CEU Course Review: Childhood Apraxia of Speech (CAS): Defining the Territory

Over the past few months I've had some extra time for myself. (Woo!) How did I spend some of that time? Taking some of what I call "Student non-CEUs Courses" (since I can't get CEU credits being and undergrad)! I have finished quite a few and have more pending in my speechpathology.com account. So within the next weeks to months you'll be sure to get more reviews. You can see other reviews I've done here.This time I "attended" the text-based course entitled "Childhood Apraxia of Speech (CAS): Defining the Territory" presented by Peter Flipsen, Ph.D. Jr., S-LP(C), SLP-CCC.

I think this is a splendid course that gives thorough information on defining CAS, as well as giving perspective on diagnosis and assessment of this disorder. He discusses the issues that are faced when figuring out what all is unique to this disorder, differential diagnosis, long-term risks existent with CAS and how we can go about  diagnosing/ assessing this disorder in children compared to adult Apraxia of Speech and other Speech Sound Disorders.With that said, it only touches base on treatment in the last paragraph. This isn't much of a surprise, though, as the title says it is only describing the scope of what CAS entails, not how to treat or manage it.

One of the major components of CAS that this course pinpoints are the unique characteristics that are presented in this disorder and how they can affect differential diagnosis. These are very important concepts to keep in mind when diagnosing a child with Childhood Apraxia of Speech. Some of them are as follows ¹:

1. Inconsistent Output- There are varying definitions of 'inconsistent', and he specifically states that in the case of CAS it is a lack of consistency when uttering the same word over multiple attempts. It does not mean pronouncing a sound correctly in one position and not in another or correctly in some words and not others.
2. Transition Issues- This can be presented in a few ways, but entails issues with unnecessary disruptions or lengthening between consonants, vowels or syllables.
3. Distorted Prosody- When a child has excessive and equal stress placed on syllables that don't need them. An example he gives is when a one half of an utterance/word has stress but the child places equal stress on both halves.

He also mentions differences and similarities between CAS and the adult version (Apraxia of Speech) and also between CAS and other speech sound disorders. Some of them I was surprised by, simply because I hadn't thought of those before, but they make sense. There are often issues with diagnosing CAS, especially with children younger than three. Some "characteristics" can often be viewed as relevant to CAS when they may be actually pertain to (a possibly co-existing) oral apraxia or dysarithria. It also is difficult to assess and diagnose since all tests were created before ASHA created their position statement for Childhood Apraxia of Speech, lending each test to only screen for 1 or 2 of the 3 unique characteristics listed above. He does list them and give other examples of possible ways to test each trait for a more full diagnosis. Flipsen also notes that diagnosis may be correct, but treatment plans are not fully comprehensive or tackle issues more pertinent to language, phonetic or articulatory disorders. 

For more information and details on his views of the background/genetics, possibly co-existing genetic/speech disorders, diagnosis and assessment of Childhood Apraxia of Speech, please read his text-based course. It provides a wealth of information on a disorder that hasn't been readily defined until the past decade. 

*Disclaimer: All statements are my own opinion and not those of the presenter or host website. These statement are also not a paid endorsement, solely my views on the material from the course.

References:

1. Flipsen, Peter, Ph.D. Jr., S-LP(C), SLP-CCC. "Childhood Apraxia of Speech (CAS): Defining the Territory." Lecture. SLP Course Details. SpeechPathology.com, 26 Mar. 2013. Web. 2 Sept. 2013.