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A Dual-Paradigm Approach for MSDs and AAC for Children

Updated: Jun 6, 2023

For children with motor speech disorders, a dual paradigm approach is recommended with a focus on both improving natural speech skills, but also AAC as a form of communication to improve overall communication skills (Oommen & McCarthy, 2014).

  • Pediatric motor speech disorders (MSDs) include childhood dysarthria (CD) and childhood apraxia of speech (CAS). Children with CAS demonstrate impaired programming/planning of speech while children with CD demonstrate a deficit in the execution of speech. Both CD and CAS are estimated to occur in 1 to 2 children per 1,000 (Shriberg et al., 2019).

  • In cases of moderate-severe MSDs, children may be unable to intelligibly communicate basic wants, needs, and information about their safety, health, and well-being. With the dual-paradigm approach, intervention focuses on improving both natural, spontaneous speech while also addressing AAC as a form of communication to improve overall communication skills. In cases of severe MSDs, such as severe CAS, addressing multimodal communication is particularly important as treatment for natural speech for this population can take several years (Weitz et al., 1997).

  • AAC for childhood MSDs should be utilized to facilitate language development while also treating the MSD. Our ProSlate™ Series offers several apps that support language development making it an ideal choice for individuals with MSDs. The ProSlate 4D is the most portable device in our ProSlate™ series and is perfect for on-the-go communication while the ProSlate 8D is the perfect middle ground between size and portability.

AAC intervention and MSD treatment can be implemented at the same time, in a dual-paradigm approach, resulting in improvement of natural speech development as well as progress with functional communication and expressive language using AAC.


  • Oommen, E. R., & McCarthy, J. W. (2014). Natural speech and AAC intervention in childhood motor speech disorders: Not an either/or situation. Perspectives on Augmentative and Alternative Communication, 23(3), 117-123.

  • Shriberg, L. D., Kwiatkowski, J., & Mabie, H. L. (2019). Estimates of the prevalence of motor speech disorders in children with idiopathic speech delay. Clinical linguistics & phonetics, 33(8), 679-706. 10.1080/02699206.2019.1595731

  • Weitz, C., Dexter, M., & Moore, J. (1997). AAC and children with developmental disabilities. In S. Glennen & D. Decoste (Eds.), Handbook of augmentative and alternative communication (pp. 395–431). San Diego, CA: Singular.

Katie Threlkeld, M.S., CCC-SLP is a licensed, ASHA-certified speech-language pathologist and the Educational Program Developer at Forbes AAC. She has over eight years of experience in AT and AAC assessment and treatment with both the pediatric and adult populations. Katie has presented at the state and national level on AAC topics and she has University teaching experience at the undergraduate and graduate level.

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