Defense Date


Graduation Date

Summer 1-1-2016


Worldwide Access

Submission Type


Degree Name



Speech-Language Pathology (SLP)


Rangos School of Health Sciences

Committee Chair

Megan Overby

Committee Member

Diane Williams

Committee Member

Katie Micco


childhood apraxia of speech, education, outcomes, pragmatics, self-esteem, social


Childhood apraxia of speech (CAS) is a pediatric speech sound disorder (SSD) that results from a motor planning impairment for volitional speech movements. This underlying impairment causes pervasive errors in speech sound production and often leads to problems with intelligibility, thus inhibiting effective communication. Longitudinal studies have found children with various communication impairments to be less successful in social interactions compared to their typically developing peers, and that this can lead to poor social functioning outcomes (Beitchman et al., 1996; Clegg, Hollis, Mawhood, & Rutter, 2005; Craig, 1993; Durkin & Conti-Ramsden, 2007). Yet, there is no research to date on what the particular effects are for individuals with CAS. This mixed methods single subject case study examined, first, the speech production characteristics of a young adult with a history of CAS, and, second, whether or not her earlier experiences with inefficient communication had long-term effects on her pragmatic skills, self-esteem, friendships, and/or selection of occupation.

Speech tasks from the Madison Speech Assessment Protocol (MSAP) – such as nonword and multisyllabic word repetition, lexical stress, and diadochokinesis tasks – were used to assess the participant’s precision and consistency of speech sound production and prosody. Measures of personality, nonverbal intelligence, and language abilities were also taken to further describe the participant and provide a context to interpret the subsequent results. The participant’s pragmatic skills and self-esteem were assessed by triangulating data collected from quantitative measures as well as two separate semi-structured interviews with the participant and her mother. The effects of the participant’s communication impairment on the formation of friendships and her selection of future career were examined through the semi-structured interviews.

Quantitative analysis included comparing the participant’s performance to available norms in the research literature, and qualitative analysis was conducted using a grounded theory approach.

Overall, the participant’s conversational speech was 100% intelligible with a mild /s/ distortion noted. The participant demonstrated further errors associated with CAS when she attempted the more challenging speech tasks of the MSAP. Results revealed the participant’s overall pragmatic skills to be within normal limits but deficits were expressed in specific social situations. The participant’s self-esteem was scaled on the low end of the average range, and maintaining her self-esteem has been a continuous process that has necessitated outside support at times. Also, the participant’s speech sound disorder hindered her ability to form a high number of friendships, but her few close friendships are of high quality. Lastly, the qualitative results demonstrated how the participant’s past experiences with inefficient communication have driven her to find a career path in which she can advocate for children facing similar challenges.