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Vuolo J, Wisler A. Acoustic Analysis of Spatiotemporal Variability in Children With Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3536-3548. [PMID: 39259872 DOI: 10.1044/2024_jslhr-24-00079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
PURPOSE The purpose of this study was to investigate acoustic spatiotemporal variability in children with childhood apraxia of speech (CAS) compared to children with typical development (TD). Increased spatiotemporal variability in children with CAS relative to nonapraxic peers has been documented in multiple kinematic studies. To date, few studies have investigated spatiotemporal variability in CAS using an acoustic signal. METHOD Data were drawn from 10 children with CAS and 10 children with TD, ranging in age from 5;0 to 11;2 (years;months), who participated in an online study. All children with CAS had a verified diagnosis and showed at least five CAS features across at least two tasks, independently confirmed by two speech-language pathologists with expertise in CAS. Children repeated the sentences "Buy Bobby a puppy" (BBAP) and "Mom pets the puppy" (MPP) 10 times each. The acoustic spatiotemporal index (STI), calculated from the amplitude envelope, was used to investigate acoustic spatiotemporal variability. Using a regression analysis, we analyzed group differences in STI values while controlling for age and gender. RESULTS Children with CAS did not produce enough usable tokens of BBAP to analyze. MPP revealed significantly higher acoustic STI values in children with CAS compared to children with TD. No significant effects were observed for age or gender. Acoustic data collected online without the use of specialized equipment yielded high-quality audio data from which amplitude envelope tracing could be reliably accomplished. CONCLUSIONS This study adds to a growing body of empirical data indicating that children with CAS produce speech with more variable spatiotemporal control compared to children with TD. In addition to producing more variable speech, children with CAS were less consistently able to form productions free of phonetic errors. These findings also demonstrate the feasibility of using remote data collection to investigate acoustic spatiotemporal variability, which allows for the recruitment of larger samples of low-incidence populations. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26814883.
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Affiliation(s)
- Janet Vuolo
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Alan Wisler
- Department of Mathematics and Statistics, Utah State University, Logan
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Murray E, Velleman S, Preston JL, Heard R, Shibu A, McCabe P. The Reliability of Expert Diagnosis of Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3309-3326. [PMID: 37642523 DOI: 10.1044/2023_jslhr-22-00677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
PURPOSE The current standard for clinical diagnosis of childhood apraxia of speech (CAS) is expert clinician judgment. The psychometric properties of this standard are not well understood; however, they are important for improving clinical diagnosis. The purpose of this study is to determine the extent to which experts agree on the clinical diagnosis of CAS using two cohorts of children with mixed speech sound disorders (SSDs). METHOD Speech samples of children with SSDs were obtained from previous and ongoing research from video recordings of children aged 3-8 years (n = 36) and audio recordings of children aged 8-17 years (n = 56). A total of 23 expert, English-speaking clinicians were recruited internationally. Three of these experts rated each speech sample to provide a description of the observed features and a diagnosis. Intrarater reliability was acceptable at 85% agreement. RESULTS Interrater reliability on the presence or absence of CAS among experts was poor both as a categorical diagnosis (κ = .187, 95% confidence interval [CI] [0.089, 0.286]) and on a continuous "likelihood of CAS" scale (0-100; intraclass correlation = .183, 95% CI [.037, .347]). Reliability was similar across the video-recorded and audio-only samples. There was greater agreement on other diagnoses (such as articulation disorder) than on the diagnosis of CAS, although these too did not meet the predetermined standard. Likelihood of CAS was greater in children who presented with more American Speech-Language-Hearing Association CAS consensus features. CONCLUSIONS Different expert raters had different thresholds for applying the diagnosis of CAS. If expert clinician judgment is to be used for diagnosis of CAS or other SSDs, further standardization and calibration is needed to increase interrater reliability. Diagnosis may require operationalized checklists or reliable measures that operate along a diagnostic continuum. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23949105.
