Creating goals for children with Childhood Apraxia of Speech can be something that speech pathologists struggle with as we are often trained to work on many things all at once. For children with childhood apraxia of speech or CAS, we want to simplify things to help their speech systems be successful. Think of it a little like stacking blocks, we want to add one piece add a time to build the sturdiest tower! To create goals that allow them to have success, we want to create goals that either focus on adding a new sound, or adding a new syllable shape. We can introduce a new or tricky sound into existing words shapes the child is already using to help them have more success. If you try and create a goal that combines a new syllable shape and a new sound, the child is less likely to have success because their motor system becomes too overwhelmed and they begin to have breakdowns in their speech.
If you ever feel like you are spinning your wheels with finding targets for your children with childhood apraxia of speech, try and simplify what you are targeting. Look to easier movement patterns between consonant and vowels, easier syllable shapes or learning new syllable shapes with sounds they already have in their repertoire. It can be tempting to try and throw a lot of new things at their system to help them become easier to understand, but this will quickly lead to frustration for both of you. Working with other speech pathologists to help them find successful targets for their children with childhood apraxia of speech, I often remind them to choose less targets and look to movement patterns that will be successful for them. At the beginning, it is helpful to write out the sounds the child is able to make and the syllable shapes they are already able to make, and then build from there.
For clients with Childhood Apraxia of Speech, we want to consider:
1) Adding a new sound to existing syllable shapes.
2) Adding a new syllable shape using existing sounds the child can make.
For our older children with CAS, in speech therapy we need to start looking at the longer and more complicated syllable shapes. Consider targetting multisyllabic words and helping the child to focus on being clear with these three and four syllable words. Don't forget to help them move them into phrases and then sentences as we need to help them work on adding in these connected speech movement patterns. Hopefully this gets you thinking about new targets for your children with CAS that you can incorporate into your next speech therapy session.