Giving a voice to individuals with apraxia of speech
Childhood Apraxia of Speech (CAS) Therapy & Treatment
Children's therapies
These therapies are designed specifically for childhood apraxia of speech. Each approach provides a structured way to support the development of speech sounds, motor planning, and overall communication skills. They can be adapted for adults with some modifications,
Treatment decisions for speech and language
The Three Pathways
Clear speech → communication/language pathway
Some sound errors → articulation/phonology
Very unclear speech → motor speech pathway (CAS)
Meet a therapist who works with Childhood Apraxia of Speech
Hazel Shaw Specialist Independent Speech and Language Therapist BSc (Hons), MRCSLT, HCPC Reg
I am a Registered Paediatric Speech and Language Therapist with over 25 years’ experience and am passionate about working with children with speech sound difficulties, including Childhood Apraxia of Speech (CAS). I initially specialised in working with children with a cleft but found an equal interest in CAS.
I put my heart and soul into my work—though I’ll admit, it can be exhausting at times! Still, I believe wholeheartedly in every child I have the privilege to work with and I often find they teach me just as much about CAS as any textbook ever could.
Hazel is one of our 'Friends of Speech Apraxia,' helping us to answer your concerns
Meet a parent of a child with Childhood Apraxia of Speech
Kendra with her son Elliot have been dealing with the challenges of childhood apraxia of speech. She is become one of our parent champions and has also set up 'Elliot's Voice'. You can find more about her inspirational journey in the 'meet others' page of our website.
Motor-Based Therapy Principles
- Therapies designed specifically for childhood apraxia of speech (CAS) are based on motor learning principles.
- Focus on improving speech movement planning and programming, rather than teaching individual sounds.
- Target movement sequences, syllable shapes and accurate transitions between sounds.
- Use a hierarchical approach, progressing from simple to more complex speech tasks.
- Incorporate multimodal cueing (visual, auditory and tactile), with cues gradually faded to encourage independence.
- Common evidence-based approaches include DTTC, Nuffield Dyspraxia Program and ReST.
Principles of effective therapy
- Provide intensive, individual therapy, particularly for severe CAS.
- Aim for frequent, repetitive practice of meaningful speech movements.
- Select functional words and phrases that are important to the child.
- Practise in both structured activities and natural communication settings.
- Progress from repetitive drills to spontaneous conversation.
- Encourage self-monitoring and self-correction as skills develop.
- Augmentative and Alternative Communication (AAC) may be used alongside speech therapy to support communication.
- Non-speech oral motor exercises alone are not sufficient to improve speech.
Motor learning in therapy
- High-intensity practice is essential for motor learning.
- Frequent repetition leads to greater accuracy, generalisation and long-term retention.
- Aim for 50 or more target productions in a 30-minute session, where appropriate.
- Use both knowledge of results ("correct or incorrect") and knowledge of performance ("how to improve the movement") feedback.
- Gradually reduce feedback to encourage independent motor planning.
- A slower speech model can improve planning time and speech accuracy.
- Keep children motivated with functional, meaningful and age-appropriate targets.
- Treatment should be guided by the child's current motor speech abilities and adjusted as skills improve.
- A qualifed professional should always be consulted.
Accessing Therapy Services, Apps and Resources
Private speech and language therapy in UK
Directly contact a private therapist via the Independent Speech and Language Therapists | ASLTIP
There is currently a shortage of private therapists working with speech apraxia.
Most therapists offer an intial 15 minute free or low-cost consultation to discuss needs
Average Costs
- Initial assessment: £250-£500
- Therapy sessions: £85–£225 per 45–60 minutes
- Travel/home/initial assessment visits may cost extra
Check the Register and find a registered health and care professional | The HCPC
It is normal practice for SLTs to work together if more then one therapist is involved in care. Currently service pressures in State provision can mean that services are limited and therefore this mode of operation is common.
Therapy dosage and frequency
What can I do at home?
Ideally, anyone with any form of speech apraxia should be assessed and treated by a speech and language therapist with expertise in motor speech disorders. However, this is not always possible due to location, waiting lists or cost.