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Affiliation(s)
- Elizabeth Murray
- The University of Sydney, New South Wales, Australia
- Remarkable Speech + Movement, Sydney, New South Wales, Australia
| | | | | | - Robert Heard
- The University of Sydney, New South Wales, Australia
| | - Akhila Shibu
- The University of Sydney, New South Wales, Australia
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Lewis BA, Miller GJ, Iyengar SK, Stein C, Benchek P. Long-Term Outcomes for Individuals With Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3463-3479. [PMID: 37734154 DOI: 10.1044/2023_jslhr-22-00647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
PURPOSE The study's primary aims were to describe the long-term speech outcomes for adolescents and young adults with a history of childhood apraxia of speech (CAS) and to examine the association of persistent speech sound errors with measures of literacy skills, phonological processing, motor speech production, and parent report of early motor difficulty. METHOD Data from a large longitudinal 25-year study were used to explore outcomes for 32 individuals with a history of CAS, ages 12;6 (years;months) to 25 years (M = 17.4, SD = 4.7). Persistent and nonpersistent groups were compared on decoding, phonological processing, multisyllabic word repetition, diadochokinetic rate, and parent report of motor involvement. Parametric (Welch's t tests) and nonparametric tests (Wilcoxon and Fisher exact tests) were used to identify differences between the groups' distributions. Developmental trajectories of speech production were plotted. RESULTS Outcomes for individuals with CAS are highly variable, with some demonstrating speech sound errors into adolescence and young adulthood. Speech sound errors were primarily on later developing sounds. Persistence was significantly associated with early motor difficulties. Difficulties with multisyllabic words, phonological processing, and literacy were often present regardless of persistence or nonpersistence of speech errors. CONCLUSIONS Children with CAS are at risk for persistent speech sound errors into adulthood. For children showing limited progress with more traditional speech therapy, alternative interventions should be explored. Individuals with persistent speech sound errors are more likely to have a history of early motor deficits. Regardless of persistence, participants with CAS demonstrated ongoing weaknesses in literacy, phonological processing skills, and complex speech production tasks.
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Affiliation(s)
- Barbara A Lewis
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Gabrielle J Miller
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Sudha K Iyengar
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Catherine Stein
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Penelope Benchek
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
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McCabe P, Beiting M, Hitchcock ER, Maas E, Meredith A, Morgan AT, Potter NL, Preston JL, Moorer L, Aggarwal P, Ballard K, Smith LB, Caballero NF, Cabbage K, Case J, Caspari S, Chenausky KV, Cook S, Grzelak E, Gomez M, Hagopian A, Highman C, Hodits A, Iuzzini-Seigel J, LeVos-Carlson J, Lewis BA, Mayro P, Mehta J, Miller G, Mory KD, Murray E, Overby MS, Pasquel-Lefebvre L, Peavy D, Raaz CV, Rea B, Ford DS, Smith L, Swartz MT, Taberski M, Terband H, Thomas DC, Valentine H, Tellingen MV, Velleman S, Wang E, White S, Wong ECH, Grigos MI. Research Priorities for Childhood Apraxia of Speech: A Long View. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3255-3268. [PMID: 39173052 DOI: 10.1044/2024_jslhr-24-00196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
This article introduces the Journal of Speech, Language, and Hearing Research Special Issue: Selected Papers From the 2022 Apraxia Kids Research Symposium. The field of childhood apraxia of speech (CAS) has developed significantly in the past 15 years, with key improvements in understanding of basic biology including genetics, neuroscience, and computational modelling; development of diagnostic tools and methods; diversity of evidence-based interventions with increasingly rigorous experimental designs; and understanding of impacts beyond impairment-level measures. Papers in this special issue not only review and synthesize the some of the substantial progress to date but also present novel findings addressing critical research gaps and adding to the overall body of knowledge. A second aim of this prologue is to report the current research needs in CAS, which arose from symposium discussions involving researchers, clinicians, and Apraxia Kids community members (including parents of children with CAS). Four primary areas of need emerged from discussions at the symposium. These were: (a) What questions should we ask? (b) Who should be in the research? (c) How do we conduct the research? and (d) How do we move from research to practice? Across themes, symposium attendees emphasized the need for CAS research to better account for the diversity of people with CAS and improve the timeliness of implementation of high-level evidence-based practice across the lifespan. It is our goal that the articles and prologue discussion in this special issue provide an appreciation of advancements in CAS research and an updated view of the most pressing needs for future research.
