“It always seems impossible until it’s done.”
Nelson Mandela
Evidence-Based Speech Therapy for CAS and Complex Speech Sound Disorders
Every child deserves a voice
What we offer:
Dynamic Temporal and Tactile Cueing (DTTC)
Over 20 years experience
Telehealth available
For all things childhood apraxia of speech (CAS)...
Olga Komadina Apraxia Therapy is a private speech pathology practice serving Albury-Wodonga and surrounding areas, focusing on the evaluation and treatment of childhood apraxia of speech, as well as professional development and evidence-based resources for speech speech pathologists, educators and health professionals.
Olga Komadina
Speech Pathologist
Olga is a Speech Pathologist and owner of Olga Komadina Apraxia Therapy. She has extensive experience in Childhood Apraxia of Speech (CAS) since 2010 after having worked in a speclialist clinic for CAS, where each speech pathologist was individually trained by a director of Apraxia-Kids from the United States. Olga is passionate about increasing awareness of Childhood Apraxia of Speech in Austraila and is listed in the Apraxia Kids SLP Directory of SLPs with an understanding of and experience in, treating children with apraxia of speech.
Does my child have Childhood Apraxia of Speech (CAS)?
What is Childhood Apraxia of Speech (CAS)?
Children with CAS usually understand what others say to them, but they have great difficulty forming clear words in order to speak to others. One of the most telling signs that a child may have CAS is that they drop sounds off the beginning and/or ends of words.
Childhood Apraxia of Speech (CAS) can be difficult to diagnose. Your speech pathologist needs to have worked with many children with CAS in order to accurately identify signs of CAS. It is also necessary to be able to tell the difference between CAS and other disorders which can present in similar ways. The information provided below, as well as the parent checklist you will find on this webpage can help you work out whether a visit to our clinic may be appropriate for your child. Often the best way to understand what CAS is, is to hear it. Don’t miss the video listed in the ‘useful links' page of this website, to hear what CAS sounds like.
Definition of Childhood Apraxia of Speech (CAS)
“Childhood Apraxia of Speech is a neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits” (Adhoc committee)
“The core impairment… in planning and/or programming… movement sequences results in errors in speech sound production and prosody” (Adhoc committee)
Childhood apraxia of speech is a motor speech disorder where the speech muscles are fine, and the brain is fine, however, the difficulty lies with getting the message from the brain to the speech muscles in order to say sounds/words/sentences. Childhood Apraxia of Speech is also known by other names such as Developmental Verbal Dyspraxia and Developmental Coordination Disorder.
Understanding Childhood Apraxia of Speech (CAS)
One way to explain CAS is to think back to when you were learning to drive a manual car. There were times when, if you thought too hard, you were likely to become confused ("Do I put the clutch in and then press the accelerator, or do I accelerate first?"), however, when the process became more automatic and you didn't need to ‘think about it’ so much, driving was much less effortful. Another example is when we are riding a bike, if we really start to think about all the small steps involved, we may become confused, however, if we are well-practiced in bike-riding and ride without thinking through all the steps involved, the ride is likely to be a much smoother one.
What this may look like in a child that has apraxia of speech is:
Child with CAS wants to say: '‘Mummy I want to go to Rebecca's house'’
Actual realisation: “ummy, eh on oo ou oo Etta's ouse”.
This child experienced great difficulty thinking through all the steps involved in joining all the needed consonants and vowels, therefore a much more simplified version of the message was produced. One that perhaps, only the child’s parents would understand (provided they were aware of the context of what was being said), however, sometimes even parents of children with Childhood Apraxia of Speech are not able to understand what their child is saying.
Will My Child Ever Speak?
Childhood Apraxia of Speech is different to ‘late talkers’ where a child develops speech and language later and then catches up. A child with Childhood Apraxia of Speech won't "just grow out of it'’.
Although treatment of Childhood Apraxia of Speech is long-term, most children with CAS are capable of achieving significant progress.