If specialist therapy is not readily available, there are still many ways to support progress. Speech Apraxia International provides hundreds of hours of educational content through its website, webinars and training events. There are also many evidence-based speech therapy apps, online therapy resources and books that can support home practice.
For many people, it may be possible to see a speech and language therapist less frequently while following a structured therapy programme at home. Regular guidance from an experienced clinician, combined with consistent independent practice, can still be an effective way to develop and maintain communication skills.
FREE general speech and language resources for helping communication development at home
The BBC have some great free resources
23 language and literacy tips to support your child - BBC Bitesize
We really like Peachie Speechie for free & affordable videos and materials. Use the button below. They have some fantastic resources. Quote
PSAF267 and get 10% off
How to help your child to start talking
The Speech, language and Communication Framework
Developed by The Communication Trust, this is a free online professional development tool. This has useful training and online CPD activities for practitioners that develop their own knowledge and understanding about the topic. The site also has useful case studies.
Early years child development training : Home page
FREE training program in early years development. The training is based on the Early Years Foundation Stage (EYFS) framework used in England. However, you may still find the content beneficial if you live outside England and are welcome to undertake the training if you wish
Tiny Happy People
With tips for during pregnancy to activities to try with your toddler this website includes lots of fun play ideas to encourage children’s communication skills. Includes SEND resources and activities for parents to try at home from pregnancy to age 5.
Talking Point
This is run by I CAN and has many resources, information and ideas about supporting children’s communication. The site also offers a free ‘I CAN Help Enquiry Service’ for you if you have questions.
Somerset Speech and Language Toolkit 2019
Accompanies the book 'Sunny’s Sound Play' and is copyright the author and J & R Press. Sunny's Sound Play read to camera.
Speech Apps and Online therapy
Technology can be an excellent way to supplement speech and language therapy by providing additional practice at home, school, or in the workplace.
These resources have been selected because they provide accessible activities, therapy materials, and guidance for children with speech, language and communication needs. They are useful for families, schools and speech and language therapists.
HelpKidzLearn Bitesize Apps
https://www.helpkidzlearn.com/bitesize-apps/
A collection of simple, engaging educational apps specifically designed for children with special educational needs, including switch-accessible and early communication activities.
Free SLP
A large collection of free printable therapy materials, games, worksheets and activities covering speech sounds, language, literacy and communication skills.
Schools Guide to Implementing Online Speech and Language Therapy
https://www.lancashirespeechtherapy.co.uk/online-speech-and-language-therapy-schools-guide
A practical guide for schools explaining how to deliver online speech and language therapy successfully, including technology, safeguarding and staff responsibilities.
Online Speech and Language Therapy: 10 Facts You Need to Know
Answers common questions about online speech and language therapy, including who it is suitable for, how effective it is, and what families can expect from remote sessions.
2021 App Guide
www.abainpa.com/wp-content/uploads/2022/12/2021-App-Guide-Final-mobile.pdf
A comprehensive guide reviewing a wide range of speech, language and cognitive therapy apps for children
FREE therapy videos
CVC repetitive video (DTTC Kaufman - based)
CVCV reduplicated words for at home Childhood Apraxia of Speech practice
VC words for at home Childhood Apraxia of Speech practice
CV1CV2 words for at home Childhood Apraxia of Speech Practice
Apraxia Therapy CV Words - follow-along-style home practice video using the DTTC approach for CAS
Neurodiversity-Affirming Motor Speech Intervention for Autistic Individuals with Co-Existing CAS
Dynamic Temporal and Tactile Cueing (DTTC)
What is Dynamic Temporal and Tactile Cueing (DTTC)
What is Dynamic Temporal and Tactile Cueing (DTTC)
Dynamic Temporal and Tactile Cueing (DTTC) is an intensive motor-based treatment for Childhood Apraxia of Speech (CAS). It is particularly associated with the work of Dr Edythe Strand and is commonly used with younger children and children with moderate-to-severe CAS.
Rather than teaching individual speech sounds in isolation, DTTC focuses on helping children develop and practise the movement gestures and sequences required for meaningful speech. The therapist continually adjusts the amount and type of support according to how successfully the child produces the target.