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Affiliation(s)
- Patricia McCabe
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Molly Beiting
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | | | | | | | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
- Royal Children's Hospital, Parkville, Victoria, Australia
| | | | - Jonathan L Preston
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | | | | | - Kirrie Ballard
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Nicole F Caballero
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | | | | | | | | | | | - Ewa Grzelak
- Poznan University of Medical Sciences, Poland
| | - Maryane Gomez
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Chantelle Highman
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, AustraliaPortland, OR
| | | | | | | | | | | | | | | | | | - Elizabeth Murray
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Remarkable Speech + Movement, Padstow, New South Wales, Australia
| | - Megan S Overby
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Remarkable Speech + Movement, Padstow, New South Wales, Australia
| | | | - Derrick Peavy
- Department of Communication Sciences and Disorders, Syracuse University, NY
- Apraxia Kids, Pittsburgh, PA
| | | | - Brooke Rea
- Childhood Apraxia & Speech Therapy Centre, Guelph, Ontario, Canada
| | | | - Lynn Smith
- Alberta Health Services, Edmonton, Canada
| | | | | | - Hayo Terband
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
| | - Donna C Thomas
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | | | - Shelley Velleman
- Department of Communication Sciences and Disorders, University of Vermont, Burlington
| | | | | | - Eddy C H Wong
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hung Hom
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Formicola D, Podda I, Dirupo E, Andreucci E, Giglio S, Cipriani P, Bombonato C, Santorelli FM, Chilosi A. Expanding the molecular landscape of childhood apraxia of speech: evidence from a single-center experience. Front Neurosci 2024; 18:1396240. [PMID: 39381681 PMCID: PMC11459770 DOI: 10.3389/fnins.2024.1396240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 08/28/2024] [Indexed: 10/10/2024] Open
Abstract
Background Childhood apraxia of speech (CAS) is a genetically heterogeneous pediatric motor speech disorder. The advent of whole exome sequencing (WES) and whole genome sequencing techniques has led to increased identification of pathogenic variants in CAS genes. In an as yet uncharacterized Italian cohort, we aimed both to identify new pathogenic gene variants associated with CAS, and to confirm the disease-related role of genes already reported by others. We also set out to refine the clinical and neurodevelopmental characterization of affected children, with the aim of identifying specific, gene-related phenotypes. Methods In a single-center study aiming to explore the genetic etiology of CAS in a cohort of 69 Italian children, WES was performed in the families of the 34 children found to have no copy number variants. Each of these families had only one child affected by CAS. Results High-confidence (HC) gene variants were identified in 7/34 probands, in two of whom they affected KAT6A and CREBBP, thus confirming the involvement of these genes in speech impairment. The other probands carried variants in low-confidence (LC) genes, and 20 of these variants occurred in genes not previously reported as associated with CAS. UBA6, ZFHX4, and KAT6A genes were found to be more enriched in the CAS cohort compared to control individuals. Our results also showed that most HC genes are involved in epigenetic mechanisms and are expressed in brain regions linked to language acquisition processes. Conclusion Our findings confirm a relatively high diagnostic yield in Italian patients.
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Affiliation(s)
- Daniela Formicola
- Department of Neurobiology and Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Irina Podda
- Parole al Centro Studio di Logopedia, Genoa, Italy
| | - Elia Dirupo
- Medical Genetics Unit, Meyer Children’s University Hospital IRCCS, Florence, Italy
| | - Elena Andreucci
- Medical Genetics Unit, Meyer Children’s University Hospital IRCCS, Florence, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola Cipriani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Scientific Institute, Pisa, Italy
| | - Clara Bombonato
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Scientific Institute, Pisa, Italy
| | - Filippo Maria Santorelli
- Department of Neurobiology and Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Scientific Institute, Pisa, Italy
| | - Anna Chilosi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Scientific Institute, Pisa, Italy
