Treatment of childhood apraxia of speech: clinical decision making in the use of nonspeech oral motor exercises.

In this article, the authors provide background concerning the nature of childhood apraxia of speech (CAS) and conventional speech-based treatments for it. In addition they discuss a clinical decision-making process within which to consider the appropriateness of nonspeech oral motor exercises (NSOMEs). This process requires clinicians to ask questions of themselves as they interpret clinical observations and consider alternative treatment approaches (including both NSOMEs and speech-oriented treatments). Given a virtual absence of relevant empirical evidence on the question of the value of NSOMEs for children with CAS, clinicians are urged to examine the soundness of theoretical rationales they turn to when making clinical decisions.