A Different Focus: Movement, Not Sounds
What is Dynamic Temporal and Tactile Cueing (DTTC)
DTTC focuses on the movement of speech as a whole, rather than simply teaching individual sounds. The aim is to help the child learn the movement patterns needed to move accurately and smoothly through syllables and words.
Vowels, transitions between sounds and syllables, and prosody are important because these can all be affected in CAS. The child repeatedly practises complete movement sequences so that increasingly accurate and consistent speech-motor patterns can develop.
Resource: ASHA – Childhood Apraxia of Speech
ASHA provides an independent professional overview of CAS assessment and treatment, including motor-programming approaches, principles of motor learning and the use of sensory cueing.
https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/
Choosing Meaningful and Individualised Targets
DTTC does not depend upon every child working through the same predetermined word list. Treatment targets are selected according to the individual child's speech-motor abilities and functional communication needs.
The speech and language therapist considers the movement gestures the child needs to learn and selects appropriate words for practising them. Meaningful words can make practice more relevant to the child's everyday communication while providing repeated opportunities to establish new speech-motor plans.
Targets are adjusted as the child progresses so that the speech movements being practised become increasingly accurate, fluent and complex.
Resource: Dr Edythe Strand – DTTC Treatment Strategy
This important clinical paper by Dr Strand provides an in-depth explanation of the theoretical basis, essential elements and clinical decision-making involved in delivering DTTC.
Moving Towards Independent Speech
The word dynamic is fundamental to DTTC. The therapist continually changes the amount and type of assistance provided according to the child's performance.
Support may involve producing the target simultaneously with the child, slowing the production, providing repeated models, drawing attention to the clinician's speech movements or providing tactile information when appropriate.
When the child experiences difficulty, the clinician can increase support. When production becomes more accurate, support is reduced so that the child gradually assumes greater responsibility for planning and producing the speech movement.
This continual adjustment distinguishes DTTC from approaches that use a predetermined sequence of prompts regardless of the child's response.
Resource: DTTC Hierarchy
This practical downloadable infographic illustrates the DTTC hierarchy and how support can be systematically altered as a child progresses towards more independent speech production.
https://www.grahamspeechtherapy.com/uploads/7/5/6/4/75649261/dttc_freebie.pdf
Finding out about DTTC
DTTC uses a hierarchy of temporal delay designed to gradually increase the child's responsibility for planning and producing speech.
A child may initially produce a target at the same time as the clinician. As accuracy develops, the clinician progressively changes the timing and amount of support until the child is able to produce the target more independently.
Importantly, progression is not necessarily one-directional. If the child's production becomes inaccurate, the clinician can immediately return to a greater level of support before reducing it again. This flexibility helps maintain successful practice while continually challenging the developing speech-motor system.
Resource: Diagnosis and Treatment of CAS Using DTTC
A free online video course taught by Dr Edythe Strand covering CAS assessment and differential diagnosis, principles of motor learning and treatment using DTTC, including clinical video examples.
https://childapraxiatreatment.org/diagnosis-and-treatment-of-cas-online-course/
Research Evidence for DTTC
DTTC has a growing body of direct research evidence for Childhood Apraxia of Speech. Studies have reported improvements in speech production following treatment, including changes in word accuracy and speech-motor control. Systematic reviews have also identified Integral Stimulation/DTTC among the motor-based approaches showing positive treatment and generalisation effects.
The evidence base should still be interpreted within the wider context of CAS research. Compared with many other clinical areas, CAS treatment studies remain relatively small in number and participant size. Reviews of the wider literature nevertheless generally identify motor-programming approaches as having the strongest overall evidence, with DTTC being one of the most established approaches within this group.
Resources
Systematic Review of Treatment Outcomes for Children With Childhood Apraxia of Speech
This systematic review examines treatment studies across different CAS interventions and identifies Integral Stimulation/DTTC among the approaches demonstrating positive treatment and generalisation effects.
https://pubmed.ncbi.nlm.nih.gov/24686844/
Speech Intervention Effects for Childhood Apraxia of Speech: Quality Appraisal of Systematic Reviews
This paper evaluates the quality of previous systematic reviews and provides a useful overview of the relative evidence supporting different CAS intervention approaches, including motor-programming treatments.
