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Pittsburgh, PA, July 26, 2011—The Childhood Apraxia of Speech Association of North America (CASANA), has awarded a Treatment Research Grant to Dr. Aravind Namasivayam of the Speech and Stuttering Institute in Toronto, Ontario, Canada for his proposal, “Exploring the Relationship Between Treatment Intensity and Treatment Outcomes for Children with Apraxia of Speech.” Other co-investigators on this grant include Dr. Ben Maasen of the University of Groningen, The Netherlands; Dr. Pascal van Lieshout of the University of Toronto, Canada; and Margit Pukonen, M.H.Sc. of the Speech and Stuttering Institute.

“There are a number of factors that may contribute to treatment outcomes in children with Apraxia of Speech (CAS) ranging from frequency, intensity and type of practice sessions, to the amount of home practice, parental participation, parental skill, and treatment fidelity. Yet, there is little empirical data regarding how these factors actually contribute to treatment effectiveness,” said Dr. Namasivayam, the principal investigator on the funded study. “Having this information will help us refine and guide clinical practice.”

Childhood Apraxia of Speech (CAS) is a very challenging and complicated speech disorder in children, making it difficult or impossible for children to accurately produce sounds, syllables and/or words despite having a good understanding of language. This research project, funded by CASANA through its Treatment Research Grant Program, will be part of a multi-center, large-scale study that is currently underway and was initiated by the Ministry of Child and Youth Services in Ontario, Canada. Researchers expect approximately 200 children with motor speech problems to participate in this larger study. The CASANA grant will be used specifically for the investigation of a subpopulation of two to five-year-old children, demonstrating characteristics of CAS. Highly trained speech-language pathologists will deliver a treatment program – Motor Speech Treatment Protocol (MSTP) Based Intervention – in a randomly assigned high or low intensity condition. The MSTP intervention combines features of several speech therapy approaches for CAS and delivers them according to general principles of speech skill motor learning. Researchers will then evaluate the magnitude of treatment effects across variations in treatment intensity as well as other factors such as parental involvement.

Dr. Namasivayam feels that the study will contribute significantly to the understanding of how the service delivery models, for example with respect to treatment intensity, affect treatment outcomes in CAS. With this information, researchers could then justify treatment schedule changes and fund allocation for treatment of this population. Findings of the study will yield important information relating to the impact of parental training and home practice on treatment success. He believes this information can be discussed with parents to then motivate and increase their participation in the therapy process.

“Information on magnitude of treatment effects for outcome measure related to speech intelligibility and functional communication is limited for this population,” said Dr. Namasivayam.

He believes knowing the magnitude of treatment effects is important for two reasons. First, it can be used to set appropriate levels of clinician and parental expectations prior to treatment and second, it allows for planning of future studies in terms of study design and sample size.

If successful, Dr. Namasivayam hopes to continue several lines of research based on the factors that may contribute to treatment outcomes in children. “We would like to investigate how a clinician’s skill level and training may affect treatment outcomes or how a clinician’s accuracy, timing, and type of cueing in treatment alters treatment outcomes for CAS,” he said. “These are critical follow-up questions to this project.”

The proposal, awarded to Dr. Namasivayam, was through a competitive application process managed by CASANA’s Research Review Committee. Funds for CASANA research projects are generated by the efforts of volunteers and donors in the Walk for Children with Apraxia.

“Our research team would like to extend our sincere thanks to CASANA for providing us with the opportunity to contribute to this cause,” said Dr. Namasivayam. “Without the financial help of CASANA we would not be able to identify, analyze, and report on data relating to treatment effects in this subpopulation of CAS within the larger motor speech research study.”


The Childhood Apraxia of Speech Association of North America (CASANA) is the only national non-profit public charity exclusively dedicated to the needs and interests of children with apraxia of speech and their families. CASANA, founded in 2000, strives to improve the systems of support in the lives of children with apraxia so that each child is afforded their best opportunity to develop speech and to achieve to their potential. CASANA works toward this mission through promoting international awareness of childhood apraxia of speech; providing high quality information and support to families and professionals; conducting multiple educational workshops, webinars and conferences each year; and supporting as well as funding treatment research. For more information on CASANA and Childhood Apraxia of Speech, visit the Apraxia-KIDS website at