CAS Differential Diagnostic Checklist

Featured Pic for CAS checklist

In my opinion, there is no “go-to” standardized test for childhood apraxia of speech (CAS) out on the market at this time.

CAS checklist

I personally feel it is very difficult to attempt an accurate diagnosis of CAS within the 15-30 minutes it takes to implement these standardized tests or checklists.  So over the years I have created my own checklist to help achieve an accurate differential diagnose of CAS as compared to other disorders (e.g. dysarthria, oral apraxia, phonological processing/patterning issues, articulation disorders, etc.) and I am very excited to share it with you today.

Based on my clinical experience, the key to effective differential diagnosis of CAS, is in recording a pattern of behavior over a period of time (numerous sessions over a period of weeks or months).  The consistent use of behaviors related to CAS is one indicator to support such a diagnosis.

While recording a pattern of behaviors, I also like to trial various communication therapy techniques (related and unrelated to treatment of CAS).   If clients, who appear to present consistent signs/symptoms of CAS ALSO respond positively to therapy techniques used for children with CAS, I feel this is clearer indication that CAS is present.  Conversely, clients who may exhibit a number of signs/symptoms of CAS but respond to therapy techniques NOT related to CAS, may in fact have an different underlying problem with speech production and a different diagnosis (e.g. phonological processing/patterning issues, articulation disorder, dysarthria, etc.) may be more appropriate.

Decision Tree pic

In order to accurately complete a differential diagnosis, one must first take a clear medical, developmental and family history of their client, assess oral motor skills for non-speech activities, determine if a pattern of CAS behaviors exist in speech production, followed by attempting a number of therapy activities to determine which techniques have a positive impact on speech production.  In this packet you will receive checklists for all portions of this assessment as well as a diagnostic decision tree to aid in making the most accurate diagnosis.


The CAS Differential Diagnostic Checklist includes:

  • Page 1-Cover page
  • Page 2-Directions and Diagnostic Decision Tree (to aid in making correct diagnosis)
  • Page 3-4-Medical and Personal Histories, Oral Motor Assessment and Oral Phase of Dysphagia Assessment (to r/o dysarthria and oral apraxia)
  • Page 5-CAS Signs/Symptoms Checklist
  • Page 6-Other Exhibited Behaviors and Trialed Therapy Techniques
  • Page 7-Differential Diagnosis Notes
  • Page 8-Resources page

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