scholarly journals Differential Diagnosis of Childhood Apraxia of Speech Compared to Other Speech Sound Disorders: A Systematic Review

2020 ◽  
pp. 1-22
Author(s):  
Elizabeth Murray ◽  
Jenya Iuzzini-Seigel ◽  
Edwin Maas ◽  
Hayo Terband ◽  
Kirrie J. Ballard
Keyword(s):  
American Academy ◽  
Study Design ◽  
Speech Sound ◽  
Future Research ◽  
Apraxia Of Speech ◽  
Class Iii ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Retrospective Case ◽  
American Academy Of Neurology

Purpose The aim of this study was to determine the discriminative features that might contribute to differentiation of childhood apraxia of speech (CAS) from other speech sound disorders (SSDs). Method A comprehensive literature search was conducted for articles or doctoral dissertations that included ≥ 1 child with CAS and ≥ 1 child with SSD. Of 2,071 publications screened, 53 met the criteria. Articles were assessed for (a) study design and risk of bias; (b) participant characteristics and confidence in diagnosis; and (c) discriminative perceptual, acoustic, or kinematic measures. A criterion was used to identify promising studies: American Academy of Neurology study design (Class III+), replicable participant descriptions and adequate confidence in diagnosis (≥ 3), and ≥ 1 discriminative and reliable measure. Results Over 75% of studies were retrospective, case–control designs and/or assessed English-speaking children. Many studies did not fully describe study design and quality. No studies met the Class I (highest) quality rating according to American Academy of Neurology guidelines. CAS was mostly compared to speech delay/phonological disorder. Only six studies had diagnostic confidence ratings of 1 (best). Twenty-six studies reported discriminative perceptual measures, 14 reported discriminative acoustic markers, and four reported discriminative kinematic markers. Measures were diverse, and only two studies directly replicated previous findings. Overall, seven studies met the quality criteria, and another eight nearly met the study criteria to warrant further investigation. Conclusions There are no studies of the highest diagnostic quality. There are 15 studies that can contribute to further diagnostic efforts discriminating CAS from other SSDs. Future research should utilize careful diagnostic design, support replication, and adhere to standard reporting guidelines. Supplemental Material https://doi.org/10.23641/asha.13158149

Lexical and phonological development in children with childhood apraxia of speech – a commentary on Stoel-Gammon's ‘Relationships between lexical and phonological development in young children’*

2010 ◽  
Vol 38 (1) ◽  
pp. 82-86 ◽  
Author(s):  
SHELLEY L. VELLEMAN
Keyword(s):  
Young Children ◽  
Speech Sound ◽  
Interesting Case ◽  
Prognostic Indicators ◽  
Phonological Development ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech Disorder ◽  
Remediation Strategies

Although not the focus of her article, phonological development in young children with speech sound disorders of various types is highly germane to Stoel-Gammon's discussion (this issue) for at least two primary reasons. Most obvious is that typical processes and milestones of phonological development are the standards and benchmarks against which we measure disorder and delay. Factors that impact children without disorders may suggest underlying causes or co-occurring symptoms of speech sound deficits, prognostic indicators of improvement, appropriate remediation strategies or some combination of these. Equally important is the fact that studying children with disorders can help us to verify and, in some cases, even unpack relationships among factors that are so closely interwoven in children who develop their phonologies at the typically very rapid rate that their individual influences cannot be discerned. Childhood Apraxia of Speech (CAS) is a particularly interesting case in point because, while it is universally accepted to be a motor speech disorder, symptoms include deficits in speech perception and often in literacy-related skills as well.

Treating Speech Subsystems in Childhood Apraxia of Speech With Tactual Input: The PROMPT Approach

2013 ◽  
Vol 22 (4) ◽  
pp. 644-661 ◽  
Author(s):  
Philip S. Dale ◽  
Deborah A. Hayden
Keyword(s):  
Standardized Tests ◽  
Treatment Approach ◽  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Within Subjects ◽  
Speech Control ◽  
Criterion Referenced

