CURRENT ISSUE

Assessment and Therapy in Childhood Apraxia of Speech: A Review

Nazmiye Atila-Çağlar Ayşın Noyan-Erbaş
Abstract

Purpose Childhood apraxia of speech (CAS) is a neurological speech sound disorder not accompanied by neuromuscular deficits, characterized by disorders in the planning and/or programming of spatio-temporal parameters of movement sequences. Both congenital and acquired CAS can occur in association with known neurological events, as primary or secondary symptoms of complex neurobehavioral disorders, or as idiopathic neurogenic speech sound disorder. Many of the behaviors and symptoms associated with CAS are also found in children with other speech sound disorders, so differential diagnosis is very important. For the differential diagnosis of CAS, the features specified by ASHA (2007) (inconsistent vowel and consonant errors in repeated productions of syllables or words, inappropriate prosody and/or impaired and prolonged coarticulation transitions between sounds and syllables) and Strand's 10-item clinical checklist are frequently used. After the diagnosis of CAS, it is very important to choose the appropriate assessment and intervention methods for these children. This review aims to present speech and language assessment methods and evidence-based intervention methods applied to children with CAS.

Method: In this study, the traditional review method was used. A literature review was conducted regarding speech- language assessment and intervention methods applied to children with CAS.

Results: A comprehensive CAS assessment should include both formal assessments and informal tasks to accurately address the children's speech motor system. Assessment of a children with suspected CAS; include case history, oral examination, speech analysis, assessment of suprasegmental features, stress, rhythm, pauses, tone of voice, stimulability and cues, as well as language, literacy assessment. Formal tests that can be used in the assessment of CAS are Apraxia Profile, Dynamic Evaluation of Motor Speech Skill, Kaufman Speech Praxis Test, Verbal Motor Production Assessment for Children, Orofacial Praxis Test, Madison Speech Assessment Protocol. Since the age ranges and areas evaluated differ in each formal test, the speech and language therapist should take these factors into consideration when choosing appropriate assessment tools for children. After speech and language evaluations are completed, an individualized intensive intervention program is required for children. The starting point and progression of therapy are shaped depending on the assessment data received from the children. Speech and language therapy in children with CAS progresses systematically, in a hierarchical manner, becoming increasingly difficult. Therapeutic approaches used for children with CAS fall under three headings: motor-based approaches, linguistic-based approaches and multi-modal communication approaches. Evidence-based therapy methods for children with CAS in the field of speech and language therapy are Dynamic Temporal and Tactile Cueing, Rapid Syllable Transitions Therapy, Nuffield Dyspraxia Programme, Integrated Phonological Awareness Intervention.

Conclusion: Speech and language therapists should have comprehensive knowledge and experience about different assessment and therapy methods used for children with CAS and choose the most appropriate therapy method for a child diagnosed with CAS.

Keywords

childhood apraxia of speech, speech sound disorder, speech and language therapist, speech and language assessment, speech and language therapy

References

American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech.

Atila Çağlar, N., & Noyan Erbaş, A. (2022). Vaka Çalışması: Çocukluk Çağı Konuşma Apraksisi Olan Bir Çocukta Dil ve Konuşma Müdahalesinin Etkililiğinin İncelenmesi. Ergoterapi ve Rehabilitasyon Dergisi, 10(3), 127-132. https://doi.org/10.30720/ered.868211.

Baas, B. S., Strand, E. A., Elmer, L. M., ve Barbaresi, W. J. (2008). Treatment of severe childhood apraxia of speech in a 12-year-old male with CHARGE association. Journal of Medical Speech-Language Pathology, 16(4),181-191.

Bearzotti, F., Tavano, A., ve Fabbro, F. (2007). Development of orofacial praxis of children from 4 to 8 years of age.Perceptual and motor skills, 104(3_suppl), 1355-1366.

Case, J., & Grigos, M. (2020). How the study of speech motor control can inform assessment and intervention in childhood apraxia of speech. Perspectives of the ASHA Special Interest Groups, 5(4), 784-793.

Crary, M. A., & Anderson, P. (1991, November). Speech and motor performance in developmental apraxia of speech. Technical session presented at the Annual Convention of the American-Speech-Language-Hearing Association, Atlanta, GA.

Davis, B., Jakielski, K., ve Marquardt, T. (1998). Developmental apraxia of speech: Determiners of differential diagnosis. Clinical Linguistics & Phonetics, 12, 25–45.

Davis, B. L., & Velleman, S. L. (2000). Differential Diagnosis and Treatment of Developmental Apraxia of Speech in Infants and Toddlers. Infant-toddler intervention: The Transdisciplinary Journal, 10(3), 177-92.

Delaney, A. L., & Kent, R. D. (2004, November). Developmental profiles of children diagnosed with apraxia of speech. InPoster presented at the annual convention of the American Speech-Language-Hearing Association, Philadelphia, PA.

Dewey, D., Roy, E. A., Square-Storer, P. A., ve Hayden, D. (1988). Limb and oral praxic abilities of children with verbal sequencing deficits. Developmental Medicine and Child Neurology, 30, 743–751.