DTTC in Clinical Practice: Training, Implementation and Treatment Fidelity
DTTC in Clinical Practice: Training, Implementation and Treatment Fidelity
DTTC in Clinical Practice: Training, Implementation and Treatment Fidelity
Research into DTTC is increasingly examining not only whether the treatment works, but how it can be transferred successfully from specialist research settings into everyday speech and language therapy practice.
Community-based research has explored the experiences of both clinicians and caregivers receiving protocolised DTTC. This provides valuable information about treatment intensity, acceptability, practical delivery and how research-based intervention compares with routine clinical practice.
Because DTTC requires the clinician to make continuous decisions about targets, timing, cueing, feedback and progression, appropriate training and treatment fidelity are particularly important. Recent research has examined how community clinicians can be trained to deliver DTTC reliably using structured learning, feedback, mentorship and self-reflection.
Resources
Clinician and Caregiver Perspectives on Community-Based DTTC
This study explores clinician and caregiver experiences of a community-based DTTC treatment trial and provides insight into the practical delivery and acceptability of DTTC outside specialist research environments.
https://pubmed.ncbi.nlm.nih.gov/39932428/
A Pathway to Research-Reliable Dynamic Temporal and Tactile Cueing
This research describes a multiphase process for training community clinicians to deliver DTTC with high treatment fidelity and considers how research-based DTTC can be translated into clinical practice.
Learning More About DTTC: FREE Training, Podcast and Video Resources
DTTC in Clinical Practice: Training, Implementation and Treatment Fidelity
DTTC in Clinical Practice: Training, Implementation and Treatment Fidelity
A range of freely accessible resources can help speech and language therapists, students and families develop their understanding of DTTC. These are particularly useful because DTTC is a dynamic approach: aspects such as simultaneous production, modelling, timing, cueing and the gradual reduction of support can be easier to understand when they are heard or observed rather than described in writing.
Professional learning should extend beyond learning a cueing hierarchy. Effective DTTC requires understanding of CAS differential diagnosis, speech-motor target selection, principles of motor learning and the clinical reasoning involved in deciding when and how to alter support.
Resources
Dr Edythe Strand Discusses DTTC – Apraxia Foundation Podcast
Hear Dr Edythe Strand discuss DTTC and explain the thinking and clinical principles behind this motor-based approach to CAS.
https://open.spotify.com/episode/441nZzYYP1JrNxq5iQ39dg
DTTC Video Resource
A visual resource that helps demonstrate aspects of DTTC that can be difficult to appreciate from written descriptions alone, including modelling and clinician-child interaction.
https://youtube.com/watch?v=pJyVfjJYgbY
Free Continuing Education – Child Apraxia Treatment
Provides free professional education relating to the diagnosis and evidence-based treatment of Childhood Apraxia of Speech, including opportunities to learn more about DTTC.
Evidence Summary
DTTC in Clinical Practice: Training, Implementation and Treatment Fidelity
Evidence Summary
Evidence level: Strong and growing direct evidence for CAS. DTTC is one of the more established motor-based interventions specifically used for Childhood Apraxia of Speech. Research supports positive speech outcomes, while newer studies are addressing important questions about community implementation, clinician training, treatment fidelity and optimal delivery.
ReST Rapid Syllable Transition Training
How it works video
How it works video
How it works video
https://www.youtube.com/watch?time_continue=3&v=hrv0r4Oqxs0&embeds_referring_euri=https%3A%2F%2Frest.sydney.edu.au%2F&source_ve_path=Mjg2NjY ReST has been tested for children up to 13 but is currently being trailed with adults. ReST Rapid Syllable Transition Training – ReST Rapid Syllable Transition Training
What is it
How it works video
How it works video
ReST is an evidence-based treatment for treating children but could be adapted for adults with childhood apraxia of speech or ataxic dysarthria. Both disorders are motor speech disorders, where children know what they want to say but cannot plan in their heads the movements required for clear speech.
