There is no single factor that determines severity. During the evaluation, the speech-language pathologist may consider several factors to determine the level of severity of the CAS including:
Sometimes clinicians may give an initial severity rating based on observations during the assessment but then modify the rating as they observe the child’s early response to treatment.
See examples of children with different severity levels of CAS here.
Does severity change over time?
Yes, especially with effective treatment. In fact, the goal of treatment is to lessen the severity of the CAS. Although some experts believe that CAS is a lifelong disorder, most agree that effective treatment is essential and the earlier that treatment begins, the better. Children who receive appropriate treatment should be expected to improve and may eventually only demonstrate very mild signs of the disorder. However, delaying treatment or not receiving the appropriate treatment may result in a greater lifelong disability.
It is important to note that when a child has CAS and another developmental disorder (such as Down Syndrome) the rate of progress may be slower even with effective treatment and the child may not achieve the same long-term outcome as a child with only CAS.
How does severity impact treatment?
Different methods of treatment were developed to target different CAS severity levels. Therefore, a child may begin therapy using one method and then transition to a different method as the CAS improves. Age is also a factor because some therapy methods were designed for older children. The following is a summary of current evidence-based treatment methods that correlate with age/severity:
Learn more about these different treatment methods here.
There are other methods to treat CAS that do not have sufficient evidence of efficacy (effectiveness in a controlled condition such as a research study) and are therefore not included in this list.