I am currently working on an evaluation for a child who appears to have a severe form of CAS. After completing the GFTA, it was apparent that he made only six sounds. No final sounds. Is this typical or does it seem more like severe phonological disorder? Any suggestions for language testing since he is so unintelligible?
Answer
Certainly you are talking about a child with a limited phonetic inventory. That is one of those features that is not necessarily unique to childhood apraxia. This may be a case of the child simply having not really mastered very many of the sounds yet. It could be an articulation disorder. It could be a phonological disorder. It could be apraxia. You would want to start looking at factors like consistency and transitions. Do those DDK tasks. Look at conversation and look at use of stress. Look at those three key features to see whether or not the child is in fact producing that. I tend to advocate that with a child who is highly unintelligible, we actually cannot make a judgment on their language skills until we make them more intelligible. Until we get them to where they are more intelligible, we really cannot know what their expressive language skills are. You can assess receptive language skills, but that is pretty much the best you can do.
Dr. Peter Flipsen Jr. is a Professor of Speech-Language Pathology at Idaho State University. He is the author of more than 20 peer-reviewed journal articles and the co-author (with John Bernthal and Nicolas Bankson) of "Articulation and Phonological Disorders: Speech Sound Disorders in Children."
Peter Flipsen, Ph.D. Jr., S-LP(C), CCC-SLP
Dr. Peter Flipsen Jr. is a Professor of Speech-Language Pathology at Idaho State University. He is the author of more than 20 peer-reviewed journal articles and the co-author (with John Bernthal and Nicolas Bankson) of Articulation and Phonological Disorders: Speech Sound Disorders in Children. His current research focuses on speech and language development in children with cochlear implants as well as on the measurement of intelligibility of speech in children.
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