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Eyre M, Rose S, Gwynn R, Pressler RM, Clark M. Acquired motor speech disorders in childhood epilepsy. Dev Med Child Neurol 2024. [PMID: 39255362 DOI: 10.1111/dmcn.16091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 08/02/2024] [Accepted: 08/07/2024] [Indexed: 09/12/2024]
Abstract
AIM To evaluate a group of children with epilepsy and motor speech regression, with the aim of characterizing their speech disorders, electrographic features, and outcomes. METHOD Children referred to a tertiary developmental epilepsy clinic with epilepsy and motor speech regression were identified retrospectively. A clinical history was taken, and longitudinal speech and cognitive data were recorded. Speech samples were scored for severity and speech features. Seizure frequency and epileptiform discharges in the interictal electroencephalogram were analysed. RESULTS Eighteen children (10 female) were evaluated, including seven with Landau-Kleffner syndrome and six with Rasmussen syndrome. Speech regression occurred at a mean age of 5 years (SD = 2 years 6 months), which was concurrent with seizure onset or peak seizure burden in eight children. Speech features included dysarthria (n = 13), phonological errors (n = 7), and dyspraxia (n = 6). Electrographic abnormalities occurred most frequently in the left centrotemporal and right frontal regions. Among children who were followed up, intelligibility of speech was affected in 13 at baseline and seven at follow-up (p = 0.03). Expressive language standardized scores increased from a mean (SD) of 50.0 (11.3) to 91.4 (27.8) in children with Landau-Kleffner syndrome (mean change = 41.4, 95% confidence interval [CI] 0.04-82.8, p = 0.0498) and decreased from 75.2 (15.3) to 59.0 (9.8) in children with Rasmussen syndrome (mean change -16.2, 95% CI -9.0 to -23.4, p = 0.002) over the follow-up. INTERPRETATION Motor speech disorders in epilepsy were severe, multifarious, and often fluctuated with seizure burden. Symptoms typically improved, especially in children with Landau-Kleffner syndrome, but rarely fully resolved.
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Affiliation(s)
- Michael Eyre
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Children's Neurosciences, Evelina London Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Steve Rose
- Department of Neurodisability, Great Ormond Street Hospital for Children, London, UK
| | - Rachel Gwynn
- Department of Neurodisability, Great Ormond Street Hospital for Children, London, UK
| | - Ronit M Pressler
- Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children, London, UK
- Programme of Developmental Neurosciences, University College London National Institute for Health Research, Biomedical Research Centre, Great Ormond Street Institute of Child Health, London, UK
| | - Maria Clark
- Department of Neurodisability, Great Ormond Street Hospital for Children, London, UK
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Mitchel MW, Turner S, Walsh LK, Torene RI, Myers SM, Taylor CM. MED13L-related disorder characterized by severe motor speech impairment. RESEARCH SQUARE 2024:rs.3.rs-4790993. [PMID: 39257968 PMCID: PMC11384029 DOI: 10.21203/rs.3.rs-4790993/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
Background MED13L-related disorder is associated with intellectual disability, motor delay, and speech deficits. Previous studies have focused on broad clinical descriptions of individuals, but limited information regarding specific speech diagnoses and results of direct testing has been published to date. We conducted deep phenotyping to characterize the speech, language, motor, cognitive, and adaptive phenotypes of individuals with MED13L-related disorder. Methods In this cross-sectional study, we administered standardized articulation, language, motor, and cognitive testing to 17 children and adolescents (mean age 9y 9m; SD 4y 5m; range 4y 2m to 19y 7m). In-person testing was supplemented with broad developmental, medical, and behavioral information collected virtually from a cohort of 67 individuals. Results All individuals who completed in-person articulation testing met diagnostic criteria for speech apraxia, dysarthria, or both. Language impairment was present in all of the in-person cohort and almost all (97%) of the virtual cohort. Those who were able to complete motor testing demonstrated significant deficits in visual motor integration (mean 57.08, SD 9.26). Full scale IQs fell in the borderline to intellectual disability range, consistent with reported cognitive impairment in 97% of the virtual cohort. Notable medical features included hypotonia (83%), vision problems (72%), recurrent otitis media (58%), gastrointestinal problems (57%), and seizures (31%). Conclusions MED13L-related disorder is characterized by a high rate of motor speech disorders that occur in the context of globally impaired motor, language, and cognitive skills. Children would benefit from intensive, individualized speech therapy and the early adoption of augmentative communication strategies.
