Apraxia / Motor Speech

Motor speech assessment examines the planning, programming, and execution of speech movements. Childhood apraxia of speech requires a comprehensive differential assessment; a few observed characteristics or checklist selections do not establish a diagnosis. Document the specific movement sequences and functional messages addressed, and consider AAC when it improves access to communication.

What to consider in assessment

Sample repeated productions, different syllable shapes, movement transitions, vowels, stress, and changes as words grow longer. Consider hearing, language, structural, and other motor-speech factors. No isolated checklist feature establishes childhood apraxia of speech; differential diagnosis requires appropriate expertise.

What the SLP can address

The SLP selects functional speech targets, structures motor practice, tracks the effect of cueing and repetition, and supports communication in parallel. AAC may provide a reliable way to communicate while speech is developing.

Select a small set of meaningful words or phrases and practice them with individualized auditory, visual, or other appropriate cues. Track movement accuracy across repeated trials, then vary the context or fade cues when performance supports it.

• Select meaningful words and phrases and document repetitions, accuracy, and the cueing hierarchy.
• Consider how timing, movement transitions, syllable complexity, and prosody change across targets.
• Support speech practice and AAC together when the person benefits from both.

Choose strategies using assessment findings, the person’s preferences, and the treatment context.

Specify the functional context, observable response, criterion, support level, and how progress will be checked.

Describe observable movement and prosody, target complexity, correct/total productions, and the cue hierarchy. Avoid adding a CAS diagnosis unless it is already established by the clinician.

• S: Include communication frustrations, goals, and reported carryover when supplied.
• O: Record target sequence, practice type, repetitions, cue level, transitions, and prosody actually observed.
• A and P: Describe response to cues and the next movement target; do not generate a CAS diagnosis from checkboxes.

Continue with resources currently available on Culturally Speaking SLPs.