My child is able to understand much more than they are able to say
No history/limited history of babbling as a baby
Late talker
My child uses non-verbal communication (e.g. pointing, leading me to objects, gesturing)
My child deletes many consonant sounds when speaking
My child will often say the same word differently
I notice that my child visibly struggles to pronounce words and ‘gropes’ around with their mouth and jaw to try to produce the word
My child displays limited sound play
My child is not able to say many different types of sounds
My child may be able to say a word spontaneously, but is then unable to repeat it on command
My child experiences great difficulty with trying to put sounds together in words
As words or sentences get more complex, my child becomes more difficult to understand (even for me)
My child's speech is characterised by unusual pauses, stress patterns and pitch
My child will mix up voiced/voiceless sounds. For example "bee" may sound like "pee"
My child uses incorrect or distorted vowels at times
My child omits the first sound in words at times
Parent/Caregiver CAS Checklist
My child displays other fine or gross motor difficulties
Download our free CAS Screener
Designed for parents/caregivers, teachers and health professionals
Watch the free online tutorial of how to use the screener here: https://youtu.be/LL2W_Lm0z1s?si=YSx4sb3DVZpnArNd
About Olga...
Olga Komadina has had extensive experience and training in the area of Childhood Apraxia of Speech. She received individual training from a director of Apraxia-Kids from the United States.
Olga has previously worked at Max's House in Queensland, a clinic specialising in childhood apraxia of speech. In addition to her Childhood Apraxia of Speech experience, Olga has also worked extensively with children who have Autism and other disabilities and has worked for the largest Autism provider in Australia for the past 14 years.
Olga's extensive background in supporting children with CAS, as well as other disabilities, enables her to identify whether a child presents with childhood apraxia/motor speech disorder.
Treatment Approach
Olga has adopted an eclectic approach to treating children with Childhood Apraxia of Speech, incorporating Dynamic Tactile and Temporal Cueing (DTTC), The Kauffman approach, Melodic Intonation Therapy (MIT), and ReST therapy (for later stages working on prosody).
Olga has helped many 2-3 year old children with Childhood Apraxia of Speech who were only able to say 4-5 words/approximations at the commencement of therapy to be able to speak in sentences after 2-3 months of intensive therapy.
Olga works collaboratively with other professionals (e.g. Occupational Therapists, Physiotherapists, Paediatricians, Teachers) to help achieve the best possible outcome for your child.
What we offer
Telhealth available
NDIS approved
Private Pay/Health Fund and Medicare rebates available
Joint speech therapy sessions available, in person or via telehealth; where we offer Apraxia-specific support to your local speech therapist
In person and virtual professional development speaking events
In person and virtual consulting to speech pathologists interested in growing their skills in the area of CAS
What we offer:
Dynamic Temporal and Tactile Cueing (DTTC)
Over 20 years expereince
Telehealth available
Client Stories
Client Story: Amelia's Journey with DTTC Speech Therapy
Background: In 2012, at the age of 2 years and 5 months, Amelia began her speech therapy journey with Olga Komadina Apraxia Therapy. Initially, Amelia's verbal communication was very limited, primarily consisting of the sound “ba” for most things, and occasionally “amum” and “ada”. She often relied on physical actions like pulling on her parents to be picked up and pointing to indicate her needs and wants. Amelia had been diagnosed with hypotonia, hypermobility, and global developmental delay, and later with Autism and a Moderate Intellectual Disability.
Initial Assessment and Therapy Goals: The initial assessment conducted by Olga identified Childhood Apraxia of Speech (CAS) in Amelia. The therapy goals were established to focus on enhancing Amelia's verbal communication, progressing from simple syllable shapes using early developing sounds, to more complex words to simple sentences, and eventually to longer, contextually appropriate sentences.
Therapy Approach: Amelia attended two 30-minute speech therapy sessions per week. These sessions were structured and goal-oriented, incorporating various techniques designed to stimulate speech production. The sessions were designed to maximise the number of repetitions of target words during each therapy session, and followed up in a similar manner at home by Amelia’s parents.
Progress and Outcomes: Within two months of starting therapy, Amelia began using individual words more frequently. By the six-month mark, she was able to form simple sentences. Over the next two years, Amelia’s speech evolved to include longer and more complex sentences used in the correct context. The consistent and intensive nature of the DTTC therapy and home practice played a crucial role in her rapid progress.
