First and only clinic in Puerto Rico for the diagnosis and treatment of Childhood Apraxia of Speech, Oral-Motor Disorders and Feeding Problems.

The clinic specializes in designing an individualized treatment protocol that integrates the most effective and specialized therapeutic approachs, according to the age and difficulty of the child. Children with difficulties in bilabial closure, lack of saliva control, lack or severely distorted speech, among other difficulties, are suitable candidates for this new protocol.

It is unique in its kind in Puerto Rico, so we get children from across the island. Parents do not skimp on time and effort after experiencing the effectiveness and feel the satisfaction of seeing their children communicating and being understood by others.

Each treatment plan of our protocol is designed by Nellie Torres de Carella, director of the Clinic and a recognized speech and language pathologist with over 30 years of experience. She has certifications and /or experience with the following approaches: Beckmann Protocol, PROMPT, oral placement therapy (OPT TalkTools®), Kaufman SLP (Speech to Language Protocol) protocol, Margaret Fischer and Susan Evans Feeding Protocol, among others.


What is Childhood Apraxia of Speech?

This diagnosis is a motor speech disorder in which children has difficulty creating an auditory code and to plan, coordinate, sequence, produce and combine oral movements necessary to produce phonemes, syllables, words, phrases and sentences.

Indicators of possible childhood apraxia:

  • Does not babble.
  • It takes time to say their first word and is not clearly produced.
  • Only produces some consonants and vowels.
  • Has trouble blending sounds to produce words.
  • Simplifies words by replacing or deleting difficult sounds for easier ones.
  • May have trouble eating.
  • May have difficulty imitating mouth movements, like blowing or lip kissing.
  • Have frequent errors and is inconsistent speaking, so sometimes you cannot understand.
  • Can understand better than speaking.
  • Has difficulty imitating words.
  • More difficulty saying long words, phrases or sentences than short words.
  • It is very difficult for an outsider to understand it.
  • Difficulty reading and writing.

Important note: If your child has one of these indicators, you should try to have, as soon as possible, an assessment in our clinic, which is the most important initial step. Perhaps your child does not have a traditional articulation problem, but another diagnosis like childhood apraxia of speech.

Protocol for children diagnosed with childhood apraxia of speech (AHI) and oral motor disorders:

  • Tomatis® auditory therapy

  • Auditory sensory diet.

  • Therapy specialized in oral motor disorders and childhood apraxia of speech.

  • Training parents to provide home follow-up.



  • Children develop sounds and begin to use them in combinations of simple to complex words, allowing them to start talking more clearly.

  • Parents are part of the therapy team, so they are trained in each session for the child to generalize at home what they have learned in therapy.

  • Parents report more rapid progress.

  • A significant percentage of children outgrow the diagnosis of childhood apraxia of speech, depending on the age and the absence of other diagnosis.