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Case J, Caspari S, Aggarwal P, Stoeckel R. A Goal-Writing Framework for Motor-Based Intervention for Childhood Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1590-1607. [PMID: 38754036 DOI: 10.1044/2024_ajslp-24-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
PURPOSE There are multiple frameworks for goal writing that are applicable to the practice of speech-language pathology. Motor-based speech disorders are a subset of speech sound disorders that are thought to require specific elements of intervention that are typically not addressed in the traditional frameworks used in the clinical setting. The purpose of this tutorial is to review general approaches of goal writing and suggest additional elements that may be used to improve the efficiency and effectiveness of treatment for childhood motor speech disorders, specifically childhood apraxia of speech (CAS). METHOD Existing models of goal writing were reviewed to ascertain elements common to most of these models. A basic framework was chosen and modified to include behaviors, conditions, and approaches to goal measurement tailored to the clinical needs of children with CAS. A resource for clinical decision making for children with CAS was developed to inform goal writing at the onset of treatment and adaptations that occur over the course of treatment. Case studies are presented to demonstrate how the presented framework can be applied to writing goals for motor-based treatment for two different children with CAS. DISCUSSION Children with CAS require a specialized approach to intervention, which requires goals to reflect the unique clinical needs of this population. This tutorial offers resources that use the best available research evidence and current understanding of effective treatment practices for CAS to guide clinical decision making for motor-based intervention and goal writing. This tutorial is intended to guide treatment planning across varied settings to facilitate progress and optimize treatment outcomes for children with CAS.
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Affiliation(s)
- Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Susan Caspari
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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López-Riobóo E, Martínez-Castilla P. Prosodic skills in Spanish-speaking adolescents and young adults with Down syndrome. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1284-1295. [PMID: 38152925 DOI: 10.1111/1460-6984.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Down syndrome (DS) is a neurodevelopmental disorder of genetic origin with a cognitive-behavioural profile that distinguishes it from other syndromes. Within this profile, language difficulties are particularly marked, having been more studied in childhood than in adulthood. More generally, there is a paucity of research on the prosodic skills of individuals with DS, despite the relevance of this linguistic component for effective communication. AIMS This study aimed to analyse, for the first time, the prosodic profile of Spanish-speaking teenagers and young adults with DS. We hypothesized that participants with DS would show significantly lower skills for the perception and production of prosodic functions and forms when compared to peers with intellectual disability (ID) of unknown origin. We also hypothesized that teenagers and young adults with DS would have better prosody perception than prosody production. METHODS & PROCEDURES The final sample included in the study comprised 28 Spanish-speaking teenagers and young adults with DS and 29 teenagers and young adults with other ID matched on chronological age and nonverbal cognition. Their prosodic skills were tested by means of the Profiling Elements of Prosody for Speech and Communication battery. This battery allows for the separate evaluation of the comprehension and expression of the communicative functions of prosody and the discrimination and production of the forms that carry out such functions. OUTCOMES & RESULTS In the prosody function tasks, which are the most adaptive tasks for the communicative process, we found, as expected, significantly lower scores on the turn-end, chunking, and focus tasks in the group with DS. However, no significant between-group differences were found for the affect tasks. Participants with DS also had significantly lower scores on the prosodic form tasks than participants with other ID. The results of the comparison between prosodic perception and production skills showed that a generalization about a better profile in comprehension versus production is not possible and that there is a dependence on the demands of the prosodic task undertaken. CONCLUSIONS & IMPLICATIONS The findings contribute to the ongoing development of the language profile of teenagers and young adults with DS and imply the need to design prosodic intervention programs based on their specific profile. WHAT THIS PAPER ADDS What is already known on the subject Prosody is a fundamental element of language, and its mastery affects the effectiveness of communication. However, research on prosody in Down syndrome (DS) that offers a holistic view from a psycholinguistic approach is still scarce. To date, studies focused on providing a detailed profile of prosodic skills in individuals with DS have been mainly conducted with a few English-speaking children. These studies have shown that the comprehension and production of prosody is severely impaired, especially when considering affect and focus production, as well as the perception and production of prosodic forms. During childhood, greater efficacy is found in prosody comprehension than in prosody expression. What this study adds This is the first study analysing the prosodic profile of a large group of Spanish-speaking teenagers and young adults with DS. Poorer performance in the perception and production of both prosodic functions and forms was observed in participants with DS compared to participants with intellectual disability of unknown origin matched on chronological age and nonverbal cognition. Unlike what has been previously found in children, teenagers and young adults with DS performed at the same level as the control group on the understanding and expression of affect through prosodic cues. Results also showed that a generalization about a better prosody profile in comprehension versus production is not possible. What are the clinical implications of this work? This study provides new data on the prosodic skills of Spanish-speaking teenagers and young adults with DS. Given the impact of prosody on effective communication and the pattern of difficulties found in this study, speech and language therapists working with individuals with DS should consider including prosodic skills in interventions not only in childhood but also in adolescence and adulthood. Therefore, the prosodic profile of strengths and weaknesses in individuals with DS found in this research has direct implications for clinical practice.
