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Purpose: Motor speech characteristics of children with Down syndrome (DS) have historically been viewed as either Childhood Dysarthria (CD) or, more infrequently, as Childhood Apraxia of Speech (CAS). The objective of this study was to investigate motor speech deficits in a systematic manner, considering characteristics from both CAS and CD., Method: Motor speech assessments were carried out on seven 3;4-8;11-year old children with DS in comparison with younger, typically-developing children using a Language-Neutral Assessment of Motor Speech for young children (LAMS). Additionally, the motor speech and non-speech oral motor skills of all participants were analysed qualitatively using an investigator checklist of characteristics of CAS, CD and Motor Speech Disorder-Not Otherwise Specified (MSD-NOS)., Result: Results indicated that the children with DS exhibited symptoms of CAS, CD and MSD-NOS, with variability within the group and overlapping symptoms of the disorder types. This finding is different from previous assumptions that children with DS have either CD or CAS., Conclusion: The motor speech disorder accompanying DS is complex. The data provide some preliminary descriptions of motor speech disorders in this population and some tools that clinicians would find useful when assessing motor speech skills of young children with DS.

Interactions among psycholinguistic deficits and literacy difficulties in childhood apraxia of speech (CAS) have been inadequately studied. Comparisons with other disorders (Specific Language Impairment (SLI) and phonological dyslexia) and the possibility of reading remediation in CAS warrant further research. This case study describes the speech, language, cognitive, and literacy deficits and therapy gains in a girl aged 11;6 with severe CAS and borderline IQ. A comprehensive assessment of literacy-related cognitive skills, including phonological memory and working memory capacity, language, speech production and reading skills, was administered. Treatment from 6;0 to 11;6 targeted speech sounds, oral sequencing, phonological awareness (PA), speech-print connections, syllabic structure, and real and non-word decoding. Phonological memory was similar to that of children with SLI, but working memory was significantly worse. Unlike children with phonological dyslexia, our participant demonstrated relative strength in letter-sound correspondence rules. Despite deficits, she made progress in literacy with intensive long-term intervention. Results suggest that the underlying cognitive-linguistic profile of children with CAS may differ from those of children with SLI or dyslexia. Our results also show that long-term intensive intervention promotes acquisition of adequate literacy skills even in a child with a severe motor speech disorder and borderline IQ.

Words derive their structure not only from the sounds they include but also from the organization of those sounds within the word. This organization is the phonotactic level of the word: roughly, its shape including the sequence of its elements. Often, children with immature or disordered phonologies demonstrate phonotactic as well as phonetic limitations. Sometimes, the child may produce an age-appropriate variety of consonants and vowels but be unable to use them in the configurations required by the language: final consonants, clusters, multisyllabic words, and so forth. In such cases, the most appropriate therapy goals may be phonotactic, rather than phonetic, ones. Studies have shown that clinical focus on a new word or syllable shape may generalize well beyond the specific sound or sounds targeted in that position. These ideas are explored in this article, along with specific therapy results and recommendations for various phonotactic limitations.