Building Pre-Imitation Skills Ahead of an Evaluation for Childhood Apraxia of Speech
For families navigating speech development concerns, suspected Childhood Apraxia of Speech (CAS) can feel overwhelming. Many children with suspected CAS, particularly those with co-occurring conditions like autism or Down syndrome, may need to build the joint attention and imitation skills to be able to participate in a dynamic motor speech evaluation.
Pre-imitation skills play a crucial role in preparing for a dynamic motor speech assessment and speech therapy for CAS. This blog will explore what a motor speech evaluation entails, why pre-imitation skills matter, and strategies families can use at home to help their child develop these foundational abilities.
What Is Childhood Apraxia of Speech (CAS)?
Childhood apraxia of speech is a motor speech disorder that affects a child’s ability to plan and sequence the movements needed for clear speech. Children with CAS know what they want to say, but their brain struggles to send the correct signals to the articulators (e.g., lips, tongue, jaw)..
What is a Dynamic Motor Speech Evaluation?
A dynamic motor speech evaluation is a specialized assessment conducted by a speech-language pathologist (SLP) to diagnose CAS. It is designed to evaluate how a child produces speech in various contexts and with different levels of support.
During the evaluation, the SLP will typically:
Assess vocal play to observe what sounds and/or syllables the child is producing
Test for inconsistency by asking the child to repeat the same syllables or words multiple times
Observe motor planning abilities, including how the child transitions between sounds or syllables
Conduct an oral-motor examination during which the child will be asked to imitate oral movements, such as pursing their lips or sticking out their tongue
If the child is unable to engage in these tasks due to limited verbal output or imitation skills, the evaluation may not be able to provide conclusive results. This is why building pre-imitation skills is a crucial initial step.
Why are Pre-Imitation Skills Important?
Imitation is a critical building block for speech and language development. Before children learn to imitate speech sounds, they typically master copying gestures, actions, or simple vocalizations. These skills lay the foundation for developing the motor planning abilities required for speech production. For children with suspected CAS and co-occurring diagnoses, pre-imitation skills also help increase joint attention and social engagement.
Strategies for Building Pre-Imitation Skills
Parents and caregivers can use a variety of strategies to encourage pre-imitation skills at home:
Start with Gestural Imitation
Model simple, meaningful gestures, such as waving, clapping, or blowing kisses. Encourage your child to mimic these movements during play or everyday routines. Gestural imitation helps children understand the concept of copying others, an essential precursor to imitating sounds.
Example: Wave and say, “Bye-bye!” or clap your hands while saying, “Yay!”
Focus on Object Imitation
Use toys to model actions, such as rolling a ball, stacking blocks, or shaking a rattle. Encourage your child to copy these actions. Object imitation is another way to teach children to observe and reproduce specific actions.
Example: Roll a car back and forth while saying, “Vroom, vroom!”
Use Interactive Play
Engage in interactive games like peek-a-boo, pat-a-cake, or simple action songs (e.g., “If You’re Happy and You Know It”). Repetitive, predictable games give children multiple opportunities to observe and imitate actions.
Example: During pat-a-cake, guide your child’s hands to clap, then pause to see if they begin to clap independently.
Encourage Vocal Play
Model fun, easy sounds, such as “ah,” “oo,” “ba,” or animal noises like “moo” and “meow.” Praise any attempts your child makes to mimic these sounds, even if they’re not perfect. Vocal play encourages early sound production and helps children experiment with their voice.
Example: During bath time, blow bubbles and say “pop, pop
Incorporate Visual Supports
Use visual cues, such as pictures, gestures, or exaggerated mouth movements, to help your child understand what you’re modeling. Visual supports can make it easier for children to process and replicate what they see.
Example: Point to your lips while saying “mm” or “boo” to emphasize the movement.
When is a Child Ready for a Motor Speech Evaluation?
Your child may be ready for a dynamic motor speech evaluation when they can:
Consistently imitate simple gestures or actions
Copy basic sounds, syllables, or words
Sustain attention for short, structured tasks
If your child is still working on these skills, an SLP can provide guidance on building pre-imitation skills and tracking progress toward readiness for a formal evaluation.
How Speech Therapy Supports Pre-Imitation Skills
Speech therapy for children with suspected CAS often focuses on:
Engaging the child in play-based activities that encourage imitation
Coaching families on how to incorporate imitation practice into daily routines
Using visual and tactile prompts to support motor planning
Key Takeaway
For children with suspected CAS, building pre-imitation skills is a critical step toward preparing for a dynamic motor speech evaluation and starting therapy. By incorporating playful, interactive strategies at home, families can help their child develop the foundational skills needed for speech development. If you’re concerned about your child’s ability to speak or imitate, reach out to a speech-language pathologist for guidance. Early support makes all the difference!
If you are looking for speech therapy in San Francisco or a speech therapist in California, The Speech Path in San Francisco can help. We understand that each individual is unique. For each communication challenge, we offer personalized care to ensure effective results. Our team of dedicated and experienced speech therapists is committed to tailoring evidence-based interventions to meet the specific needs of you or your child.
We offer pediatric speech therapy in San Francisco, speech therapy for adults, and virtual speech therapy for adults and children throughout California, plus specialized programs, such as the Hanen It Takes Two to Talk Program, PEERS® social skills groups, parent consultations and assessments for childhood apraxia of speech, and play groups.
Whether the concern is childhood apraxia of speech, articulation difficulties, language delay, or any other communication difference, we employ a holistic approach to foster progress and build confidence. We ensure that every session is a positive step towards improved communication skills. Contact us today to get started on the journey to enhanced communication and a brighter, more connected future.