who have fine and gross motor movement difficulties in their arms or legs may need physical or occupational therapy.
If a child with CAS has another medical condition, then effective treatment for that condition may be important to improving the child's speech.
Treatments which aren't helpful for CAS
Some treatments aren't helpful in improving the speech of children with CAS. For example, there is no evidence to show that exercises to strengthen speech muscles will help improve speech in children with CAS.
- Childhood apraxia of speech. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/disorders/ChildhoodApraxia/. Accessed Nov. 5, 2012.
- Morgan AT, et al. Intervention for childhood apraxia of speech. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006278.pub2/abstract. Accessed Nov. 5, 2012.
- Carter J, et al. Etiology of speech and language disorders in children. http://www.uptodate.com/home. Accessed Oct. 16, 2012.
- Souza TN, et al. Childhood speech apraxia in focus: Theoretical perspectives and present tendencies. Pro-Fono Revista de Atualizacao Científica. 2009;21:76.
- Technical report: Childhood apraxia of speech. American Speech-Language-Hearing Association. http://www.asha.org/policy/TR2007-00278.htm. Accessed Nov. 5, 2012.
- Position statement: Childhood apraxia of speech. American Speech-Language-Hearing Association. http://www.asha.org/policy/PS2007-00277.htm. Accessed Dec. 12, 2012.
- Library: Resources and support: Apraxia support groups — United States. Apraxia-KIDS. http://www.apraxia-kids.org/library/apraxia-support-groups-united-states/. Accessed March 6, 2013.
- Strand E (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 23, 2013.
- U.S. News best hospitals 2012-2013. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings. Accessed Dec. 12, 2012.
- McCauley RJ, et al. Evidence-based systematic review: Effects of nonspeech oral motor exercises on speech. American Journal of Speech-Language Pathology. 2009;18:343.
- McCauley RJ, et al. Treatment of childhood apraxia of speech: Clinical decision making in the use of nonspeech oral motor exercises. Seminars in Speech and Language. 2008;29:284.
- Shriberg LD, et al. Prevalence and phenotype of childhood apraxia of speech in youth with galactosemia. Journal of Speech, Language, and Hearing Research. 2011;54:487.
- Shriberg LD, et al. Proceedings of the 2002 Childhood Apraxia of Speech Symposium. Carlsbad, Calif.: The Hendrix Foundation; 2002.
- Creaghead NA, et al. Assessment and Remediation of Articulatory and Phonological Disorders. 2nd ed. New York, N.Y.: Macmillan Publishing Company; 1989.
- Caruso AJ, et al. Clinical Management of Motor Speech Disorders in Children. New York, N.Y.: Thieme; 1999.
- Speech sound disorders: Articulation and phonological processes. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/disorders/SpeechSoundDisorders/. Accessed March 8, 2013.
- Dysarthria. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/disorders/dysarthria/. Accessed March 8, 2013.
- Yorkston KM, et al. Management of Motor Speech Disorders in Children and Adults. 3rd ed. Austin, Texas: Pro-Ed; 2010.