The basics
The ReST treatment uses nonsense words – words that sound and read like real words, but do not have any meaning. This allows children to concentrate on their movements, lessens the need for working on old words which already have errors and allows clinicians to make words specifically for each child’s needs
ReST resources
University of Sydney – ReST
The official ReST resource provides information about the treatment, its principles, training and clinical materials for professionals.
Cochrane Review – Interventions for Childhood Apraxia of Speech
An independent systematic review evaluating controlled evidence for CAS intervention, including the randomised trial comparing ReST with NDP3.
ReST versus Ultrasound Biofeedback Randomised Trial
This study directly compared ReST with ultrasound biofeedback in school-aged children with CAS and found significant improvements following both interventions.
PROMPT +Myofunctional therapy
What is Prompt?
PROMPT therapy is used with a wide range of children and adults who have motor speech difficulties. The most common clients have motor speech disorders, articulation problems, or are non-verbal children.
Speech Apraxia International approached the PROMPT institute to ask if PROMPT was suitable for children AND adults. They confirm that it would be with some adaptation for this audience.
Research provides support for tactile/motor approaches, although the evidence specifically for PROMPT in well-defined CAS populations remains less extensive than for some better-studied CAS treatments
How does it work
PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) is a multidimensional approach to treating speech production disorders. It integrates physical-sensory, cognitive-linguistic, and social-emotional aspects to support meaningful communication. Suitable from around 6 months of age, it targets all speech production disorders. PROMPT focuses on developing motor skills for interaction, rather than just improving oral-motor movements or producing individual sounds or phonemes. PROMPT practitioners need to be trained by taking the usually paid PROMPT course
Kaufman Speech to Language Protocol
What is the Kaufman Speech to Language Protocol?
What is the Kaufman Speech to Language Protocol?
What is the Kaufman Speech to Language Protocol?
The Kaufman Technique is a motor-based speech therapy approach designed to help children with childhood apraxia of speech progress from simpler speech forms to more complex, adult-like words and phrases. It focuses on teaching the motor plans for speech through systematic, step-by-step shaping.
Strengths: adaptable for various ages and severity levels, promotes early communication success, motivating for children.
Considerations: works best with frequent sessions and may be combined with other approaches, such as DTTC, to address additional speech elements like prosody. .
Most Kaufman training and related resources are chargeable.
How it works
What is the Kaufman Speech to Language Protocol?
What is the Kaufman Speech to Language Protocol?
- Successive Approximation – simplifying words into easier forms the child can produce, then gradually shaping them toward the correct version (e.g., “banana” → “nana” → “bana” → “banana”).
- High Repetition – frequent practice to reinforce motor learning.
- Visual and Tactile Cues – prompts and modelling to guide mouth movements.
- Functional Vocabulary – focusing on words that are meaningful to the child’s daily life.
Photos from speechkids.com
Resources
What is the Kaufman Speech to Language Protocol?
Resources
Kaufman Children's Center
Provides an explanation of the Kaufman approach, clinical information, therapy resources and information for families and professionals.
Kaufman – Evidence-Based Practice
Brings together research and publications associated with the Kaufman Speech to Language Protocol.
https://www.kidspeech.com/ebp/
ASHA – Childhood Apraxia of Speech
Provides an independent overview of CAS intervention against which individual commercial or specialist treatment programmes can be considered.
https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/
Kaufman Speech to Language Protocol official website: kidspeech.co
Evidence review: The Informed SLP – Kaufman Protocol
Nuffield Dyspraxia Programme
Approach
Approach
Approach
NDP3 is a structured motor-programming approach that develops speech systematically from individual sounds and syllables towards words, phrases and connected speech. It has direct controlled evidence, including a randomised comparison with ReST. Training is chargeable.
Resources
Approach
Approach
NDP3 – Official Website
Provides an overview of the Nuffield Dyspraxia Programme, its assessment and treatment approach and available clinical materials.
