Abstract

Childhood Apraxia of Speech (CAS) is a subtype of motor speech disorder characterized by disrupted timing for intersegmental transitions, inconsistent errors involving both consonants and vowels and altered lexical and phrasal prosody (ASHA, 2007). The core mechanism underlying CAS is the alteration of speech motor planning and programming, which is therefore considered to be the main causative factor maintaining the speech disorder over time. Typically CAS tends to persist through childhood into adolescence and, in some cases, into adulthood, therefore affecting communication, academic learning and participation in age appropriate social settings. Lately an increasing number of studies are adding knowledge to the understanding of the genetic basis and of the neurostructural characteristics of CAS. Along with the rare isolated presentation, CAS is often associated with a wide array of comorbid neurodevelopmental disorders, such as Developmental Coordination Disorder, Intellectual Disability, Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder. One frequent associated disorder is Language Impairment (LI), mainly affecting expressive grammar and in many cases persisting after the resolution of the speech symptoms. The high number of children with DCD comorbid to CAS (about 20%) may suggest a possibly common pathophysiological mechanisms affecting higher order sensory-motor processing, to the interpretation of DCD in CAS as the symptom of a widespread multimodal sequencing disorder or of difficulties with implicit learning. CAS is a challenging condition that mandates a multidimensional diagnostic approach and a multidisciplinary management. Integrated speech and language therapy is typically characterized by high intensity repetition loads, the implementation of the principles of motor learning and multimodal-multisensory cueing.