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Maas E. Treatment for Childhood Apraxia of Speech: Past, Present, and Future. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-26. [PMID: 38768073 DOI: 10.1044/2024_jslhr-23-00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
PURPOSE The purposes of this review article were to provide an introduction to and "bird's-eye" overview of the current evidence base for treatment of childhood apraxia of speech (CAS), identify some gaps and trends in this rapidly growing literature, and formulate some future research directions, in order to advance the evidence base and clinical practice for children with CAS. METHOD Following a brief introduction outlining important concepts, a narrative review of the CAS treatment literature is provided, and trends and future directions are identified based on this review. The review is organized around four fundamental treatment research questions: (a) "Does Treatment X work?", (b) "Does Treatment X work better than Treatment Y?", (c) "For whom does Treatment X work?", and (d) "What does 'work' mean, anyway?" RESULTS A wide range of CAS treatments with varying degrees of evidence for efficacy exists. Research is beginning to emerge that compares different treatments and seeks to determine optimal treatment parameters. Few studies to date have explored child-level predictors of treatment response, and the evidence base currently is limited in scope with respect to populations and outcomes studied. CONCLUSIONS A growing evidence base supports the efficacy of a number of treatments for CAS. However, many important gaps in the literature were identified that warrant redoubled and sustained research attention. Research is beginning to emerge that addresses treatment optimization, comparison, candidacy, and outcomes. Suggestions for future research are offered, and the concept of a hypothesized pathway was applied to CAS to illustrate how components of an intervention can effect change in a clinical goal and can help guide development and refinement of treatments for children with CAS.
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Affiliation(s)
- Edwin Maas
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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Al Awaji NN, Al-Taleb SM, Albagawi TO, Alshammari MT, Sharar FA, Mortada EM. Evaluating Parents' Concerns, Needs, and Levels of Satisfaction with the Services Provided for ASD Children in Saudi Arabia. J Multidiscip Healthc 2024; 17:123-146. [PMID: 38222477 PMCID: PMC10785689 DOI: 10.2147/jmdh.s447151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024] Open
Abstract
Background Supporting children with autism spectrum disorder (ASD) and their parents is vital in improving their children's abilities and their parents' ability to care for them. Thus, parents' perceptions of and levels of satisfaction with the services provided for their children must be assessed. Aim This study aimed to understand parents' perceptions of and satisfaction with the speech-language services (SLS) provided for ASD children in different health facilities in Saudi Arabia. Methods This cross-sectional study included 109 parents of ASD children. The survey included five sections dealing with (1) general information about the child; (2) assessment of the child's ASD characteristics (including their age when diagnosed, when they first noticed symptoms, and their speech, language, and communication abilities); (3) the reasons for enrollment in SLS sessions; (4) questions about SLS; and (5) parents' perceptions of SLS, satisfaction with the service, descriptions of their children's progress, and the respect and support they received. Results Parents' satisfaction levels were significantly higher when they had easy access to SLS, sufficient information and support, proper training in applying therapy exercises at home, and perceived respect and support from speech and language pathologists (SLPs). The reasons for discontinuing SLS included high session costs, the need for initial behavioral sessions, the lack of qualified SLPs, the end of the sessions, the lack of improvement, the nonavailability of specialized centers, and parents' dependence on home training only. They also sought opportunities for work and education, continuous and intensive SLS sessions, reduced costs, centers for adults with ASD, and accessible schools. Parents' main concerns were their children's poor speech and language skills, independence, and social acceptance. Conclusion and Implications The study highlighted the importance of understanding parents' experiences with SLS, identifying the factors that enhance SLS use by ASD children, and improving parents' satisfaction with such services.
