Prognosis/Outcomes of Childhood Apraxia of Speech

 

The good news story, for the most part, is, that with the appropriate treatment, children with CAS will eventually speak. This area has not been extensively studied yet though, because no two children with apraxia are alike, and the causes for their apraxia may not be the same.  However, studies have been done comparing the many treatments available, and have shown that lasting maintenance of good outcomes only occurred with certain methods compared to others.  Treatments that have showed the best gains include the approaches using Integral Stimulation/DTTC, ReST.  Also, the amount and frequency of treatment had an impact too, showing that intensive treatment delivery was so important in attaining successful treatment outcomes. This meant at least 2-3 times per week of sessions of up to sixty minutes, with high doses of practice repetition.  Also, the earlier a child was diagnosed and started treatment, the better they seem to do. 

The speech of children with CAS has been found to be stronger and more extended compared to normally developing children. In addition these children are often found to be groping or searching for the right word while speaking. Additionally, they can have problems with rate the tone of their speech.

Because there are so many variables involved, such as the age and severity of the child, the child’s associated medical conditions eg Autism, Down’s Syndrome etc, the resources available, the amount of home practice being done, the initial efficacy of the intervention (ie was the appropriate motor treatment done and was the Speech-Language Pathologist knowledgeable in Apraxia treatment ? ), as well as the individual abilities of child to sit and be engaged in repeated sessions, it is a difficult area to truly study and compare different outcomes.  Studies are ongoing in this area. Furthermore, even though a child will be speaking with effective treatment, they may be susceptible to other issues such as difficulties with literacy, language and learning, spelling, memory, motor planning etc.

Parental support and involvement is vital in many aspects of ensuring success for children with CAS.  From getting help early, to finding the right Speech Pathologist in the case of suspected CAS, to providing adequate modelling and opportunities for home practice, to advocating for their child in school, and supporting literacy with the right programs shown to be effective, the role of a parent in the successful outcome of their child in general cannot be emphasized enough.

A note for Teachers/Educators: While children with Apraxia may have significant improvement in their speech over time, the condition “changes” from that of speech issues to that of academic and learning issues. Children with Apraxia may have difficulties with language comprehension, expressive and written language, understanding commands, sequencing and gross motor difficulties, literacy difficulties including difficulty with spelling and comprehension, and other academic difficulties. Success depends on identifying and implementing strategies to assist children to overcome these challenges. Your understanding and support is essential!

Read more at Apraxia-KIDS.org/Prognosis

References:

Lewis, B.A., Freebairn L.A., Hansen A.J., Iyengar S.K., Taylor H.G. (2004), School-Age Follow-up of Children with Childhood Apraxia of Speech, Language, Speech and Hearing Services in Schools, Vol 35, 122-140.
Murray E, McCabe P, Ballard K.J.(2014)A Systematic Review of Treatment Outcomes for Children with Childhood Apraxia of Speech, American Journal of Speech-Language Pathology, Vol 23, 486-504.  Downloaded from http://pubs.asha.org. on 08/15/2015.

Nijland L., Terband H., Maassen B. (2015), Cognitive Functions in Childhood Apraxia of Speech, Journal of Speech, Language and Hearing Research, Vol 58, 550-565.