NDP3 – Clinical Evidence
Summarises published research supporting NDP3, including randomised controlled trials, case studies and relevant systematic reviews.
https://www.ndp3.org/evidence-base/
Cochrane Review – CAS Interventions
Provides an independent evaluation of controlled CAS treatment research and discusses the evidence from the trial comparing NDP3 with ReST.
Ultrasound Biofeedback with Speech Motor Chaining
How it works
Ultrasound Visual Biofeedback uses an ultrasound probe beneath the chin to provide a real-time image of tongue movements during speech. When combined with Speech Motor Chaining, children practise target movements before progressing systematically through syllables, words, phrases and increasingly complex speech. Visual feedback can help children understand and modify movements that are otherwise difficult to see. Research in CAS is growing, including controlled trials involving school-aged children. Biofeedback is generally used as part of a broader motor-based intervention rather than as a stand-alone treatment, and requires appropriate equipment, clinician training and careful selection according to the child's age and speech needs.
Resources
ReST versus Ultrasound Biofeedback – Randomised Controlled Trial
A pilot randomised controlled trial comparing ReST with ultrasound biofeedback in children aged 6–13 with CAS, providing direct evidence about treatment outcomes and generalisation.
https://pubs.asha.org/doi/10.1044/2022_AJSLP-22-00144
ASHA – Childhood Apraxia of Speech
Provides professional guidance on CAS treatment, including motor-programming approaches and the potential use of biofeedback and other sensory cueing techniques.
https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/
Syracuse University Speech Production Laboratory – Ultrasound Biofeedback
Provides practical information about ultrasound biofeedback, how tongue movements are visualised and how the technology can be used in speech assessment and intervention.
https://speechproductionlab.syr.edu/resources/ultrasound-biofeedback/
New York University – Biofeedback Speech Therapy Research
Reports research comparing biofeedback with traditional motor-based treatment and explains how visual feedback may support faster learning during some stages of speech intervention.
University of Strathclyde – Electropalatography (EPG)
Explains EPG technology, which uses a sensor-equipped artificial palate to provide visual information about tongue-to-palate contact during speech.
Institute of Education Sciences – Ultrasound Visual Biofeedback Research
Provides access to US education research and funded research relating to interventions including ultrasound visual biofeedback for speech sound disorders.
Neuroscience News – Biofeedback Speech Therapy
Provides an accessible research-news explanation of findings comparing biofeedback speech therapy with more traditional treatment approaches.
SmartPalate®
Provides information about a commercial visual biofeedback system that uses a sensor-containing mouthpiece to show tongue-to-palate contact during speech practice.
Opti-Speech
Provides information about a visual biofeedback system designed to represent speech movements and support articulatory learning during speech therapy.
Evidence Position
Evidence level: Growing direct evidence for CAS, particularly in older children. Ultrasound biofeedback has direct CAS treatment research, including controlled studies, while biofeedback more broadly has a larger evidence base for persistent and residual speech sound disorders. It should therefore be distinguished from claiming that all forms of biofeedback have equivalent evidence specifically for CAS.
Evidence level
Evidence level: Growing direct evidence for CAS, particularly in older children. Ultrasound biofeedback has direct CAS treatment research, including controlled studies, while biofeedback more broadly has a larger evidence base for persistent and residual speech sound disorders. It should therefore be distinguished from claiming that all forms of biofeedback have equivalent evidence specifically for CAS.
Emerging and Specialist Approaches
Electropalatography
Electropalatography provides visual information about where the tongue contacts the palate during speech. It may be useful for persistent articulatory errors, particularly in older children, but CAS-specific research remains limited compared with the major motor-programming approaches.
Resources
ASHA – Childhood Apraxia of Speech
Discusses biofeedback and other treatment options used within motor-based CAS intervention.
https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/
Oral Sensory-Motor Intervention Review
Reviews evidence for interventions including EPG and reports more limited scientific support because of factors including small participant numbers.
https://apps.asha.org/EvidenceMaps/Articles/ArticleSummary/bcf1410c-5c3e-47ea-a2b1-766a8c6571e6
CAS Treatment: Past, Present and Future
Provides a contemporary overview of the CAS treatment evidence base and areas where additional research is needed.
