Psychosocial Comorbidities in Adolescents With Histories of Childhood Apraxia of Speech

2021 ◽  
pp. 1-17
Author(s):  
Barbara A. Lewis ◽  
Penelope Benchek ◽  
Jessica Tag ◽  
Gabrielle Miller ◽  
Lisa Freebairn ◽  
...  
Keyword(s):  
Mental Health Professionals ◽  
Social Problems ◽  
Speech Sound ◽  
Psychosocial Outcomes ◽  
Self Report ◽  
Psychosocial Assessment ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Significant Group ◽  
Thought Problems

Purpose Adolescent psychosocial outcomes of individuals with histories of childhood apraxia of speech (CAS) were compared to outcomes of individuals with histories of speech sound disorders (SSD) only and SSD with language impairment (LI). It was hypothesized that individuals with more severe and persistent disorders such as CAS would report poorer psychosocial outcomes. Method Groups were compared using analyses of variance on a psychosocial assessment battery that included measures of hyperactivity and inattention, anxiety, depression, internalizing and externalizing behaviors, thought problems, and social outcomes. Results Results revealed significant group differences on self-report of social problems and parent report of hyperactivity, thought problems, and social problems at adolescence. Compared to the SSD-only group, the CAS group had significantly higher parental ratings of hyperactivity and social problems in adolescence. The CAS and SSD + LI groups did not differ on psychosocial measures, possibly due to the high rate of comorbid LI in the CAS group. The CAS group also had more individuals who scored in the borderline/clinical range on self-report of social problems than the SSD-only group. The CAS group did not differ from the SSD + LI group in the number of participants scoring in the borderline/clinical range on measures. Conclusions Individuals with histories of CAS demonstrate increased rates of social problems and hyperactivity based on parent ratings compared to adolescents with histories of SSD only; however, most do not score within the clinical range. The persistence of speech sound errors combined with self-reported and parent-reported social difficulties suggests that speech-language pathologists should be sensitive to the social and emotional impact of CAS and make appropriate referrals to mental health professionals when warranted.

scholarly journals Cognitive, Linguistic, and Motor Abilities in a Multigenerational Family with Childhood Apraxia of Speech

2016 ◽  
Vol 31 (8) ◽  
pp. 1006-1025 ◽  
Author(s):  
Bronwyn Carrigg ◽  
Louise Parry ◽  
Elise Baker ◽  
Lawrence D. Shriberg ◽  
Kirrie J. Ballard
Keyword(s):  
Phonological Processing ◽  
Speech Sound ◽  
Large Family ◽  
Published Data ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Significant Group ◽  
Motor Abilities ◽  
Multigenerational Family ◽  
Language Literacy

Abstract Objective This study describes the phenotype in a large family with a strong, multigenerational history of severe speech sound disorder (SSD) persisting into adolescence and adulthood in approximately half the cases. Aims were to determine whether a core phenotype, broader than speech, separated persistent from resolved SSD cases; and to ascertain the uniqueness of the phenotype relative to published cases. Method Eleven members of the PM family (9–55 years) were assessed across cognitive, language, literacy, speech, phonological processing, numeracy, and motor domains. Between group comparisons were made using the Mann–WhitneyU-test (p < 0.01). Participant performances were compared to normative data using standardized tests and to the limited published data on persistent SSD phenotypes. Results Significant group differences were evident on multiple speech, language, literacy, phonological processing, and verbal intellect measures without any overlapping scores. Persistent cases performed within the impaired range on multiple measures. Phonological memory impairment and subtle literacy weakness were present in resolved SSD cases. Conclusion A core phenotype distinguished persistent from resolved SSD cases that was characterized by a multiple verbal trait disorder, including Childhood Apraxia of Speech. Several phenotypic differences differentiated the persistent SSD phenotype in the PM family from the few previously reported studies of large families with SSD, including the absence of comorbid dysarthria and marked orofacial apraxia. This study highlights how comprehensive phenotyping can advance the behavioral study of disorders, in addition to forming a solid basis for future genetic and neural studies.

