How do you diagnose apraxia

Because there is no single symptom or test that can be used to diagnose AOS, the person making the diagnosis generally looks for the presence of several of a group of symptoms, including those described earlier. Ruling out other conditions, such as muscle weakness or language production problems e. In some cases, people with acquired AOS recover some or all of their speech abilities on their own.

This is called spontaneous recovery. Children with AOS will not outgrow the problem on their own. They also do not acquire the basics of speech just by being around other children, such as in a classroom.

Therefore, speech-language therapy is necessary for children with AOS as well as for people with acquired AOS who do not spontaneously recover all of their speech abilities. Speech-language pathologists use different approaches to treat AOS, and no single approach has been proven to be the most effective.

Therapy is tailored to the individual and is designed to treat other speech or language problems that may occur together with AOS. Frequent, intensive, one-on-one speech-language therapy sessions are needed for both children and adults with AOS. The repetitive exercises and personal attention needed to improve AOS are difficult to deliver in group therapy. Children with severe AOS may need intensive speech-language therapy for years, in parallel with normal schooling, to obtain adequate speech abilities.

Be able to attempt to imitate at least simple syllables or words. Observing what happens when the child tries to imitate speech is how the therapist observes motor planning and programming. The following characteristics are the best indicators of CAS:. Speech movements are inaccurate, clumsy, or awkward as the child attempts to imitate syllables and words. The child may have groping movements or show signs that speech is effortful.

Vowel errors can limit intelligibility, or how well speech is understood, and therefore are often the focus of CAS treatment. Poor intelligibility, meaning it is difficult to understand the child. What speech characteristics do you see that indicate CAS?

Compare those symptoms to the to the above information. How will you determine if it is CAS? What will you do differently since my child might have CAS? Clinicians who suspect a child of having CAS may try treatment methods designed to treat CAS and see how the child responds. You may also be referred to another speech-language pathologist with more experience in assessment and treatment of CAS.

The therapist tells you that children under 3 cannot be diagnosed with CAS. Be persistent and do not give up! If your child is not developing as expected, your pediatrician should assist you in arranging for or referring to an appropriate professional or specialist. Let me begin by noting that my clinical and research experience convinces me that the core problem in this disorder is appropriately described by the diagnostic term childhood apraxia of speech.

The controversy, as I see it, is that there currently are no research findings that provide unequivocal support for the core problem or its diagnostic label.

To answer those who take issue with this diagnostic classification, with its important implications for prognosis and treatment planning, a compelling study or program of research would have to provide at least one of three types of evidence. The most convincing research evidence for the validity of childhood apraxia of speech as a diagnostic classification would be a clear biological finding.

Although researchers have many leads to follow, the relatively small research literature on childhood apraxia to date has failed to identify a biological locus or processing correlate of the disorder. Unlike acquired apraxia in adults, in which neurological loci and neurolinguistic processing correlates are readily documented, there are no studies indicating that children with this suspected disorder share a common neurological challenge. Worldwide, research using molecular genetics and imaging techniques has only recently begun.

A less convincing, but still useful source of evidence would be a set of behavioral assessment findings that discriminate children with this disorder from children with severe phonological disorder or with dysarthria. Currently, each clinician and researcher must rely on a weighted checklist that yields individual profiles believed to be consistent with the disorder.

Note the circularity here: a biological correlate of childhood apraxia will eventually be needed to determine which behavioral assessment findings are the markers for the disorder. The third type of research finding providing support for this diagnostic classification would be tied to treatment outcomes for children with suspected childhood apraxia.

As in other areas of medicine, a treatment regimen documented to be both necessary and sufficient to normalize a disorder provides some measure of support for the validity of a diagnostic category-particularly to the degree that the treatment differs significantly from treatments used with one or more other disorders that closely resemble the target disorder.

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. 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:.

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 may be unique to children with CAS and can be helpful to diagnose the problem. However, some symptoms of CAS are also symptoms of other types of speech or language disorders. It's difficult to diagnose CAS if a child has only symptoms that are found both in CAS and in other types 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:. 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:. Some speech sound disorders often get confused with CAS because some of the characteristics may overlap.

These speech sound disorders include articulation disorders, phonological disorders and dysarthria. A child who has trouble learning how to make specific sounds, but doesn't have trouble planning or coordinating the movements to speak, may have an articulation or phonological disorder.

Articulation and phonological disorders are more common than CAS. Dysarthria is a motor speech disorder that is due to weakness, spasticity or inability to control the speech muscles. Making speech sounds is difficult because the speech muscles can't move as far, as quickly or as strongly as normal.

People with dysarthria may also have a hoarse, soft or even strained voice, or slurred or slow speech. Dysarthria is often easier to identify than CAS.