Motor Speech Treatment Protocol / Speech Motor Learning
These approaches explicitly apply principles of motor learning to speech practice, including practice amount, complexity, feedback and repetition. Motor-learning principles also underpin several of the better-established CAS treatments.
Resources
ASHA – Childhood Apraxia of Speech
Explains motor-programming approaches and how principles of motor learning are incorporated into CAS intervention.
https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/
Oral Sensory-Motor Intervention Review
Evaluates research into motor-speech interventions and reports scientific support for Motor Speech Treatment Protocol approaches.
https://apps.asha.org/EvidenceMaps/Articles/ArticleSummary/bcf1410c-5c3e-47ea-a2b1-766a8c6571e6
CAS Treatment Evidence Appraisal
Examines systematic reviews of CAS treatment and concludes that motor-programming approaches currently provide the most convincing overall evidence.
https://pubs.asha.org/doi/10.1044/2020_PERSP-19-00019
International and Country-Specific Approaches
KoArt®
TAKTKIN®
TAKTKIN®
KoArt® is a German approach targeting voluntary control of speech movements and coarticulation. Therapy progresses systematically through sounds, syllables and increasingly complex speech productions.
Resources
KoArt – Official Information
Provides an introduction to KoArt, its clinical principles and its use with Verbal Developmental Dyspraxia and other speech-motor difficulties.
https://www.logopaedie-becker-redding.de/koart
KoArt Professional Training
Provides information about professional courses and training in the KoArt approach.
https://www.logopaedie-becker-redding.de/fortbildung/
German Association of Speech Therapy – VED Therapy Approaches
A professional German-language resource discussing KoArt and other approaches used for Verbal Developmental Dyspraxia.
https://www.dbl-ev.de/datenbankdokument/therapieansaetze-bei-verbaler-entwicklungsdyspraxie
TAKTKIN®
TAKTKIN®
TAKTKIN®
TAKTKIN® uses structured tactile-kinaesthetic information involving the child's face and speech mechanism to support the development of speech movements. Its specific independent evidence base remains considerably smaller than the broader literature on motor-based and tactile approaches.
Resources
German Association of Speech Therapy – VED Approaches
Provides professional information about therapeutic approaches used for VED, including tactile-kinaesthetic intervention.
https://www.dbl-ev.de/datenbankdokument/therapieansaetze-bei-verbaler-entwicklungsdyspraxie/
Motor-Based CAS Treatment Review
Reviews motor-based treatment principles and intervention protocols relevant to CAS.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4192721/
Cochrane – CAS Interventions
Provides an independent systematic assessment of higher-level evidence for CAS treatment and illustrates the limitations of the overall research base.
TOLGS
TOLGS® uses specific sound-associated hand gestures to provide additional visual and motor information during speech production. It has professional and clinical literature, but comparatively little independent controlled research.
Resources
TOLGS – Official Website
Introduces the TOLGS system and provides information about the approach and available materials.
TOLGS and Verbal Developmental Dyspraxia
Explains specifically how TOLGS is applied with children with VED/CAS.
https://tolgs-seminar.de/tolgs-bei-verbaler-entwicklungsdyspraxie/
TOLGS Professional Information
Provides information aimed at speech and language professionals interested in learning or using the approach.
VEDiT®
VEDiT® is an intensive approach developed specifically for Verbal Developmental Dyspraxia. It incorporates the Phonembestimmtes Manualsystem (PMS), in which manual cues provide additional information about speech production.
Resources
VEDiT – Official Website
Provides an overview of VED, the VEDiT approach, training and associated therapy information.
https://www.vedit-therapie.de/
PMS – Phoneme-Specific Manual System
Explains the manual cueing system used within VEDiT to provide information about features of speech production.
https://www.vedit-therapie.de/pms-phonembestimmtes-manualsystem-nach-vedit/
VEDiT Literature
Provides a bibliography of books, papers and professional publications relating to VED and the VEDiT approach.
