Speech Tablets for Apraxia
Parent/Guardian Application Information

Application Deadline is end of day on Monday, November 6, 2023
Decisions will be emailed on Wednesday, November 29, 2023


If you need to complete a paper application instead of this virtual application, please contact speechtablets@apraxia-kids.org for accommodations.

Application Instructions

Please note that you cannot save your progress during this application so please make sure you have all of the required information ready when you begin the application.

Parent/Guardian Preparation
Make sure you have the following:
– Important information about your child’s CAS diagnosis and CAS services
– Household income from 2022 and projected for 2023
– Make sure your child’s primary SLP is aware they will be involved in the application process

SLP Preparation
Make sure you have the following:
– Permission from the parent/guardian to complete your portion
– Client information, history, and clinical notes
– Client evaluation report or detailed therapy summary regarding CAS diagnosis

2023 Speech Tablets for Apraxia
Parent/Guardian Application Form


Speech Tablets for Apraxia Parent/Guardian Application Form

Biographical Information


For research purposes, please answer the following questions.

These questions are for research purposes only and will not be used during the review process.

What is the sex of your child?
How long ago was your child diagnosed with childhood apraxia of speech?
How would you describe your child?
How would you best describe your community?
Are you new to the Apraxia Kids organization?
How did you find out about the Apraxia Kids Speech Tablet Program?


How much of your child’s speech can currently be understood by an unfamiliar listener?
My child also has the following (Please check all that apply):

Augmentative Alternative Communication Usage

Does your child currently use augmentative alternative communication (AAC)?
Has your child used an iPad or speech generating device before?
Have you personally used an iPad before?
Do you currently own an iPad?
Have you applied for a speech tablet from Apraxia Kids (formerly CASANA) in the past?


Your SLP

Your child’s current primary SLP plays a crucial role in this application process. They must complete an online application about your child and upload a written speech-language evaluation report or provide a therapy summary report for your child. When you provide your SLP’s information below, they will automatically receive an email to that listed address with their instructions and application link. You are responsible for making sure that your SLP is aware of this process and to encourage them to complete their portion by the deadline in order for your application to be complete and reviewed.

By completing this portion, you are giving permission and consent for your child's primary SLP to provide relevant information about your child in their application portion. If your SLP or their employer require a copy of written consent, they may ask you to sign a copy of their SLP application for their records.

I have notified my SLP to expect this email and application. (If you check "no," you must notify your SLP immediately of their involvement in your application.)

Financial Information

Tell us about your child

I understand the following:

My submitted application does not guarantee that my child will be selected.
My application must be submitted by the deadline noted (Monday, November 6, 2023) or it will not be considered.
All required information must be submitted or my application will be disregarded and not considered.
If selected, I agree to sign an Equipment Donation Agreement, write a thank you letter to Apraxia Kids, and provide a photo of my child with their speech tablet.
If selected, I understand my child will receive an iPad and protective case.
I am responsible for purchasing applications (apps) for use on the iPad.
I am responsible for purchasing any extended warranties.
I have read, understand, and agree to all of the FAQs and application requirements.
I understand that I may be asked for supplemental information to process my application and will provide what is asked of me.
I agree that de-identified information (removal of all names and birthdate) from this application can be used for research purposes by Apraxia Kids.
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