CAAP-2

The Clinical Assessment of Articulation and Phonology - 2nd Edition (CAAP-2)  is a reliable, time-efficient assessment for articulation and phonology that can be administered to children from ages 2 years 6 months to 11 years-old. Articulation and phonology are fundamental aspects of speech development and speech sound disorder (SSD) is the most common communication disorder that speech-language pathologists working with the pediatric population observe.

With that, a clinical assessment of articulation and phonology is a vital aspect of an SLPs’ ability to identify speech disorders. A comprehensive assessment allows therapists to create individualized treatment plans for clients to effectively improve their speech production skills.

The CAAP-2 yields valuable information about a client’s speech production skills from its Articulation Inventory. The Phonological Process Checklist evaluates 10 phonological processes.

Let’s explore the need-to-know information about the CAAP-2 for SLPs, including the key components of the assessment, the theoretical framework behind it, how to apply the results, and much more. 

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Theoretical framework

The CAAP-2, published in 2013,  was developed to provide an assessment of articulation and phonology that virtually eliminates the need for phonetic transcription. The assessment is based on a sample of 1,486 children from the United States that closely resembles the U.S. Census Data from 2013.

The CAAP-2 addresses the following areas:

• Assessment of  the production of all English consonants

• Assessment of consonants in increasingly complex contexts

• Differentiation of an articulation vs. phonological impairment

• Differentiation of motor production vs. motor planning difficulties

When developing the CAAP-2, interrater reliability correlations were determined to be above 0.99 for the assessment.

Key components of the CAAP-2

The CAAP-2 assesses the individual’s articulation inventory and use of phonological processes. Developmental age norms provide valuable information about the child’s performance, including strengths and areas of difficulties.

Articulation Assessment

The purpose of the articulation assessment is to evaluate the client’s ability to accurately produce speech sounds. The CAAP-2 provides a comprehensive assessment of the client’s articulation skills by evaluating production of sounds in isolation as well as within words, sentences, and connected speech.

The SLP uses the stimulus easel and the articulation inventory record form while following the prompts of the assessment and recording the child’s responses.

Using the examiner’s manual, the clinician can calculate two types of scores:

• Consonant Inventory Score (CI)

• School Age Sentence Score (SAS)

Analyzing these standard scores allows the therapist to identify speech sound production difficulties and their level of severity. 

Phonological assessment

The CAAP-2 contains two Phonological Process Checklists that examine patterns of sound errors (phonological processes) that the client might use.

Phonological Process Checklist I is completed by transferring information and answering questions from the articulation inventory. Checklist II is completed by following the prompts on the stimulus easel and recording the child’s responses on the record form.

The phonological checklists will provide two scores that measure the prevalence of phonological processes:

• Percentage of occurrence

• Standard score

Norms and standardization

The clinician uses the examiners manual to determine the child’s scores by using normative data. Standard scores are based on a mean of 100 and standard deviation of 15.

The standard score that a client achieves can be used to determine the severity level of their articulation disorder or phonological disorder (mild, moderate, or severe).   

Changes and updates in the second edition

For the development of the CAAP-2, the assessment was re-normed to reflect current U.S. census data. The age limit of the CAAP were also extended to 11 years 11 months.

Other changes to the assessment reflected in the CAAP-2 include:

• Discontinuation of the error difference score

• Inclusion of children with speech delays and differences in the normative sample

• Updated stimulus pictures

• New reliability and validity studies

An iPad app was also created, which has electronic stimulus pictures, an integrated age calculator, and can automatically generate scores. 

Practical application for speech language pathologists

Standardized assessments provide speech language pathologists with objective, reliable measurements of a client’s skills. The CAAP-2 provides valuable information specifically about a child’s speech production skills.

SLPs can analyze the results of the CAAP-2 to diagnose an articulation disorder or phonological disorder. By using the CAAP-2 to identify specific phonological processes that the child is using (and determining which ones are not considered to be developmentally appropriate for the child’s age), therapists can target elimination of these processes in speech therapy.

Therapists can use the results of the Articulation Inventory to identify specific sounds to target production of in therapy. CAAP-2 results can also be used to identify the specific level of difficulty that the child should target sound production within (e.g., isolation, single words, phrases, or sentence level). 

Integration with collaborative and interdisciplinary practices

To effectively improve a child’s speech production skills, interdisciplinary collaboration is key. SLPs can maintain close communication with teachers and other professionals working with the child. This allows these other professionals to carryover speech therapy goals into other settings and to learn strategies for working with a child who may have reduced speech intelligibility.

Collaboration with parents and caregivers is also critical. According to research, this collaboration can lead to positive impacts on both parental and children’s outcomes. Parents should be given recommendations for home exercises and activities to improve the child’s generalization of progress with speech sound production skills in their natural environment.