Update on Identification and Treatment of Infants and Toddlers With Suspected Childhood Apraxia of Speech

Highman, Chantelle; Overby, Megan; Leitão, Suze; Abbiati, Claudia I.; Velleman, Shelley L.

doi:10.1044/2023_jslhr-22-00639

Cited by 5 publications

(1 citation statement)

References 109 publications

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“…This diagnostic uncertainty can be seen in the research literature and clinically in labels such as "suspected CAS" (e.g. Highman et al [53] Randazzo [52]). Given that choice of intervention generally depends on confident diagnosis, this leaves the speech-language pathologist in a dilemma which is often solved by resorting to well described but lower evidenced general interventions such as articulation therapy or hybridization of multiple interventions designed for a range of disorders [e.g.…”

Section: Confidence In Motor Speech Diagnosismentioning

confidence: 99%

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

McCabe,

Korkalainen,

Thomas

2024

Curr Dev Disord Rep

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Purpose Speech-language pathologists report difficulty in the accurate differential diagnosis of complex speech presentations. This paper explores possible reasons for diagnostic uncertainty and reviews new tools and recent approaches to address this concern. Recent Findings Children with motor speech disorders often have complex mixed presentations, comprising interacting motor-speech, cognitive-linguistic, and psychosocial factors, which may lead to clinicians having difficulty selecting appropriate interventions. Clinicians are frequently uncertain about differential diagnosis and lack time to complete comprehensive analysis required to understand the children’s complex speech profiles. This review examines papers that deal with this issue through identification of multiple speech disorders [5], consideration of impaired speech processes rather than discrete diagnoses [1], and the impact of new genetic understandings [20]. These insights will help to reduce the impact of this complexity on clinical decision-making. Summary New tools are emerging including clinical diagnostic pathways, genetic analysis, and theoretical modelling which may resolve many of the identified issues and improve clinical decision-making for children with complex motor speech disorders.

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Section: Confidence In Motor Speech Diagnosismentioning

confidence: 99%

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

McCabe,

Korkalainen,

Thomas

2024

Curr Dev Disord Rep

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Effectiveness of the Kaufman Speech to Language Protocol for Children With Childhood Apraxia of Speech and Comorbidities When Delivered in a Dyadic and Group Format

Namasivayam,

Cheung,

Atputhajeyam

et al. 2024

Am J Speech Lang Pathol

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Purpose: The current study is a Phase I clinical study with the goal of determining feasibility and the effectiveness of the Kaufman Speech to Language Protocol (K-SLP) for children with childhood apraxia of speech (CAS) and comorbidities. We hypothesized that K-SLP intervention would result in improved outcomes and maintenance of treatment effect at 3–4 months postintervention. Method: Single-subject experimental design with multiple baselines across behaviors was replicated across a group of six children. Five out of six participants completed the study. The K-SLP intervention was administered in dyads four times a week for three consecutive weeks. Outcomes included assessment of word/syllable shapes, articulation accuracy, speech intelligibility, and functional communication. Treatment progress was measured through: (a) the administration of custom probe word lists and (b) assessments carried out at pretreatment, immediately following intervention and approximately 3–4 months after the study period. Results: Four out of five participants demonstrated significant improvements to words targeted in treatment and three out of five generalized these to untreated words. Furthermore, three out of five participants showed immediate and clinically significant posttreatment improvements in speech intelligibility and functional outcomes, and this increased to four out of five participants at 3–4 months follow-up. Conclusions: The study provides preliminary support for the effectiveness of the K-SLP program when delivered in dyads to children with CAS with comorbidities. The study replicates earlier findings and reaffirms the positive outcomes of K-SLP for children with CAS.

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Dynamic Temporal and Tactile Cueing in Young Children With Childhood Apraxia of Speech: A Multiple Single-Case Design

Grigos,

Case,

et al. 2024

J Speech Lang Hear Res

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Purpose: Childhood apraxia of speech (CAS) is a multivariate motor speech disorder that requires a motor-based intervention approach. There is limited treatment research on young children with CAS, reflecting a critical gap in the literature given that features of CAS are often in full expression early in development. Dynamic Temporal and Tactile Cueing (DTTC) is a treatment approach designed for children with severe CAS, yet the use of DTTC with children younger than 3 years of age has not been examined. Method: A multiple single-case design was employed to examine the use of DTTC in seven children with CAS (aged 2.5–5 years) over the course of 6 weeks of intervention. Changes in word accuracy were measured in treated words from baseline to posttreatment and from baseline to maintenance (6 weeks posttreatment). Generalization of word accuracy changes to matched untreated words was also examined. A linear mixed-effects model was used to estimate the change in word accuracy for treated and untreated words across all children from baseline to posttreatment and to maintenance. A quasi-Poisson regression model was used to estimate mean change and calculate effect sizes for treated and untreated words. Results: Group-level analyses revealed significant changes in word accuracy for treated and untreated words at posttreatment and maintenance. At the child level, six of seven children displayed medium-to-large effect sizes where word accuracy increased in an average of 3.4/5 words across all children. Each child displayed some degree of generalization to untreated targets, specifically for words with the same syllable shape as the treated words. Conclusions: These results demonstrate that DTTC can yield positive change in some young children with CAS. Key differences in each child's performance are highlighted.

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Update on Identification and Treatment of Infants and Toddlers With Suspected Childhood Apraxia of Speech

Cited by 5 publications

References 109 publications

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

Effectiveness of the Kaufman Speech to Language Protocol for Children With Childhood Apraxia of Speech and Comorbidities When Delivered in a Dyadic and Group Format

Dynamic Temporal and Tactile Cueing in Young Children With Childhood Apraxia of Speech: A Multiple Single-Case Design

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