# Identifying and Treating Childhood Apraxia of Speech in Minimally Verbal Children with Autism

> **NIH NIH R00** · MGH INSTITUTE OF HEALTH PROFESSIONS · 2024 · $97,984

## Abstract

Although one in four children with autism remain minimally verbal past age five, we do not know all
the factors that limit spoken language in these minimally verbal children with autism. One powerful
contributor may be a concomitant motor speech disorder, Childhood Apraxia of Speech (CAS). CAS
is an impairment in the ability to plan and sequence for speech, which renders speech inconsistent
and imprecise. But because producing intelligible speech is a prerequisite to acquiring spoken
language, there is an urgent need to understand how CAS may affect speech movements and
intelligibility in minimally verbal children with autism, and to develop interventions that incorporate
strategies to address CAS, when present. This project proposes three studies to investigate the
relationship between CAS and speech in minimally verbal children with autism and CAS. First, we
compare a group of 11 minimally verbal children with autism who meet criteria for CAS to a group of
11 who do not meet criteria for CAS. We hypothesize that facial movement tracking, a non-invasive
method to investigate speech motor function, will reveal that the +CAS group show lower movement
consistency and precision than the –CAS group. Next, we investigate the relationship of clinical signs
of CAS to speech movement parameters and to intelligibility. We hypothesize that more severe CAS
predicts lower movement consistency and precision, and lower intelligibility, in an additional group of
22 minimally verbal children with autism+CAS. Finally, we use the previous investigations to inform
treatment for a group of 20 minimally verbal children with autism+CAS. First we identify the speech
movements for each child that are both disordered and degrade intelligibility,. Then, we create a set
of mono- and bisyllabic stimuli involving these movements and train participants on a subset of them
in a series of single-subject experiments. Treatment will involve principles of motor learning (massed
and distributed practice) and dynamic cueing, which have been shown to be effective for treating
CAS. Both perceptual (intelligibility-based) and objective (movement-based) outcome measures will
demonstrate the extent to which this targeted treatment improves speech production in these
children. The findings will inform clinical practice for minimally verbal children with autism and lead to
the development of novel interventions for this severely affected population.

## Key facts

- **NIH application ID:** 11033372
- **Project number:** 3R00DC017490-06S1
- **Recipient organization:** MGH INSTITUTE OF HEALTH PROFESSIONS
- **Principal Investigator:** KAREN V CHENAUSKY
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $97,984
- **Award type:** 3
- **Project period:** 2019-09-01 → 2025-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11033372

## Citation

> US National Institutes of Health, RePORTER application 11033372, Identifying and Treating Childhood Apraxia of Speech in Minimally Verbal Children with Autism (3R00DC017490-06S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/11033372. Licensed CC0.

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