Intervention for childhood apraxia of speech. 2008

Angela T Morgan, and Adam P Vogel
Healthy Development [Theme], Language & Literacy, Murdoch Childrens Research Institute, Parkville, Melbourne, Victoria, Australia, 3052. angela.morgan@mcri.edu.au

BACKGROUND The diagnostic criteria for Childhood Apraxia of Speech (CAS), and the underlying cause(s) for this disorder, remain heavily debated. Some agreement exists that children with CAS may have impairments in one or more of the following domains: non-speech oral motor function, motor speech function, speech sounds and structures (i.e., syllable and word shapes), prosody, language, phonemic awareness / metalinguistic skills, and literacy . Recently consensus has been reached that only three features across these domains have diagnostic validity: (1) inconsistent error production on both consonants and vowels across repeated productions of syllables or words, (2) lengthened and impaired coarticulatory transitions between sounds and syllables, and (3) inappropriate prosody (ASHA 2007). Perhaps due to the ongoing deliberation over aetiology and diagnosis, little evidence on intervention for CAS is published. OBJECTIVE To assess the efficacy of intervention delivered by Speech and Language Pathologists(s)/Speech and Language Therapists targeting CAS in children and adolescents. METHODS The following databases were searched: CENTRAL (Issue 4, 2006), MEDLINE (1966 to 01/2007), CINAHL (1982 to 12/2006), EMBASE (1980 to 01/2007), ERIC (1965 to 01/2007), Linguistics Abstracts Online (1985 to 01/2007), PsycINFO (1872 to 01/2007). Reference lists of articles thus identified were examined. METHODS The review considered randomised controlled trials (RCTs) and quasi-randomised studies of children aged 3 to 16 years with CAS, grouped by treatment types (e.g., perceptual and instrumentally-based biofeedback treatment techniques). METHODS Two authors independently assessed titles and abstracts identified from the searches and obtained full text versions of all potentially relevant articles. Articles were assessed for design and risk of bias. In addition to outcome data, a range of variables about participant group and outcomes were documented. RESULTS Of 825 titles and abstracts searched, only 31 abstracts appeared to meet inclusion criteria. The remaining 794 papers were excluded predominantly on the basis of not including participants with CAS (e.g., focused on other developmental speech disorders or adult acquired apraxia of speech), or for not being intervention studies (i.e. being diagnostic or descriptive). All 31 full text articles obtained were excluded following evaluation as they did not meet inclusion criteria on design. . Thus no studies are included in this review. CONCLUSIONS The review demonstrates a critical lack of well controlled treatment studies addressing treatment efficacy for CAS, making it impossible for conclusions to be drawn about which interventions are most effective for treating CAS in children or adolescents.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D001072 Apraxias A group of cognitive disorders characterized by the inability to perform previously learned skills that cannot be attributed to deficits of motor or sensory function. The two major subtypes of this condition are ideomotor (see APRAXIA, IDEOMOTOR) and ideational apraxia, which refers to loss of the ability to mentally formulate the processes involved with performing an action. For example, dressing apraxia may result from an inability to mentally formulate the act of placing clothes on the body. Apraxias are generally associated with lesions of the dominant PARIETAL LOBE and supramarginal gyrus. (From Adams et al., Principles of Neurology, 6th ed, pp56-7) Dressing Apraxia,Dyspraxia,Ideational Apraxia,Apraxia,Apraxia of Phonation,Apraxia, Articulatory,Apraxia, Developmental Verbal,Apraxia, Facial-Oral,Apraxia, Gestural,Apraxia, Motor,Apraxia, Oral,Apraxia, Verbal,Developmental Verbal Dyspraxia,Dyspraxia, Articulatory,Dyspraxia, Oral,Dyspraxia, Verbal,Speech And Language Disorder With Orofacial Dyspraxia,Speech-Language Disorder 1,1s, Speech-Language Disorder,Apraxia, Dressing,Apraxia, Facial Oral,Apraxia, Ideational,Apraxias, Articulatory,Apraxias, Developmental Verbal,Apraxias, Dressing,Apraxias, Facial-Oral,Apraxias, Gestural,Apraxias, Ideational,Apraxias, Motor,Apraxias, Oral,Apraxias, Verbal,Articulatory Apraxia,Articulatory Apraxias,Articulatory Dyspraxia,Articulatory Dyspraxias,Developmental Verbal Apraxia,Developmental Verbal Apraxias,Developmental Verbal Dyspraxias,Disorder 1, Speech-Language,Disorder 1s, Speech-Language,Dressing Apraxias,Dyspraxia, Developmental Verbal,Dyspraxias,Dyspraxias, Articulatory,Dyspraxias, Developmental Verbal,Dyspraxias, Oral,Dyspraxias, Verbal,Facial-Oral Apraxia,Facial-Oral Apraxias,Gestural Apraxia,Gestural Apraxias,Ideational Apraxias,Motor Apraxia,Motor Apraxias,Oral Apraxia,Oral Apraxias,Oral Dyspraxia,Oral Dyspraxias,Phonation Apraxia,Phonation Apraxias,Speech Language Disorder 1,Speech-Language Disorder 1s,Verbal Apraxia,Verbal Apraxia, Developmental,Verbal Apraxias,Verbal Apraxias, Developmental,Verbal Dyspraxia,Verbal Dyspraxia, Developmental,Verbal Dyspraxias,Verbal Dyspraxias, Developmental
D013064 Speech Disorders Acquired or developmental conditions marked by an impaired ability to comprehend or generate spoken forms of language. Aprosodia,Aprosodic Speech,Cluttering,Dysglossia,Dyslalia,Rhinolalia,Verbal Fluency Disorders,Aprosodias,Clutterings,Dysglossias,Dyslalias,Rhinolalias,Speech, Aprosodic,Verbal Fluency Disorder
D013066 Speech-Language Pathology The study of speech or language disorders and their diagnosis and correction. Language Pathology,Speech Pathology,Pathology, Language,Pathology, Speech,Pathology, Speech-Language,Pathology, Speech Language,Speech Language Pathology
D013070 Speech Therapy Treatment for individuals with speech defects and disorders that involves counseling and use of various exercises and aids to help the development of new speech habits. Therapy, Speech,Speech Therapies,Therapies, Speech

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