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

Author(s):  
Jenya Iuzzini-Seigel

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

Author(s):  
Julie Case ◽  
Maria I. Grigos

Purpose Variability has been interpreted in differing ways according to context (e.g., development, speech impairment, and learning). A challenge arises when interpreting variability in the context of learning for children with speech impairment characterized by high movement variability, as in childhood apraxia of speech (CAS). The objective of this study is to investigate changes in variability in CAS with practice in comparison to patterns seen in children with non-CAS speech sound disorders (SSD) and typical development. Method Speech production variability was examined in 24 children (5–6 years of age) with CAS, non—CAS SSD, and typical development in production of nonwords of varied motoric complexity. Multidimensional analyses were performed using measures of token-to-token speech consistency (percent word consistency), acoustic variability (acoustic spatiotemporal index), and movement variability (lip aperture spatiotemporal index). Changes in variability were examined in each group of children by comparing the first half to the last half of nonword tokens in the same data collection session. The impact of token complexity on practice effects was also explored across groups of children. Results All children displayed increased speech consistency within this practice period ( p = .01). Only children with CAS displayed increased movement variability following practice ( p = .01). Differences in acoustic and kinematic variability were observed across complexity levels in all groups, though these did not interact with practice effects. Discussion These findings suggest that increased movement variability in children with CAS might be facilitating perceptual consistency. It is believed that this finding reflects an inefficient strategy adapted by children with CAS in the absence of motor-based cueing and feedback to guide speech performance with practice.


Author(s):  
Elizabeth Murray ◽  
Jenya Iuzzini-Seigel ◽  
Edwin Maas ◽  
Hayo Terband ◽  
Kirrie J. Ballard

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


2010 ◽  
Vol 38 (1) ◽  
pp. 82-86 ◽  
Author(s):  
SHELLEY L. VELLEMAN

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.


2013 ◽  
Vol 22 (4) ◽  
pp. 644-661 ◽  
Author(s):  
Philip S. Dale ◽  
Deborah A. Hayden

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.


PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0232124
Author(s):  
Ayala Bloch ◽  
Michal Shaham ◽  
Eli Vakil ◽  
Simone Schwizer Ashkenazi ◽  
Gabi Zeilig

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Dalia Abdou ◽  
Omayma Afsah ◽  
Hemmat Baz ◽  
Tamer Abou-Elsaad

Abstract Background Childhood apraxia of speech (CAS) is a speech sound disorder in which the precision and consistency of movements underlying speech are impaired in absence of neuromuscular deficits. It is important to differentiate between language disorders and CAS to avoid misdiagnosis. The objective of this study was to develop a test battery for CAS in order to identify its possible presence in Arabic-speaking children, thus allowing the planning of appropriate therapy programs. The constructed test battery for CAS was administered to 70 monolingual Arabic-speaking Egyptian children including 10 children with suspected CAS, 20 children with phonological disorders, and 40 typically developing children. Participants’ responses were statistically analyzed to assess the validity and reliability, and to evaluate sensitivity and specificity of the test battery. Results Statistically significant differences were found between the three groups as regard all subtotal and total scores of CAS test battery with good validity and reliability of the test. Conclusions The constructed test battery for diagnosis of CAS is a reliable, valid, and sensitive tool that can be used to detect the presence of CAS in Arabic-speaking children and differentiate between it and phonological disorders.


2018 ◽  
Vol 61 (12) ◽  
pp. 3010-3022 ◽  
Author(s):  
Janet Vuolo ◽  
Lisa Goffman

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.


Author(s):  
Jonathan L. Preston ◽  
Nina R. Benway ◽  
Megan C. Leece ◽  
Nicole F. Caballero

Purpose To assess the concurrent validity of two tasks used to inform diagnosis of childhood apraxia of speech (CAS), this study evaluated the agreement between the Syllable Repetition Task (SRT) and the Maximum Repetition Rate of Trisyllables (MRR-Tri). Method A retrospective analysis was conducted with 80 children 7–16 years of age who were referred for treatment studies. All children had a speech sound disorder, and all completed both the SRT and the MRR-Tri. On each task, children were classified as meeting or not meeting the tool's threshold for CAS based on the sound sequencing errors demonstrated. Results The two tasks were in agreement for 47 participants (59% of the sample); both tasks classified 13 children as meeting the threshold for CAS and 34 children as not meeting the threshold for CAS. However, the two tasks disagreed on CAS classification for 33 children (41% of the sample). Overall, the MRR-Tri identified more children as having sound sequencing errors indicative of CAS ( n = 39) than did the SRT ( n = 20). Conclusions These two tasks of sound sequencing differ in the children they identify with CAS, possibly due to aspects of the underlying task requirements (e.g., time pressure). The SRT and the MRR-Tri should not be used in isolation to identify CAS but may be useful as part of a balanced CAS assessment battery that includes additional tasks that inform the nature of the impairment and that aid treatment planning. Supplemental Material https://doi.org/10.23641/asha.14110280


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