Current Status: Now, at 12 years old, Amelia exhibits significant improvements in her verbal communication skills. She is highly verbal, engaging in conversations and interacting socially with ease. Her ability to communicate effectively has greatly enhanced her social interactions, making her a well-known and active member of her community.
Conclusion: Amelia’s story highlights the transformative impact of targeted DTTC motor speech therapy for children with CAS and related diagnoses. The structured and consistent approach used in her therapy sessions at Olga Komadina Apraxia Therapy was instrumental in her development. Amelia’s journey underscores the importance of early intervention and demonstrates the potential for significant improvement in communication skills in children with CAS with the right therapeutic strategies.
Client Story: Emily’s Journey to Confident Communication
Background: When Emily first arrived at Olga Komadina Apraxia Therapy at the age of 12, she faced a challenging prognosis: she might never be able to speak. Despite this, Emily embarked on a dedicated journey to improve her speech.
Therapy Approach: In a period of 6 months, Emily worked diligently in her DTTC motor speech therapy sessions, followed up by her family and school. Her perseverance and hard work led to significant improvements in her ability to communicate.
Progress and Outcomes: Emily progressed from not being able to say early syllable structures such as “mummy” “daddy/dad” or “puppy”, to developing clearer speech patterns and gaining the confidence to express herself more effectively. She now speaks in full sentences that are mostly understood by those around her, and she has developed the confidence and perseverence to try again and make her sentences sound clearer when she is not understood the first time. Emily speech therapy sessions now also incorporate later developing sounds such as ‘s’, ‘sh’ and consonant blends. She continues to make pleasing gains in her speech development. Emily also enjoys teletherapy sessions to supplement face to face sessions, where she can see the speech therapist’s face and production of target words via the computer screen and is supported by a staff memeber from her school who sits alongside her during these sessions.
Current Status: Emily's progress was transformative. As her speech clarity improved, so did her self-confidence. This newfound ability to communicate provided her with hope for her future and enabled her to engage more fully in social and academic activities.
Conclusions: Emily's story highlights the impact of consistent and focused effort in DTTC motor speech therapy. Her journey from uncertainty to confident communicator serves as an inspiring example of what can be achieved through determination and targeted speech therapy intervention.
Case Study: David’s Journey from Silence to Aspiring Speech Pathologist
Background: David first came to Olga Komadina Apraxia Therapy at the age of 6, unable to speak. His parents were concerned about his future communication abilities and sought support to help him overcome his speech challenges.
Therapy Approach: In his initial session, David made a significant breakthrough by learning to say “mum.” This early success set a positive tone for his therapy journey. David's DTTC motor speech therapy was tailored to his unique needs, focusing on building foundational speech and language skills. Through personalised, consistent, and targeted sessions, he worked on improving his motor speech skills.
Progress and Outcomes: David’s progress over the years was remarkable. His ability to articulate words and express himself improved significantly, which in turn boosted his confidence. He gradually moved from single words to forming sentences, engaging more effectively in social interactions and academic activities. The consistent support and customised therapy plan allowed David to achieve milestones that had once seemed out of reach.
Current Status: Today, David is in Year 12 and has made the inspiring decision to pursue a career in speech pathology. His journey through speech therapy not only transformed his communication skills but also shaped his aspirations for the future. David plans to attend university to become a speech pathologist, driven by his own experiences and the desire to help others overcome similar challenges.
Conclusion: David’s story highlights the transformative power of DTTC motor speech therapy for children with CAS. David’s journey from being unable to speak to aspiring to be a speech pathologist underscores the profound impact that dedicated and personalised intervention can have. David’s progress and future goals serve as a powerful example of what can be achieved through perseverance, targeted support, and a commitment to overcoming obstacles.
Contact us for a free intake phone call with Olga
**A free intake phone call directly with Olga is the starting point for working together. During this phone call we will determine whether we are a good fit for each other for Childhood Apraxia of Speech (CAS) Speech Therapy.
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Useful Links
Listen to what Childhood Apraxia of Speech (CAS) sounds like below:
