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Literature Review of Speech Therapy Methods for Childhood Apraxia of Speech

Selective excerpts and quotes from the professional literature regarding speech therapy for apraxia in children. Reviews of various methods for therapy.

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“Principles Most Often Suggested as Important to the Treatment of Developmental Apraxia of Speech:

    1. Use of intensive paired auditory and visual stimuli
    2. Production of sound combinations vs. isolated phoneme training
    3. Focus on movement performance drill
    4. Use of repetitive production and intensive systematic drill
    5. Careful construction of hierarchies of stimuli
    6. Use of decreased rate with proprioceptive monitoring
    7. Use of carrier phrases
    8. Use of paired movement of sequences with suprasegmental facilitators such as stress, intonation, and rhythm
    9. Establishment of core vocabulary (especially for the nonverbal child)”

Edythe Strand, Ph.D. “Treatment of motor speech disorders in children,” Seminars in Speech and Language, Vol. 16, No. 2, May 1995.


“…this therapy program that has been effective with a number of apraxic children focuses on:

  1. The motor patterns of basic target phonemes, bringing these productions to surface awareness and control
  2. The reinforcement inherent in combination and blending drills for mastering production of the motor patterns of the critical syllable units of our language.
  3. Teaching of volitional control of the emission of a key word vocabulary.”

Gerald Chappell. “Childhood verbal apraxia and its treatment,” Journal of Speech and Hearing Disorders, Vol. 38, No.3.


“Rosenbek and associates (1974, p.20) outlined the following principles for management of developmental apraxia of speech: acquisition of as near normal volitional speech as physiological limitations will allow; emphasizing movement sequences; generating task continua according to phonetic principles; limiting the number of stimuli; intensive systematic drill; use of visual modality; and facilitating response adequacy with systematic use of rhythm, intonation, stress,
and motor movements.”

Mary Pannbacker. “Management strategies for developmental apraxia of speech: a review of the literature,” Journal of Communication Disorders, 21,1988.


“Macaluso-Haynes reviewed management procedures for developmental apraxia of speech… these techniques involved: ‘concentrated drill on performance’; ‘imitation of sustained vowels and consonants followed by production of simple syllable shapes’; ‘movement patterns and sequences of sounds’; ‘avoidance of auditory discrimination drills’; ‘slow rate, self monitoring’; ‘core vocabulary’; ‘carrier phrases’; ‘rhythm’; ‘intensive frequent, and systematic drill’; and ‘orosensory perceptual awareness’.”

Mary Pannbacker. “Management strategies for developmental apraxia of speech: a review of the literature,” Journal of Communication Disorders, 21, 1988.


“…treatments for motor speech disorders could be classified broadly as those that:

  1. establish physiological support
  2. enhance postural shaping and kinesthetic awareness for functional units of speech
  3. enhance kinesthetic awareness for movement sequences
  4. regulate rate and melodic flow…

…methods that highlight movement sequences and methods that heighten the melodic line and slow rate are the ones that have gained the greatest favor in the treatment of children with DAS and adults with acquired apraxia of speech.”

Paula Square, Ph.D. “Treatment approaches for developmental apraxia of speech,” Clinics in Communication Disorders, 4 (3), 1994.


“PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) treatment involves the dynamic delivery of tactile and kinesthetic cues to the speech mechanism to signal place of articulation, timing of respiratory, laryngeal, and velopharyngeal activity, and the durations of valving constrictions or vocal tract postures.”

Paula Square, Ph.D. “Treatment approaches for developmental apraxia of speech,” Clinics in Communication Disorders, 4 (3), 1994.


“The Adapted Cueing Technique (ACT), developed by Klick (1985)… focuses on movement patterns through enhanced visual feedback. That is, the clinician stimulates the child to say a phrase by providing the auditory model coupled with movement along side the clinicians face to indicate movement trajectories.”

Paula Square, Ph.D. “Treatment approaches for developmental apraxia of speech,” Clinics in Communication Disorders, 4 (3), 1994.


“Jaffe (1986) asserts that in the treatment of apraxia manual signs serve two functions: 1. By repeated association the signs can help the child recall and correctly articulate sound patterns and produce correct syntactic sequences; and 2. Signs and speech help the clinician to slow the rate of presentation and help the child reduce the rate of utterance.”

Kathleen Helfrich-Miller, Ph.D. “A clinical perspective: melodic intonation therapy for developmental apraxia,” Clinics in Communication Disorders, 4(3), 1994.


“Melodic intonation is based on three elements of spoken prosody: the melodic line, o and rhythm, and points of stress. In an intoned utterance, the o is lengthened, the rhythm and stress are exaggerated and the constantly varying pitch of speech is reduced and stylized into a pattern involving the constant pitch of several whole notes. A typical intoned utterance only varies by one whole note, much like chanting…. MIT does not teach correct production of individual speech sounds. It is not designed to replace other therapy approaches but to supplement and augment them.”

Kathleen Helfrich-Miller, Ph.D. “A clinical perspective: melodic intonation therapy for developmental apraxia,” Clinics in Communication Disorders, 4(3), 1994.

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