DTTC is an method designed for children with moderate to severe CAS and can be used with younger children. DTTC is a motor-based approach incorporating principals of motor learning in the treatment methods. Words and phrases practiced in therapy are individualized for each child based on the movement patterns the child needs to work on and the words/phrases that are meaningful and functional to the child. Learn more about DTTC here.
Rapid Syllable Transition Training (ReST)
ReST is designed to treat childhood apraxia of speech or ataxic dysarthria in children age 4-12. ReST uses nonsense words that sound like real words but do not have any real meaning, allowing the child to concentrate on movement without focusing on sound errors. Treatment sessions follow a consistent structure of training and practice. Learn more about REST here.
Integrated Phonological Awareness Training (IPA)
IPA is an intervention program for preschool children with speech-language impairment. Although IPA was not specifically designed for children with CAS, research has demonstrated that children age 4-7 with CAS demonstrated improvements in speech production. IPA is a linguistic based approach (vs. a motor approach) and it is designed to simultaneously facilitate speech production, phonological (sound pattern) awareness and letter-sound knowledge. Learn more about IPA here.
Nuffield Dyspraxia Program, Third Edition (NDP3)
NDP3 is a therapy approach used to treat severe speech sound disorders, including CAS. Although it is designed primarily for children age 3-7, it can be adapted to younger or older children. NDP3 is based on a motor learning approach that builds skills from single speech sounds to connected speech. Learn more about NDP3 here.
What about treatment methods not on this list?
There are other CAS treatments that do not have the same level of evidence as those listed above. Treatment research in CAS has expanded significantly in the past few years, but large randomized controlled studies are still needed. Many factors may influence a clinician’s decision to use a specific treatment method, including parent preference. No matter what treatment method is selected, it is always up to clinicians to carefully monitor the child’s response, including maintenance (skills learned persist over time) and generalization (skills transfer to things not directly practiced in therapy). Unfortunately, CAS has been described as “difficult to treat” and therefore clinicians assume that slow progress over an extended period of time is typical for children with CAS. If a treatment method is not resulting in notable improvement in the child’s speech within a reasonable period of time, you may want to explore other methods. You can consult the American Speech-Language and Hearing Association (ASHA) Evidence Map for CAS here.