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Affiliation(s)
- Nisreen Naser Al Awaji
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Sumaih Mohammed Al-Taleb
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Teef Olayan Albagawi
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Maram Taleb Alshammari
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Fay Abdullah Sharar
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Eman M Mortada
- Health Sciences department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
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Highman C, Overby M, Leitão S, Abbiati C, Velleman S. Update on Identification and Treatment of Infants and Toddlers With Suspected Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-21. [PMID: 37441847 DOI: 10.1044/2023_jslhr-22-00639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
PURPOSE The purpose of this tutorial is to (a) provide an updated review of the literature pertaining to proposed early features of childhood apraxia of speech (CAS), (b) discuss the findings of recent treatment studies of infants and toddlers with suspected CAS (sCAS), and (c) present evidence-based strategies and tools that can be used for the identification of and intervention for infants and toddlers with sCAS or at high risk for the disorder. METHOD Since Davis and Velleman's (2000) seminal work on assessment and intervention in infants and toddlers with sCAS, limited research has guided clinicians in the complex task of identifying and treating early speech motor difficulties prior to a definitive diagnosis of CAS. Following the structure of Davis and Velleman, we explore the proposed early characteristics of CAS with reference to contemporary research. Next, we describe the limited treatment studies that have investigated intervention for infants and toddlers at risk of or suspected of having CAS. Finally, we present practical suggestions for integrating this knowledge into clinical practice. CONCLUSIONS Many of the originally proposed correlates of CAS in infants and toddlers now have research supporting their presence. However, questions remain about the developmental trajectory of the disorder. Although limited in number and restricted by lack of experimental control, emerging treatment studies can help guide clinicians in providing appropriate intervention to infants and toddlers with sCAS who need not wait for a definitive diagnosis to initiate intervention.
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Affiliation(s)
- Chantelle Highman
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Megan Overby
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Suze Leitão
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Claudia Abbiati
- Department of Communication Sciences and Disorders, University of Vermont, Burlington
| | - Shelley Velleman
- Department of Communication Sciences and Disorders, University of Vermont, Burlington
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Iuzzini-Seigel J. Prologue to the Forum: Care of the Whole Child: Key Considerations When Working With Children With Childhood Apraxia of Speech. Lang Speech Hear Serv Sch 2022; 53:921-925. [PMID: 36150120 DOI: 10.1044/2022_lshss-22-00119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This prologue introduces the LSHSS Forum: Care of the Whole Child: Key Considerations When Working With Children With Childhood Apraxia of Speech. The goals of the forum are to provide (a) an overview of several co-occurring conditions and challenges that may affect children in this population and (b) methods and materials to enhance diagnostic accuracy and treatment efficacy to help children with childhood apraxia of speech (CAS) to thrive. METHOD The prologue provides an overview of what it means to care for the whole child and introduces the five articles in the forum, including research and clinical focus articles as well as tutorials. Infographics, assessment templates, video examples, case studies, and treatment goals are included throughout the forum to promote translation from research to practice. CONCLUSION Children with CAS may experience a breadth of skills, challenges, and diagnoses. By learning (a) to identify possible co-occurring conditions, (b) when to make referrals, and (c) how to best accommodate and treat children when different conditions are present, speech-language pathologists can further increase the quality of care provided and ability to advocate for some of our most vulnerable clients and their families.
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Heller Murray ES, Segawa J, Karahanoglu FI, Tocci C, Tourville JA, Nieto-Castanon A, Tager-Flusberg H, Manoach DS, Guenther FH. Increased Intra-Subject Variability of Neural Activity During Speech Production in People with Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 94:101955. [PMID: 35601992 PMCID: PMC9119427 DOI: 10.1016/j.rasd.2022.101955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Background Communication difficulties are a core deficit in many people with autism spectrum disorder (ASD). The current study evaluated neural activation in participants with ASD and neurotypical (NT) controls during a speech production task. Methods Neural activities of participants with ASD (N = 15, M = 16.7 years, language abilities ranged from low verbal abilities to verbally fluent) and NT controls (N = 12, M = 17.1 years) was examined using functional magnetic resonance imaging with a sparse-sampling paradigm. Results There were no differences between the ASD and NT groups in average speech activation or inter-subject run-to-run variability in speech activation. Intra-subject run-to-run neural variability was greater in the ASD group and was positively correlated with autism severity in cortical areas associated with speech. Conclusions These findings highlight the importance of understanding intra-subject neural variability in participants with ASD.
