ASHA endorses Position Statement and Technical Report on Childhood Apraxia of Speech

March 2007

We are so pleased to share the information the American Speech-Language-Hearing Association (ASHA) accepted and endorsed a Position Statement on Childhood Apraxia of Speech and its companion Technical Report on Childhood Apraxia of Speech.  These documents are of great important to those who are concerned for children affected by this disorder.  The purpose of the documents are to explain, support, and guide ASHA members and other interested parties regarding the identification and management of apraxia of speech in children, including guidance regarding addressing the needs of culturally and linguistically diverse populations.  Up until this time, ASHA did not have formal policies supporting the role of its members in the assessment and treatment of children with CAS.

These important documents are the work of the ASHA AdHoc Committee on Childhood Apraxia of Speech. Members of the Committee were Lawrence Shriberg (chair), Christina Gildersleeve-Neumann, David Hammer, Rebecca McCauley, Shelley Velleman, and Roseanne Clausen (ex officio). Celia Hooper, ASHA vice president for professional practices in speech-language pathology (2003-2005), and Brian Shulman, ASHA vice president for professional practices in speech-language pathology (2006-2008), served as the monitoring officers from ASHA.  Shriberg, Hammer, McCauley, and Velleman are also members of the CASANA Professional Advisory Board.

Several findings and recommendations from the ASHA Position Statement that are critically important to us include the following:

• "It is the position of ASHA that apraxia of speech exists as a distinct diagnostic type of  childhood (pediatric) speech sound disorder that warrants research and clinical services.
• Childhood apraxia of speech (CAS) is proposed as a unifying cover term for the study, assessment, and treatment of all presentations of apraxia of speech in childhood. CAS is preferred over alternative terms for this disorder
• A suggested definition, Childhood apraxia of speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g., abnormal reflexes, abnormal tone)
• It is the policy of ASHA that the diagnosis and treatment of CAS are the proper purview of certified speech-language pathologists with specialized knowledge in motor learning theory, skills in differential diagnosis of childhood motor speech disorders, and experience with a variety of intervention techniques that may include augmentative and alternative communication and assistive technology.
• Given the need for repetitive planning, programming, and production practice in motor speech disorders, clinical sources stress the need for intensive and individualized treatment of apraxia, especially for children with very little functional communication.  There is emerging research support for the need to provide three to five individual sessions per week for children with apraxia as compared to the traditional, less intensive,one to two sessions per week (Hall et al., 1993; Skinder-Meredith, 2001; Strand & Skinder, 1999). Ideally, this should be done in as naturalistic an environment as possible to facilitate carryover and generalization of skills. Although home practice is critical for optimal progress, it cannot take the place of individual treatment provided by a speech-language pathologist who has expertise in motor speech skill facilitation.
• There is a critical need for programmatic research and clinician training in CAS. Research that will lead to a deeper understanding of the neural substrates and behavioral correlates of CAS will require studies using contemporary methods in molecular genetics, neuroimaging, physiology, neurolinguistics, and acoustics. Two applied research goals are to develop reliable and efficient assessment protocols for age-appropriate differential diagnosis and to validate effective treatment approaches".

We are convinced that the new guidance from ASHA can have a significant effect on the system and for the lives of children affected by CAS.  Already, CASANA is positioned to be part of the solution to the critical need for research and training.  Each year, CASANA conducts at least 4 major workshops on the assessment and treatment of CAS as well as our summer conference that also addresses co-occurring conditions faced by this population and is geared to a broad audience.   Since 2001, we have provided training to nearly 4,000 professionals and parents!   In 2006, CASANA started the CAS Treatment Research Fund in order to raise funds for research on treatments for childhood apraxia of speech. 

We are excited that a major step forward has occurred and we need your help to keep momentum moving in the right direction for children with CAS.  Whether you are a professional, parent, family member, or friend, please join us to advance the situation for these children?  Please donate and help us keep this message alive and to develop solutions so that every child with apraxia can have a voice!

 ASHA Position Statement on CAS

  ASHA Technical Report on CAS