Purpose Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT; Hayden, 2004; Hayden, Eigen, Walker, & Olsen, 2010)—a treatment approach for the improvement of speech sound disorders in children—uses tactile-kinesthetic-proprioceptive (TKP) cues to support and shape movements of the oral articulators. No research to date has systematically examined the efficacy of PROMPT for children with childhood apraxia of speech (CAS). Method Four children (ages 3;6 [years;months] to 4;8), all meeting the American Speech-Language-Hearing Association (2007) criteria for CAS, were treated using PROMPT. All children received 8 weeks of 2 × per week treatment, including at least 4 weeks of full PROMPT treatment that included TKP cues. During the first 4 weeks, 2 of the 4 children received treatment that included all PROMPT components except TKP cues. This design permitted both between-subjects and within-subjects comparisons to evaluate the effect of TKP cues. Gains in treatment were measured by standardized tests and by criterion-referenced measures based on the production of untreated probe words, reflecting change in speech movements and auditory perceptual accuracy. Results All 4 children made significant gains during treatment, but measures of motor speech control and untreated word probes provided evidence for more gain when TKP cues were included. Conclusion PROMPT as a whole appears to be effective for treating children with CAS, and the inclusion of TKP cues appears to facilitate greater effect.

scholarly journals Language Skill Mediates the Relationship Between Language Load and Articulatory Variability in Children With Language and Speech Sound Disorders

2018 ◽  
Vol 61 (12) ◽  
pp. 3010-3022 ◽  
Author(s):  
Janet Vuolo ◽  
Lisa Goffman
Keyword(s):  
Language Impairment ◽  
Specific Language Impairment ◽  
Language Disorder ◽  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Retrieval Task ◽  
The Relationship

Purpose The aim of the study was to investigate the relationship between language load and articulatory variability in children with language and speech sound disorders, including childhood apraxia of speech. Method Forty-six children, ages 48–92 months, participated in the current study, including children with speech sound disorder, developmental language disorder (aka specific language impairment), childhood apraxia of speech, and typical development. Children imitated (low language load task) then retrieved (high language load task) agent + action phrases. Articulatory variability was quantified using speech kinematics. We assessed language status and speech status (typical vs. impaired) in relation to articulatory variability. Results All children showed increased articulatory variability in the retrieval task compared with the imitation task. However, only children with language impairment showed a disproportionate increase in articulatory variability in the retrieval task relative to peers with typical language skills. Conclusion Higher-level language processes affect lower-level speech motor control processes, and this relationship appears to be more strongly mediated by language than speech skill.

scholarly journals Differences Between School-Age Children With Apraxia of Speech and Other Speech Sound Disorders on Multisyllable Repetition

2020 ◽  
Vol 5 (4) ◽  
pp. 794-808 ◽  
Author(s):  
Nina R. Benway ◽  
Jonathan L. Preston
Keyword(s):  
Speech Sound ◽  
Previous Literature ◽  
School Age Children ◽  
School Age ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Speech Corpus ◽  
Word Structure ◽  
Speech Features

Purpose The aim of the study was to evaluate whether features of childhood apraxia of speech (CAS) identified in previous literature could be replicated in a sample of school-age children. Method A literature review was conducted to identify candidate speech features that have been previously considered when differentiating CAS from other types of speech sound disorders (SSDs). The candidate features recoverable from blinded transcriptions of multisyllable word repetitions (MSWRs) were applied to a cohort of 61 children aged 7–17 years, previously classified as having CAS ( n = 21) or non-CAS SSD ( n = 40). Results One hundred and ninety-four features had been explored in previous literature to assess their ability to differentiate CAS from other SSDs. Fifteen perceptual features were selected from this list to be applied to performance on the MSWR. In this sample, children with CAS differed from children with SSD on the prevalence of voicing changes, percentage of structurally correct words, correct lexical stress, and syllable deletions within a speech corpus derived from the MSWR task. Conclusion Although previous literature points to numerous features as differentiating CAS from other SSDs, only a portion of those features were replicated in this sample of school-age children. Features of CAS that affect segmental accuracy, prosody, and word structure may be likely to persist into late childhood and early adolescence.

scholarly journals Procedural Learning, Grammar, and Motor Skills in Children With Childhood Apraxia of Speech, Speech Sound Disorder, and Typically Developing Speech

2021 ◽  
pp. 1-23
Author(s):  
Jenya Iuzzini-Seigel
Keyword(s):  
Reaction Time ◽  
Speech Sound ◽  
Reaction Time Task ◽  
Procedural Learning ◽  
Future Research ◽  
Motor Deficits ◽  
Typical Development ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Learning Abilities

