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  • Speech and Language Services

    Childhood Apraxia of Speech

    CAS is a severe speech disorder.  The main problem i​s a motor speech difficulty. It is hard to start, organize, sequence and fluidly perform the complex movements required for speech.  Speech might be absent, limited, effortful or very hard to understand.  Speech is not just "immature" or "slow to develop".  Specific, individualized, intensive therapy is required. 

    Speech Sound Disorders or Delays

     Children make mistakes with certain sounds as they develop. These usually correct themselves with speaking practice. But, when speech continues to be immature, or difficult to understand, speech therapy may be required.  Therapy will typically be short-term 

    Articulation and Tongue Thrust

      Problems with one sound are often called an articulation errors. These are often lateral or frontal lisps or "w" for "r" substitutions, which persist.  There may or may not also be a tongue thrust. This is when a child continues to push their tongue against their top teeth when they swallow, as they did when they were infants. This can affect the success of orthodontic treatment. A concentrated, but short, period of speech therapy is required.

    Preschool Language

    In the first few years of life, young children need to learn to follow spoken directions, use many words,make small sentences, master grammar, and develop clear speech. Although there is some variation in the ages children accomplish this, children who continue to lag behind their peers, are at risk.  Speech and language treatment can help preschoolers catch up with their peers.

    School Age Language

      Strong oral language skills are strongly related to success in school: rich vocabulary, understanding concepts, remembering and telling stories, making long, grammatical sentences. Children with weak language skills can struggle academically and socially. Comprehensive language evaluations can help children get appropriate services in school. Specific, directed language treatment can have an important impact on children's success

    Developmental Language Disorder

     This refers to a language disorder of childhood not caused by other developmental problems or hearing impairment. It can affect receptive or expressive language, or both. The ability to acquire grammar and sentence structure rules is often difficult. This language-based learning disability has a major impact on academic and social success. Comprehensive evaluations support requests for services in school, help set effective I.E.P. goals and direct intervention.



    Caplan, D. and Evans, K. (1990) The Effect of Syntactic Structure on Discourse Comprehension in Patients with Parsing Impairments.  Brain and Language 39:  206-234

    Evans, K. (2007)  A Parent Partnership Model:  Treating Young Children with Childhood Apraxia of Speech Apraxia-Kids Monthly Vol. 8 Number 1 , Jan. 2007  

    ​Evans, Karen. (2003) Supporting Success in Oral Language Skills: Evidence-Based Service Model.  ASHA Poster Session, Atlanta, Georgia www.asha.org

     Evans, Karen. Shiller, Douglas. (2006) Title: Assessing, Treating and Measuring Outcomes:  Preschoolers with Suspected CAS.  ASHA Poster Session, Miami, Florida 

    ​Evans, Karen. (2003) Supporting Success in Oral Language Skills. LDAQ/AQETA Presentation, Nov. 14, 2003 

    ​Evans, Karen.  (2003) Toddler Talk  www.montrealfamilies.ca
    ​Evans, Karen (2003) The School Years: The Language-Learning Link  www.montrealfamilies.ca


    Hildebrandt N., Caplan, D., Evans, K (1987) The mani  left ti Without a Trace:  A case study of Aphasic processing of empty categories.  Cognitive Neuropsychology 4(3): 257-302

     Webster, R.I., Erdos, C., Evans, K.,  Majnemer, A., Kehayia, E., Thordardottir, E., Evans, A., Shevell, M. (2006) The Clinical spectrum of Developmental Language Impairment in School-Aged Children:  Language, Cognitive, and Motor Findings Pediatrics:  Vol. 118 No. 5, 1541-1549

    Webster, Richard I., Caroline Erdos,  Karen Evans, Annette Majnemer, Gaurav Saigal, Eva Kehayia, Elin Thordardottir, Alan Evans, and Michael I. Shevell , Neurological and Magnetic Resonance Imaging Findings in Children With Developmental Language Impairment, Journal of Child Neurology, Aug 2008; vol. 23: pp. 870 – 877