In other words, the clinician will carefully construct treatment phrases to increase syllable shapes (e.g., bow, boat, boats), sound sequences (e.g., cat and tack), and phrase lengths (e.g., I want more, I want more milk, I want more milk please). The focus of treatment is often on improving the motor plans and sequences needed for speech production to increase intelligibility. Historically, speech therapists have not generally been trained to think about what to do with a child with CAS once he or she has obtained all of their sounds and syllable shapes and have increased intelligibility. Spending more time on each sound being produced ‘sssuuuuuuuunnnnn’ for ‘sun’ This can lead to equal stress on each syllable, making the child sound robotic Multisyllabic phrases or words are said while tapping out syllables Longer sound durations of the target sounds. Sound (s) being targeted are overemphasized Potential effects of therapy on prosody Therapy Target The following table summarizes common therapy techniques and their effect on prosody. Many techniques speech therapists use promote correct articulation at the expense of natural sounding prosody. There are also several effects that speech therapy can have on prosody, not all of them positive. Babbling provides the opportunity to organize phonation, articulation and respiration in a rhythmic style as evidenced by the childs prosody when vocalizing. Children who were quiet and did not babble missed the opportunity to practice/achieve rhythmic organization through babbling. Children with CAS are often characterized as having been quiet babies. In addition to articulatory effort and speech errors interfering with prosody, there is also the aspect of speech development to consider. Increased effort on sequencing movement for speechĭecreased rate and sounding robotic by producing one syllable at a time. Perception of increased rate of speech (similar effect as when listening to someone who speaks a different language) Substitution of glottal stops for other consonants Vowel errors, such as tense/lax or lax/tense vowels, or vowelization of syllablic consonantsĬhild says ‘baba’ for ‘baby’ or ‘lito’ for ‘little’ The normal stress pattern in sentences is to have an alternation between strong and weak syllables. Effects of CAS Speech Characteristics on Prosody Speech Characteristic/ErrorĬhild says ‘ nana’ for ‘ba nana’ or ‘tar’ for ‘gui tar‘ĭeletion of weak syllables will leave a phrase with each syllable equally stressed. The following table summarizes common speech characteristics or errors of CAS and how they interact with prosody. If we think about the effort required for correct articulation, it is also makes sense that prosody suffers. When considering the types of sound errors children with CAS typically make, it is easy to see why we perceive disordered prosody. However, as previously mentioned, children with CAS frequently produce other types of prosodic errors, as well. Children with CAS may have more success with strong-weak stress pattern words because one they have had more practice with them and two they may be easier to produce. More specifically, children with CAS are more successful producing words with a strong-weak stress pattern (e.g., baby) than a weak-strong stress pattern (e.g., guitar). dysprosodic (i.e., using prosody that doesnt match the expected intonation pattern)Įnglish-speaking children with CAS have also been observed to use word stress patterns that are similar to children younger than they are who are developing typically (i.e., 2-4 years of age).aprosodic (i.e., decreased intonation patterns, monotone).robotic-like, producing each syllable one at a time and with equal stress.The purpose of this article is to highlight potential relationships between speech characteristics of CAS, as well as the efforts to improve speech sound accuracy, and their impact on prosody.Ĭhildren with CAS have been reported to sound: Often, these prosodic errors and articulation errors are thought of as two separate entities. Children with CAS are frequently reported to have prosodic errors as well as many speech sound errors. We also may use greater articulatory force to emphasize a word or phrase. We express prosody mainly by varying pitch, loudness, and duration. Prosody refers to intonation, stress pattern, loudness variations, pausing, and rhythm. Children with childhood apraxia of speech (CAS) are frequently noted in the literature as having disordered prosody.
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