[phono-tx] CAS vs. Phonological Disorder

Hi guys,

I currently have a little girl aged 4;7 on my caseload who i am having
trouble diagnosing.

This wee one presents with lots of processes e.g. fronting (k/g -->
t/d), affricatisation (f/v/th --> s), devoicing (z --> s), gliding (l
--> j), CCR of all clusters and de-affrication of 'ch' and 'dj'.

She also presents with very severe vowel distortion. She doesnt have an
i: vowel at all, and she tends to collapse alot of her vowels to 'au'.
She is not stimulable for any of the vowels on cue, and cannot make the
sounds with prompting.

With the DEAP ax she was found to be 21% consitent, and her DDK rates
were within normal limits. She was able to do fixed and sequenced oral
motor movements. Recently however i have noticed that she has lots of
trouble controlling her tongue movements e.g. letting her tongue lie at
the bottom of her mouth, or moving her tongue up on cue. The more
attention i place on this, the more crazy her tongue movement get.

I have taken a phonological approach - due to the consistency and lack
of oral motor deficit characteristics. We have done a block of 10
sessions weekly focusing on Auditory Bombardment, Discrimination and
some production. We have made lots of head-way with production, but she
hasn't made much progress with her production. She just finds it sooo
tricky to get the sounds right, and can get really upset.

Im starting to wonder whether i have diagnosed her correctly and picked
the right approach, or whether she might have CAS.

Has anyone had any experience with a child like this? And any
therapeutic ideas to help move her along before school?

Thanks,

Claire

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