What Does the Kaufman Apraxia Test Assess For?

If you look back at our previous blog, Imitating Speech: What is Childhood Apraxia of Speech (CAS) and How Might it Affect My Child, you will see a breakdown of what Childhood Apraxia of Speech is and how it presents in young children. In a nutshell, CAS involves lack of planning and coordination of the articulators to produce intelligible speech (i.e., unable to imitate on command). Most children who have CAS have a big gap in their receptive vs expressive language scores (receptive language skills typically much higher than expressive language). Children may recognize the word and understand what it means, but often have trouble recreating the sounds of the word independently.

Today, we will be diving deeper into how your therapist will assess Childhood Apraxia of Speech. Initially, your therapist will likely give a full language assessment, so that they are able to look at both your child’s current receptive and expressive language skills. Your speech therapist will then see if the “gap” is present between the two scores, see if your child is imitating on command (environmental sounds, vowel sounds, consonant sounds, words), and determine what kinds of consonant-vowel combinations they are currently using. If Childhood Apraxia of Speech is suspected, your therapist may also administer another assessment, the Kaufman Speech Praxis Test (KSPT).

The Kaufman Speech Praxis test (KSPT) is an assessment that measures a child’s imitative responses and identifies exactly where their speech system is breaking down. Children presenting with CAS may be able to produce single consonant and vowel sounds (i.e., “b” and “a”), but struggle coordinating the movements between the two sounds (i.e., bah), or, they may be able to produce CV (consonant vowel combinations; “ba” or “too”) but struggle with motor planning/coordination of longer multi-syllabic words (“bottle” or “tuba”).

The Kaufman Speech Praxis Test begins at the baseline level (Part I) with Oral Movement. This subtest identifies if a child can execute oral movements upon command. KSPT looks to see if the following oral commands can be imitated:

• Opening mouth
• Producing voice (“ahhh”)
• Protruding tongue (pointing out tongue)
• Lateralizing tongue right (moving tongue tip to right)
• Lateralizing tongue left (moving tongue tip to left)
• Alternating tongue lateralization (moving tongue tip side to side)
• Elevating tongue to alveolar ridge (bumpy spot behind top front teeth)
• Spreading lips (smiling)
• Puckering lips
• Alternating spreading/puckering lips

If any of the above oral movements are unable to be imitated, your clinician will likely write therapy goals working towards the consistency of imitating those motor movements.

The next section of the KSPT is Part 2, which is the Simple Phonemic/Syllabic Level. This subtest identifies if a child can execute simple phonemes (speech sounds) and syllable structures imitatively. Sections of Part 2 include:

• Simple Vowels (“ah”, “oh”, “oo”)
• Vowel Movements/Diphthongs (“ay”, “oy”, “ow”)
• Simple Consonants (“m”, “t”, “b”)
• Reduplicated Syllables (“mama”, “buh buh”)
• Consonant-Vowel Movement (“do”, “pay”)
• Vowel to Consonant to Vowel Movement (“apple”, “oboe”)
• Repetitive Syllables with a Vowel Change (“baby”, “people”)
• CVC movements (“mom”, “hop”, “nap”)
• Simple Bisyllabics with a Consonant and Vowel Change (“happy”, “tuna”).

Each of these sections looks to identify exactly which syllable structures are currently in your child’s repertoire, which ones they do not currently produce, and the exact complexity level in which their motor planning system is breaking down. As with Part 1, your clinician will write therapy goals working towards consistency of those syllable structures to work on in future sessions.

The next section of the KSPT is Part 3, which is the Complex Level. This level will not always be administered, depending on the age/current level of functioning of your child. Part 3 of the KSPT identifies if a child can imitate more complex consonant sounds/syllable structures. Sections of Part 3 include:

• Complex Consonant Production (In isolation and in CVC words)
• Blend Synthesis (/s/, /l/, /r/ blends)
• Front to Back and Back to Front Synthesis (“cat”, “take”, “get”)
• Complex Bisyllabics (Complex 2-syllable words)
• Polysyllabic Synthesis/Sequencing (Complex 3-4 syllable words)
• Length and Complexity (maintaining clarity from 1 syllableà2 syllableà3 syllable words)

As with Part 2, each of these sections looks to identify the exact complexity level where your child’s motor system is breaking down. Complex consonants assessed include: /k, g, f, v, w, j, l, r, s, z, sh, ch, dg, th/. Part 3 of the KSPT also includes some of the more difficult structures to coordinate motor movements for, including 2-4 syllable words. As with Part 1 and Part 2, your child’s clinician will write therapy goals working towards consistency of difficult syllable structures to target in future sessions.

The final section of the KSPT is Part 4, which is the Spontaneous Length and Complexity subtest. Just like Part 3, this level will not always be administered, depending on the age/current level of functioning of your child. The final section of the KSPT is a subjective measure (scale of 0-7) which looks to identify the level of intelligibility in your child’s spontaneous speech (scale is from completely unintelligible to completely intelligible). Your clinician will likely use a conversation starter, such as a vacation, birthday, or game to elicit a conversational sample to attempt to reflect their true intelligibility in connected speech.

Overall, the Kaufman Speech Praxis Test is wonderful tool that measures a child’s imitative responses and identifies exactly where their speech system is breaking down. Once your speech therapist can identify the level at which their motor plan breaks down, treatment/goal planning becomes much easier, and your child will soon be well on their way to mastery!

If you suspect Childhood Apraxia of Speech (CAS) may be something your child is demonstrating contact our office so our CAS specialists can help!