Why Dynamic Assessment Matters in Diagnosing CAS

Full transcript

Hi, it's Nicole coming in from the NYU Motor Speech Lab, talking about dynamic assessment.

Very quickly: we have dynamic assessment and we have static assessment. With static assessment, I want you to think of the Goldman-Fristoe; it's just one example of a static assessment. What happens there? We show the child a picture, they're allowed to say the target one time, we make a judgment and write down how they sound, and then we keep it moving.

With dynamic assessment, we as the diagnostician and clinician are allowed to provide multisensory cueing to facilitate production of the target after the child has attempted it. So we don't stop at that original attempt. We let them attempt multiple trials, and that is a goldmine of information. We get to see their response to cueing and where their level of breakdown is. It gives us a picture of severity, and it definitely helps with treatment planning.

I want you to think about the child who, in spontaneous speech, might not make you say to yourself immediately, "Oh, this is CAS." That's because the child is using the words they feel most confident in and most comfortable with. In that respect, the clinician doesn't get to see the breakdown. It is dynamic assessment that will reveal the motor problem. When we increase the demand, add new targets, or push the child beyond their comfort zone, which we have to do, we start to see the breakdowns. We'll see the groping, the slow rate, the vowel and consonant distortions, the awkward movement transitions, and the lexical stress errors emerge.

That's why dynamic assessment is critical in the diagnosis of childhood apraxia of speech.