Apraxia Monday: Donna Lederman, SLP (Part 1 of 2)

If you’ve been following my blog for awhile now, you know I am a self-proclaimed “nerd.”  It’s not such a bad thing.  I love being a nerd!  Mostly because I love to learn and gather new information.  There was  a wonderful Apraxia program held right in my own backyard of Wheaton, Il–of course I had to go.   New York based speech-language pathologist Donna Lederman, SLP was presenting information on CAS.  Sponsored by CASANA and costing a mere $10 for a parent participant, I was happy to spend a Thusday evening (October 14th) being enlightened by Ms. Lederman. 

Thought I’d share with you what I learned. 

First of all, Donna is very personable and energetic (two great qualities when you are talking pediatric SLPs).  Not only that, but she is very qualified to work with kids with apraxia, having worked with Deborah Hayden with PROMPT-based therapy.  She has taught and lectured in various National and International PROMPT courses. 

She started the presentation by reminding us parents that speech is more of a motor behavior and not as much as a linguistic behavior as we tend to see (hear) it.  There are so many complex processes that contribute to a kiddo’s ability to speak–and the one most affected in CAS is the motor aspect.  I never cease to learn more about CAS, no matter how many times I’ve been to lectures like this one.  Here’s more:

  • A motor speech disorder is in one in which there is a disruption on the movements (motor) of speech.  Kids needs to practice these motor movements over and over until they finally “get” them and they become automatic.  It’s like when you are learning to do step-aerobics and you just can’t get those “V” steps and “over-the-top” things all coordinated in the right way.  You stumble and trip and then towards the end of class, you finally start to get the routine.  It’s no different for our kids with CAS.
  • It is also pretty rare to have “pure” CAS (as if CAS wasn’t “rare” enough!).  Most kids have a co-existing language impairment in addition.  It is also not uncommon for kids with apraxia to have other developmental delays, autism, ADHD, as well as Down Syndrome.
  • After many years of folks talking (non pun), about the idea of CAS, there came a point in the not-so-distant past (2007) when ASHA (American Speech and Language Association) developed a Technical Report defining CAS. 
  • What’d they say?  “A neurological childhood speech sound disorder in which the prescision and consistency of movements underlying speech are impaired, in the absense of neuromuscular deficits.”  Yeah…are you scratching your head, too??! 
  • What does this mean?  Basically it’s saying that the core problem is in the planning and programming of what a child wants to say and how it comes out, resulting in errors in speech sound production and prosody (rhythm). 
  • There is NO “gold standard” for identifying CAS
  • There is NO standardized test to provide definitive diagnoses
  • CAS presents differently with each child–and varies depending on age, severity, and overall personality of the child, let alone if there is some additional disability or delay. 
  • But there are some core elements of CAS common to all kids who present with it:  1)  problems repeating the same word in the same way each time 2) Difficulty sequencing sounds from one syllable to the next, one word to the next, one phrase to the next 3) inappropriate prosody (rhythm), and difficulty with vowel sounds
  • There are some characteristics common among kids with CAS:  1) little babbling as baby 2) late on set of first words 3) limited consonant and vowel repertoire 4) words used and then later disappear 5) Use of simple syllable shapes and sounds 6) preferred sounds over learning new ones 7)oral groping (you can literally see kids searching for the “right” words) and finally, 8) frequent use of gestures when trying to communicate

Whew!  Let’s call this part 1 of 2 of Ms. Lederman’s presentation.  That’s a lot of information to soak in!  I will follow-up tomorrow with more. 

What else is coming down the pike on Leslie4Kids?

  • “Raising Your Spirited Child” info from book with the same titel and temperment of children/goodness of fit
  • “I don’t know how I do it all”
  • Interview with Dee Fish, SLP and her new book on Apraxia
  • Information on Silent Stars Foundation (non-profit CAS organization in Chicagoland)
  • Interview and book give-a-way from Teri Peterson, SLP

As always, I welcome your suggestions for ideas to present on the blog.  Feel free to shoot me an email.  Best to you and thanks for reading! 

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