Purpose This case–control study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development would perform differently on a procedural learning assessment and (b) whether grammatical ability would impact group differences. Method Communication, motor, and procedural learning abilities were assessed in 48 children with CAS ( n = 13), SSD ( n = 20), and typical development ( n = 15), between 43 and 97 months of age ( M = 66 months, SD = 12 months). Results On average, children with CAS demonstrated grammatical and motor impairments and required an increased number of exposures to the visuospatial sequence to demonstrate procedural learning, compared to peers with SSD or typical development. A subset of children from each group demonstrated an unanticipated procedural learning pattern wherein they evidenced an uptick in reaction time during the second sequenced block. Children with CAS with this pattern still evidenced procedural learning gains by the fifth sequenced block. In contrast, children with SSD and typical development with this pattern showed poor procedural learning outcomes and were characterized by lower scores on language and motor assessments as well. Conclusions This research provides partial support for the procedural learning deficit hypothesis in children with CAS and for a subset of children with SSD as well. Future research should examine the role of a serial reaction time task in identifying children at risk of multisystem communication and motor deficits. Supplemental Material https://doi.org/10.23641/asha.14173532

The Effect of Hand Gesture Cues Within the Treatment of /r/ for a College-Aged Adult With Persisting Childhood Apraxia of Speech

2017 ◽  
Vol 26 (4) ◽  
pp. 1236-1243 ◽  
Author(s):  
Heather Leavy Rusiewicz ◽  
Jessica Lynch Rivera
Keyword(s):  
Speech Sound ◽  
Single Subject ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Visual Modeling ◽  
Verbal Instructions ◽  
Spatiotemporal Parameters ◽  
Withdrawal Design ◽  
Preliminary Support

Purpose Despite the widespread use of hand movements as visual and kinesthetic cues to facilitate accurate speech produced by individuals with speech sound disorders (SSDs), no experimental investigation of gestural cues that mimic that spatiotemporal parameters of speech sounds (e.g., holding fingers and thumb together and “popping” them to cue /p/) currently exists. The purpose of this study was to examine the effectiveness of manual mimicry cues within a multisensory intervention of persisting childhood apraxia of speech (CAS). Method A single-subject ABAB withdrawal design was implemented to assess the accuracy of vowel + /r/ combinations produced by a 21-year-old woman with persisting CAS. The effect of manual mimicry gestures paired with multisensory therapy consisting of verbal instructions and visual modeling was assessed via clinician and naïve listener ratings of target sound accuracy. Results According to the perceptual ratings of the treating clinician and 28 naïve listeners, the participant demonstrated improved speech sound accuracy as a function of the manual mimicry/multisensory therapy. Conclusions These data offer preliminary support for the incorporation of gestural cues in therapy for CAS and other SSDs. The need for continued research on the interaction of speech and manual movements for individuals with SSDs is discussed.

Apraxia of Speech in Children and Adolescents: Applications of Neuroscience to Differential Diagnosis and Intervention

2011 ◽  
Vol 21 (1) ◽  
pp. 15-32 ◽  
Author(s):  
Martha S. Burns
Keyword(s):  
Speech Sound ◽  
Outcome Study ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Initial Attempt ◽  
Phonological Disorders ◽  
Neuroscience Research ◽  
Longitudinal Case Studies ◽  
Production Characteristics

This paper presents an overview of clinical and neuroscience research that is relevant to distinguishing characteristics of childhood apraxia of speech (CAS) from perceptual/phonological disorders (PPD) in children with speech sound disorders. An initial attempt at developing a clinical checklist of as few as seven speech production characteristics, based on a literature review, may be useful for distinguishing CAS from PPD. Data on 11 children seen for intensive speech language intervention in 2008 are presented. The paper also provides longitudinal data on four children seen over two decades that presented with CAS vs. PPD. Clinical implications of a treatment outcome study, the CAS checklist, and longitudinal case studies are discussed.

Speech Sound Disorders: What's Motor Got To Do With It?

2016 ◽  
Vol 1 (1) ◽  
pp. 75-87 ◽  
Author(s):  
Maria I. Grigos
Keyword(s):  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Impairment ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Sound System ◽  
Motor Speech Disorder ◽  
The Relationship ◽  
Speech Motor

Speech sound disorders (SSDs) are commonly viewed as involving impaired articulation and/or phonological skills. Speech language pathologists working with individuals with (SSDs) assess the articulation of speech sounds and the coordination of articulatory structures with other components of the speech mechanism, including the phonatory, respiratory, and resonatory subsystems. The sound system of the language and the rules that govern how phonemes are combined are equally critical for clinicians to explore. While the terms “articulation” and “phonology” provide clinicians with a framework for classification, children who are broadly identified with (SSDs) may also display characteristics of a motor speech impairment, which can obscure the decision making process with respect to both diagnosis and treatment. One such motor speech disorder is childhood apraxia of speech (CAS). The focus of this paper is to discuss motor speech deficits in children and to review research that aims to distinguish motor speech patterns in children with (SSDs) with and without CAS. We will also address the relationship between emerging speech motor and linguistic skills.

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