Approaches with Insufficient Evidence as Primary Treatment
Non-Speech Oral Motor Exercises
Blowing, sucking, tongue strengthening and isolated oral exercises do not provide practice of the speech-motor plans affected in CAS. They should therefore not be presented as equivalent to direct speech-motor intervention for treating CAS. ASHA's technical report concludes that nonspeech oral-motor therapy is neither necessary nor sufficient for improving speech productio
McGinnis Association Method
The Association Method is a historically important structured multisensory approach incorporating auditory, visual, tactile and motor information. It was not developed specifically as a treatment for CAS, so evidence for the broader Association Method should not be interpreted as direct CAS efficacy evidence.
Resources
Original McGinnis Association Method Publication
Provides historical access to Mildred McGinnis's original description and development of the Association Method.
https://digitalcommons.wustl.edu/pacs_capstones/143/
DuBard Association Method
Explains the modern DuBard development of the Association Method and its integration of speech, language, reading and writing.
https://www.usm.edu/dubard/what-dubard-association-method.php
DuBard Professional Development
Provides information for professionals interested in training and professional development in the Association Method.
https://www.usm.edu/dubard/professional-development-frequently-asked-questions.php
Music Therapy and OT
Music Therapy
Occupational Therapy
Occupational Therapy
Music therapy
This can be a useful technique, but it is not usually effective as a standalone therapy for apraxia of speech. Instead, it is best used alongside other therapeutic approaches. For example, it may be helpful when working on prosody and other aspects of speech production.
(MedRhythms) - YouTubeSerenna Wagner talks about Melodic Intonation Therapy - YouTube
Neurologic Music Therapy - Stroke Rehabilitation (MedRhythms) - YouTube
NMT System of Standardized Techniques – Academy of Neurologic Music Therapy®
Effectiveness of metrical pacing in the treatment of apraxia of speech
Effectiveness of metrical pacing in the treatment of apraxia of speech : Aphasiology: Vol 22, No 1
.
Occupational Therapy
Occupational Therapy
Occupational Therapy
Although Speech and language therapists treat speech apraxia, occupational therapy can be useful to include for example to moderate sensory input or enhance the therapeutic environment.
World Federation of Occupational Therapists Global- professional body representing occupational therapy organisations in over 100 countries
National occupational therapy organisations
North America
- American Occupational Therapy Association (USA)
- National Board for Certification in Occupational Therapy (USA)
- College of Occupational Therapists of Ontario
- Canadian Association of Occupational Therapists
United Kingdom
Ireland
- Royal College of Occupational Therapists
- Health and Care Professions Council
- Association of Occupational Therapists of Ireland
- CORU
Europe
- Council of Occupational Therapists for the European Countries
- Deutscher Verband Ergotherapie
- Association Nationale Française des Ergothérapeutes
- Associazione Italiana Terapisti Occupazionali
- Nederlandse Vereniging voor Ergotherapie
- Colegio Profesional de Terapeutas Ocupacionales de España
Australia & New Zealand
- Occupational Therapy Australia
- Occupational Therapy Board of Australia
- Occupational Therapy New Zealand - Whakaora Ngangahau Aotearoa
Asia
- Japanese Association of Occupational Therapists
- Hong Kong Occupational Therapy Association
- Occupational Therapy Association of the Philippines
- Malaysian Occupational Therapy Association
- Singapore Association of Occupational Therapists
- All India Occupational Therapists' Association
- Occupational Therapy Association of Taiwan
- Korean Association of Occupational Therapists
Middle East
- Saudi Occupational Therapy Association
- Emirates Occupational Therapy Society
- Occupational Therapy Association of Israel
Africa
- Occupational Therapy Association of South Africa
- Occupational Therapy Africa Regional Group
- Occupational Therapists Association of Ghana
- Occupational Therapy Association of Nigeria
- Kenya Occupational Therapists Association
Central & South America
- Confederación Latinoamericana de Terapeutas Ocupacionales
- Associação Brasileira dos Terapeutas Ocupacionais
- Colegio de Terapeutas Ocupacionales de Chile
- Colegio Colombiano de Terapia Ocupacional
- Colegio Mexicano de Terapeutas Ocupacionales
This is not exhaustive—there are over 100 national occupational therapy organizations affiliated with the World Federation of Occupational Therapists.