Performance in the accuracy task in children with Childhood Apraxia of Speech after an integrated intervention of literacy and motor skills

ABSTRACT Difficult in literacy skills are often seen in children with Childhood Apraxia of Speech (CAS). This occurs because oral language has direct relationship with reading and writing learning. The purpose of this study was to evaluate the performance in the accuracy task of an integrated phonoarticulatory awareness, motor skills and literacy intervention of three children with CAS. Three boys between 5;3 and 5;8 years of age, with CAS, were offered 2 hours per week of therapy sessions based on literacy and motor skills. The children were assessed before and after therapy and at a maintenance assessment 1 month after the treatment ceased. The children improved on the accuracy task considering their deficits level. Improvement was maintained at the maintenance assessment. Therapy based on literacy considering phonoarticulatory awareness and motor skills can help children with CAS, but the severity of the children’s communication problems must be taken into consideration.

The Bouba-Kiki Effect in Children With Childhood Apraxia of Speech

Purpose: The bouba-kiki (BK) effect refers to associations between visual shapes and auditory pseudonames. Thus, when tested, people tend to associate the pseudowords bouba and kiki with round or spiky shapes, respectively. This association requires cross-modal sensory integration. The ability to integrate information from different sensory modalities is crucial for speech development. A clinical population that may be impaired in cross-modal sensory integration is children with childhood apraxia of speech (CAS). The purpose of this study was to examine the involvement of cross-modal sensory integration in children with (CAS). Method: The BK effect was assessed in participants with CAS ( n = 18) and two control groups: One control group was composed of children with developmental language disorder (DLD), also termed specific language impairment ( n = 15), and a second group included typically developing (TD) children ( n = 22). The children were presented with 14 pairs of novel visual displays and nonwords. All the children were asked to state which shape and nonword correspond to one another. In addition, background cognitive (Leiter-3) and language measures (Hebrew PLS-4) were determined for all children. Results: Children in the CAS group were less successful in associating between visual shapes and corresponding auditory pseudonames (e.g., associating the spoken word “bouba” with a round shape; the spoken word “kiki” with a spiky shape). Thus, children with CAS demonstrated a statistically significant reduced BK effect compared with participants with TD and participants with DLD. No significant difference was found between the TD group and the DLD group. Conclusions: The reduced BK effect in children with CAS supports the notion that cross-modal sensory integration may be altered in these children. Cross-modal sensory integration is the basis for speech production. Thus, difficulties in sensory integration may contribute to speech difficulties in CAS.

Clinical Utility of Repeated Urimal Test of Articulation and Phonation for Patients with Childhood Apraxia of Speech

Childhood apraxia of speech (CAS) causes inconstant oromotor production. We investigated the clinical efficacy of repeated urimal test of articulation and phonation (U-TAP) in CAS patients. Twenty-eight children were recruited: 19 with CAS and 9 with functional articulation disorder (FAD). Four age-matched typically developing children were also recruited. U-TAP was performed twice repeatedly, and the error rate of consonant accuracy (CA) was measured. Preschool Receptive-Expressive Language Scale (PRES) was also performed. The mean U-TAP CA showed a significant difference between the three groups, with 42.04% for CAS, 77.92% for FAD, and 99.68% for the normal group (p < 0.05). The mean difference between the two U-TAP CAs was 10.01% for CAS, 0.82% for FAD, and no difference for the normal group, revealing a significant intergroup difference between CAS and FAD (p < 0.05). For the expressive and receptive PRES scores, CAS group showed significantly decreased results compared to FAD and normal group. Only in the CAS group, expressive PRES showed significant decrease rather than receptive PRES score. The CAS group showed a significant difference in the two U-TAP CA compared to the FAD and normal groups. This result implies that repeated U-TAP can be useful for supportive diagnostic tool for CAS by detecting poor reliability of phonation.

Visualizing the Knowledge Domain of Motor Speech Disorders: A Scientific Review (2000-2019)

This review visualizes the knowledge domain of motor speech disorders (MSDs) in linguistics between 2000 and 2019 by means of scientometric methods. With topic searches, the study collected 869 bibliographic records and 20, 411 references from Web of Science Core Collection (WoSCC) of Thomson Reuter. The clustered and visualized document co-citation network of the MSDs knowledge domain in CiteSpace identifies 15 research foci in different periods, including apraxia of speech, acoustics, children, technology, aphemia, childhood apraxia of speech, primary progressive aphasia, speech motor delay, Parkinson’s disease, amyotrophic lateral sclerosis, rhythm, foreign accent syndrome, phonation, phonological awareness, dose and speech perception. Revolving around linguistics, these foci could be divided into studies on speech characteristics of MSDs in terms of phonology and phonetics, remedies for MSDs in terms of neurolinguistics and acoustic phonetics, dysarthria secondary to neurological diseases based on pathological linguistics, subtypes of apraxia of speech, methods of MSDs based on auditory phonetics and a newly recognized subtype of MSDs. Meanwhile, the emerging trends of MSDs in linguistics are detected by the analysis of reference citation bursts, suggesting growing research in remedies for MSDs with the focus on assessments and effectiveness of treatments, speech characteristics and indexes of dysarthria secondary to neurological diseases and assistance to diagnose apraxia of speech. To sum up, the review has indicated that the acoustic measures to assess MSDs and acoustic remedies for dysarthria may not only be the past foci but also be future trends.

Efficacy of treatment intensity in German-speaking children with childhood apraxia of speech

Motor learning principles guide treatment of childhood apraxia of speech (CAS). Previous studies found children to benefit from higher-intensity conditions; however, they did not control for the total amount of therapy time. The aims of the article are to examine the effects of high versus low treatment frequency in intervention for CAS in German-speaking children. An alternating single-subject design with multiple baselines was applied to compare frequent, short sessions with fewer, longer sessions in terms of speech production accuracy in four children with CAS while keeping the total therapy time constant. We administered a version of integral stimulation treatment. Despite inter-individual differences, changes under both treatment conditions showed similar positive trajectories for all four children. Untreated control targets also improved across participants and conditions. Maintenance and generalization to untreated targets were observed two weeks and three months post treatment, independent of treatment intensity. Our results show no significant advantage of more intensive treatment when the total therapy time is held constant. This study contributes to the evidence base for the use of integral stimulation in treating children with CAS, and in particular those who speak languages other than English.

An Automated Lexical Stress Classification Tool for Assessing Dysprosody in Childhood Apraxia of Speech

Childhood apraxia of speech (CAS) commonly affects the production of lexical stress contrast in polysyllabic words. Automated classification tools have the potential to increase reliability and efficiency in measuring lexical stress. Here, factors affecting the accuracy of a custom-built deep neural network (DNN)-based classification tool are evaluated. Sixteen children with typical development (TD) and 26 with CAS produced 50 polysyllabic words. Words with strong–weak (SW, e.g., dinosaur) or WS (e.g., banana) stress were fed to the classification tool, and the accuracy measured (a) against expert judgment, (b) for speaker group, and (c) with/without prior knowledge of phonemic errors in the sample. The influence of segmental features and participant factors on tool accuracy was analysed. Linear mixed modelling showed significant interaction between group and stress type, surviving adjustment for age and CAS severity. For TD, agreement for SW and WS words was >80%, but CAS speech was higher for SW (>80%) than WS (~60%). Prior knowledge of segmental errors conferred no clear advantage. Automatic lexical stress classification shows promise for identifying errors in children’s speech at diagnosis or with treatment-related change, but accuracy for WS words in apraxic speech needs improvement. Further training of algorithms using larger sets of labelled data containing impaired speech and WS words may increase accuracy.