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Affiliation(s)
- Elizabeth S. Heller Murray
- Boston University, Department of Speech, Language, & Hearing Sciences, 635 Commonwealth Avenue, Boston, MA, 02215
| | - Jennifer Segawa
- Boston University, Department of Speech, Language, & Hearing Sciences, 635 Commonwealth Avenue, Boston, MA, 02215
| | - F. Isik Karahanoglu
- Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, 55 Fruit Street, Boston, MA, 02215
| | - Catherine Tocci
- Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, 55 Fruit Street, Boston, MA, 02215
| | - Jason A. Tourville
- Boston University, Department of Speech, Language, & Hearing Sciences, 635 Commonwealth Avenue, Boston, MA, 02215
| | - Alfonso Nieto-Castanon
- Boston University, Department of Speech, Language, & Hearing Sciences, 635 Commonwealth Avenue, Boston, MA, 02215
| | - Helen Tager-Flusberg
- Boston University, Department of Psychological and Brain Sciences, 64 Cummington Mall Boston, MA, 02115
| | - Dara S. Manoach
- Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, 55 Fruit Street, Boston, MA, 02215
- Athinoula A. Martinos Center for Biomedical Imaging, 149 13th Street, Room 2618, Charlestown, MA 02129
| | - Frank H. Guenther
- Boston University, Department of Speech, Language, & Hearing Sciences, 635 Commonwealth Avenue, Boston, MA, 02215
- Boston University, Department of Biomedical Engineering, 44 Cummington Mall Boston, MA, 02115
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Beiting M. Diagnosis and Treatment of Childhood Apraxia of Speech Among Children With Autism: Narrative Review and Clinical Recommendations. Lang Speech Hear Serv Sch 2022; 53:947-968. [PMID: 35472263 DOI: 10.1044/2022_lshss-21-00162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Treatment for children with autism spectrum disorder (ASD) and low verbal ability is a largely neglected area of study. Existing research focuses on language abilities; however, a subset of children with ASD also has speech sound disorders (SSDs). The purpose of this tutorial is to provide clinicians with evidence-based recommendations to guide speech assessment and treatment among children with ASD, low verbal ability, and suspected childhood apraxia of speech (CAS). METHOD Multifaceted search procedures were used to identify studies that have assessed or treated speech sound production among children with ASD. A narrative review and synthesis of the literature is followed by practical clinical recommendations based on best available evidence. CONCLUSIONS It is critically important to consider all possible hindrances to the development of functional communication ability for children with ASD. Speech sound production has been identified as a key predictor of expressive language outcomes, yet there are very few studies that address assessment and treatment of SSDs among children with ASD. Less is known about the presentation of CAS among children with ASD and low verbal ability. More research is needed to determine whether existing speech assessment and treatment methods are appropriate for children with ASD, if modifications are needed, or if new methods should be designed.
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Affiliation(s)
- Molly Beiting
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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Speech Development Across Subgroups of Autistic Children: A Longitudinal Study. J Autism Dev Disord 2022:10.1007/s10803-022-05561-8. [PMID: 35438437 DOI: 10.1007/s10803-022-05561-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
Subgroups of children with different speech profiles have been described however, little is known about the trajectories of speech development or stability of subgroups over time. This longitudinal study described both speech trajectories and subgroup stability of 22 autistic children, aged 2;0-6;11 years, over 12 months. Independent and relational speech analyses, vocabulary size and nonverbal communication were used in clustering. Results suggest varied speech trajectories, particularly for children with 'low language and low speech' at Time 1. Receptive vocabulary and consonant inventory at Time 1 may predict speech outcomes after 12 months. A small subgroup of children (n = 3) present with low expressive vocabulary and speech but higher receptive vocabulary and use of gestures. This unique profile remained stable.
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