A Clinical Case of Suspected CAS
Olga Lilian Maria Antonini, Letizia Michelazzo
The reported case outlines the assessment and rehabilitation process of a child with suspected childhood apraxia of speech (CAS), emphasizing the importance of early differential diagnosis and individualized, multimodal intervention targeting both motor and prosodic features (FLI, 2025; RCSLT, 2024; ASHA Practice Portal, 2026). A perceptual analysis of connected speech, combined with the administration of the Italian-adapted Robbins & Klee Protocol (Granocchio et al., 2021), was used to evaluate lexical inconsistency and speech rate during diadochokinetic tasks. These assessments led to a diagnosis of CAS, with seven diagnostic markers identified in accordance with ASHA criteria (ASHA, 2007) and the Mayo-10 Checklist (Shriberg et al., 2011). The rehabilitation treatment is based on the Michelazzo Method® (Michelazzo & Dell’Ospedale, 2024), which employs facilitated gestures to support phoneme construction, and integrates elements of the Drézancic Method (Drézancic, 1982, 1988, 1992; Zanobini et al., 2011), using melodic cues to enhance attention to suprasegmental aspects of speech. Intensive repetition is incorporated within play-based contexts, utilizing proto-words and constructed words presented in adjacency with gradual phonotactic progression. Finally, a ReST (Rapid Syllable Transition Treatment) cycle (McCabe et al., 2024; Scarcella, Michelazzo, & McCabe, 2021) is introduced to consolidate articulatory patterns and improve coarticulation through high-frequency practice of three- to four-syllable nonwords.
Keywords
Childhood apraxia of speech (CAS); Differential diagnosis; Motor speech intervention; Prosodic intervention; Rapid syllable transition treatment (ReST).
