Childhood Apraxia of Speech: How to Do Speech Therapy for CAS
Childhood Apraxia of Speech (CAS) is a rare, neurologically-based speech disorder where the child knows what he wants to say but the message gets mixed up in the motor-planning and execution phase so the sounds come out all wrong.
What are the Symptoms of Childhood Apraxia of Speech?
Though the diagnosis of CAS is relatively new, experts have agreed that CAS usually includes these 3 generally-agreed upon components:
No-Prep Therapy Kit for Apraxia
Teach CV, VC, and CVC Words to Children with Apraxia
Join the Hub to AccessListen to the Podcast on Childhood Apraxia of Speech:
Sometimes it can be difficult to know exactly what you should be working on with your children with childhood apraxia of speech. In this podcast episode, I break down speech sound learning in different levels. Then, I give practical therapy activities that can be used for each level. Click the play button below to listen to the entire episode. Or, scroll down to see the notes below.
PreviewFree Therapy Levels Chart:
To get started, download the free PDF of the Skill Set Charts for Childhood Apraxia of Speech. This will break down a nice order to help you determine what speech skill to work on next with a child with CAS:
Click Here to Download the CAS Levels PDFPhases of Speech Therapy for Apraxia of Speech:Apraxia of Speech Level 1:
Imitating Actions
Children who are unable to imitate speech soundsChildren who are not tuned in enough to work on anything during sessionsChildren who have emotional issues and are not willing to work with you on their speech during sessionsDo a reinforcer probe and offer those preferred reinforcers if the child imitates a basic action like clapping hands, stomping feet, raising hands, etc.Take pictures that represent the actions you want the child to do and print them on cards. Have the child draw one card from a bag and do that action.Make a movie on your phone where the child is your shadow and imitates what you do (do it in reverse as well).Apraxia of Speech Level 2:
Functional Sounds, Sound Effects, Vocalizations
Children who are able to imitate actions but unable to imitate or produce sound combinations (like CV, VC)Children who need a little confidence boost before working on sound combinations (this could be mixed in)Play with vehicles and make engine sounds (or sirens).Feed puppets or stuffed animals and have them make exaggerated “mmmm” noises.Have the child request pieces to an animal puzzle by making that animal’s noise (reduce complex noises down to one sound, like “eee” for monkey).Apraxia of Speech Level 3:
Sound Combinations (CV, VC)
Children who are able to imitate or produce some sounds but are not yet spontaneously combining 2 sounds, like consonant- vowel or vowel-consonantChildren who are doing some sound combinations on their own but can’t say very many (or enough to communicate much)Get some sort of a riding toy like a bike or a swing and stop the child until he says “go” again.Throw small objects up onto a higher surface (like a table), each time, have the child say “up” to indicate he wants another thing to throw up.Put coins in a piggy bank and have the child say “in” to get each coin to indicate he wants to put it in.Apraxia of Speech Level 4:
Repeated Strings of CV or VC
Children who are able to combine a vowel and consonant together but are not yet producing longer utterancesChildren who are doing some CV, VC, and CVCV combinations on their own but can’t say very many (or enough to communicate much)Sequence words that the child can do together to work on articulatory transitions (the same word repeatedly or alternating two words together).String together several of a word that the child can say and then add a word that the child can’t say to the end that only varies by one sound (bow, bow, bow, boy).Apraxia of Speech Level 5:
Add a Structure, Add a Sound
Children who are able to say some limited structures (like CV, VC, and CVCV) but struggles to say longer or more complex wordsChildren who are able to use some sounds in CV, VC, and CVCV structures but not very manyIncrease vowels by sequencing pictures together that start with the same consonant and change the vowel, like “boy, bee, bay, bow, bow”, etc. Lay the cards in a row and have the student say the sequence.Increase consonants by using the same vowel and changing the consonant, like “me, tea, key, pea, we, see”.Increase structures by taking a known word and adding a sound like, “key…keep, pea…peep, we…weep”.Apraxia of Speech Level 6:
Sound Accuracy in Phrases and Sentences
Children who are able to produce single words of many structures with good speech sound accuracy but intelligibility decreases in phrases and sentencesCreate worksheets similar to the previous section where you provide the pictures and they glue them on, but this time, build sentences, like “see..(next line)..I see…I see cat…I see the cat”.Use one carrier phrase and fill it with different words that the child has mastered, like “I see bat, I see cat, I see hat, I see mat”. Use flip books if you have them or make your own.Apraxia of Speech Level 7:
Sound Accuracy in Connected Speech
Children who are able to produce sounds correctly in simple sentences and phrases but intelligibility decreases in connected speechTherapy Activities (work on speaking clearly in tasks with increasing complexity, don’t move on until the previous level is clear)
No-Prep Therapy Kit for Apraxia
Teach CV, VC, and CVC Words to Children with Apraxia
Join the Hub to AccessChildhood Apraxia of Speech Course
2-Hour Course on How to Help Children with Childhood Apraxia of Speech
Join the Hub to AccessAbout the Author: Carrie Clark, MA CCC-SLP
Hi, I’m Carrie! I’m a speech-language pathologist from Columbia, Missouri, USA. I’ve worked with children and teenagers of all ages in schools, preschools, and even my own private practice. I love digging through the research on speech and language topics and breaking it down into step-by-step plans for my followers.
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