Childhood Apraxia of Speech (CAS):
Irina Podda
Childhood apraxia of speech (CAS) is a speech sound disorder that almost always occurs within a constellation of neurodevelopmental disorders, affecting the cognitive-linguistic, sensorimotor, and social-motional domains. Neuroimaging and genetic studies have helped identify the neurobiological basis of the disorder, with approximately forty genes associated with CAS, as well as other neurodevelopmental and speech disorders. CAS frequently co-occurs with autism spectrum disorder, intellectual disability, ADHD, developmental coordination disorder, and, above all, developmental language disorder and reading and writing difficulties. From a treatment perspective, CAS has historically been described as resistant to contrastive treatments, so motor approaches have been developed, primarily intended as protocols based on the principles of motor learning and characterized by high intensity, structured feedback, and multimodal cues. However, evidence of efficacy remains limited, especially for children with CAS and co-occurring neurodevelopmental disorders. A dimensional and highly personalized, flexible, and multidisciplinary approach, focused on the individual child’s strengths and weaknesses, appears more appropriate than approaches derived from rigid, obsolete, and methodologically questionable categorical classifications of speech sound disorders.
Keywords
Childhood Apraxia of Speech (CAS); Dimensional approach; Neurodevelopmental disorders; Speech and language therapy; Speech sound disorders (SSD).