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 Developing a test battery for diagnosis of childhood apraxia of speech in Arabic speakers

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Dalia Abdou ◽  
Omayma Afsah ◽  
Hemmat Baz ◽  
Tamer Abou-Elsaad
Keyword(s):  
Speech Sound ◽  
Test Battery ◽  
Apraxia Of Speech ◽  
Validity And Reliability ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Phonological Disorders ◽  
Arabic Speakers ◽  
Egyptian Children ◽  
Arabic Speaking

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.

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 Concurrent Validity Between Two Sound Sequencing Tasks Used to Identify Childhood Apraxia of Speech in School-Age Children

2021 ◽  
pp. 1-9
Author(s):  
Jonathan L. Preston ◽  
Nina R. Benway ◽  
Megan C. Leece ◽  
Nicole F. Caballero
Keyword(s):  
Concurrent Validity ◽  
Time Pressure ◽  
Speech Sound ◽  
School Age Children ◽  
Apraxia Of Speech ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Sequencing Errors ◽  
Syllable Repetition ◽  
Task Requirements

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

scholarly journals Predicting Intelligibility: An Investigation of Speech Sound Accuracy in Childhood Apraxia of Speech

CommonHealth ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 44-56
Author(s):  
Kyra Skoog ◽  
Edwin Maas
Keyword(s):  
Speech Sound ◽  
Primary Outcome Measure ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Treatment Research ◽  
Speech Accuracy ◽  
Communicative Success ◽  
Listening Experiment ◽  
The Impact ◽  
The Relationship

Background: Childhood apraxia of speech (CAS) is a pediatric speech disorder that significantly affects communication and life participation. Most CAS treatment research uses speech accuracy as primary outcome measure, on the assumption that accuracy predicts communicative success. However, this relationship has not yet been examined in this population, limiting our understanding of the impact of available treatments. Purpose: The purpose of this study is to explore the relationship between speech accuracy and intelligibility in children with CAS. Intelligibility is defined here as the proportion of words correctly understood by an unfamiliar listener. Methods: Adult listeners, who were unfamiliar with children with CAS, listened to recordings of children with CAS producing single words, and typed what they heard the child say. Separately, and prior to the listening experiment, the children’s words were scored for accuracy using various measures, including the percent phonemes (sounds) correct (PPC), percent consonants correct (PCC), and percent vowels correct (PVC). The relationship between these accuracy measures and intelligibility were examined descriptively. Results: Preliminary findings suggest that there is a positive relationship between intelligibility and PPC and PCC in children with CAS. Conclusions: Implications of these findings for clinical practice as well as future treatment research are discussed.

scholarly journals Feature-driven classification reveals potential comorbid subtypes within childhood apraxia of speech

2020 ◽  
Author(s):  
Catherine Stein ◽  
Penelope Benchek ◽  
Gabrielle Miller ◽  
Noémi B. Hall ◽  
Dhanya Menon ◽  
...  
Keyword(s):  
Sound Production ◽  
Neurodevelopmental Disorder ◽  
Speech Sound ◽  
Hierarchical Cluster ◽  
Educational Interventions ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Poor Reading ◽  
Word Repetition ◽  
Reading Measures

Abstract Background Childhood apraxia of speech (CAS) is a neurodevelopmental disorder with heterogeneous communication and other comorbid manifestations. While previous studies have characterized speech deficits associated with CAS, few studies have examined variability in reading and language and/or other developmental comorbidities. We sought to identify comorbid subgroups within CAS that could be clinically relevant as well as genetically distinctive. Methods In a group of 31 children with CAS and 8 controls, we performed hierarchical cluster analysis utilizing measures of articulation, vocabulary, and reading. We also conducted a chart review of the children with CAS to examine other clinical characteristics in these children and their association with subgroup membership. Results We identified 3 comorbid subgroups within CAS of varying severity. The high severity subgroup was characterized by poor reading and vocabulary, and the moderate severity subgroup by poor reading and non-word repetition but average vocabulary, compared to the mild severity subgroup. Subgroups were indistinguishable with respect to speech sound production, the hallmark of CAS, all demonstrating poor articulation. Children in the most severe subgroup were more likely to have early problems feeding (p=0.036). Conclusions Children with CAS may potentially be classified into comorbidity groups based on performance on vocabulary and reading measures, providing additional insight into the heterogeneity within CAS with implications for educational interventions.

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