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Affiliation(s)
- Elena López-Riobóo
- Department of Developmental, and Educational Psychology, Universidad Nacional de Educación a Distancia, Facultad of Psychology, Madrid, Spain
- Fundación Síndrome de Down de Madrid, Madrid, Spain
| | - Pastora Martínez-Castilla
- Department of Developmental, and Educational Psychology, Universidad Nacional de Educación a Distancia, Facultad of Psychology, Madrid, Spain
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Wong ECH, Wong MN, Velleman SL. Acoustic Analyses of Tone Productions in Sequencing Contexts Among Cantonese-Speaking Preschool Children With and Without Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1682-1711. [PMID: 38662942 DOI: 10.1044/2024_jslhr-23-00383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE Pitch variations (tone productions) have been reported as a measure to differentiate Cantonese-speaking children with and without childhood apraxia of speech (CAS). This study aims to examine fundamental frequency (F0) changes within syllables and the effects of syllable structure, lexical status, and syllable positions on F0 in Cantonese-speaking preschool children with and without CAS. METHOD Six children with CAS, six children with non-CAS speech sound disorder plus language disorder (S&LD), 22 children with speech sound disorder only (SSD), and 63 children with typical speech-language development (TD) performed the tone sequencing task (TST). Growth curve analysis was employed to analyze and compare the F0 values within syllables with three Cantonese tones (high level, high rising, and low falling). The analysis considered the effects of syllable structure (vowel and consonant-vowel), lexical status (word and nonword), and syllable position (initial, medial, and final) on F0, as well as comparisons within and between groups. RESULTS Within each group, the effects of syllable structure and position on F0 values were found with different patterns. Between-group comparisons showed that the CAS group had reduced F0 contrasts. The CAS group could be differentiated from the control groups based on interactions of F0 with syllable structure and position, but not lexical status. The dissimilarity of F0 values detected between the CAS and SSD/TD groups was more prominent than that observed between the CAS and S&LD groups. CONCLUSIONS This study demonstrated that Cantonese-speaking children with CAS had difficulty in varying F0 within syllables as compared to those without CAS, suggesting pitch variation difficulty and language-specific impairment profiles in CAS. Future investigations of objective measures for identifying Cantonese speakers with CAS and cross-linguistic investigations using growth curve analysis and the TST are suggested.
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Affiliation(s)
- Eddy C H Wong
- Department of Chinese and Bilingual Studies, Faculty of Humanities, The Hong Kong Polytechnic University, Hung Hom
| | - Min Ney Wong
- Department of Chinese and Bilingual Studies, Faculty of Humanities, The Hong Kong Polytechnic University, Hung Hom
- Research Centre for Language, Cognition, and Neuroscience, The Hong Kong Polytechnic University, Hung Hom
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hung Hom
- The HK PolyU-PKU Research Centre on Chinese Linguistics, The Hong Kong Polytechnic University, Hung Hom
| | - Shelley L Velleman
- Department of Communication Sciences and Disorders, The University of Vermont, Burlington
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Maffei MF, Chenausky KV, Haenssler A, Abbiati C, Tager-Flusberg H, Green JR. Exploring Motor Speech Disorders in Low and Minimally Verbal Autistic Individuals: An Auditory-Perceptual Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1485-1503. [PMID: 38512040 DOI: 10.1044/2024_ajslp-23-00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
PURPOSE Motor deficits are widely documented among autistic individuals, and speech characteristics consistent with a motor speech disorder have been reported in prior literature. We conducted an auditory-perceptual analysis of speech production skills in low and minimally verbal autistic individuals as a step toward clarifying the nature of speech production impairments in this population and the potential link between oromotor functioning and language development. METHOD Fifty-four low or minimally verbal autistic individuals aged 4-18 years were video-recorded performing nonspeech oromotor tasks and producing phonemes, syllables, and words in imitation. Three trained speech-language pathologists provided auditory perceptual ratings of 11 speech features reflecting speech subsystem performance and overall speech production ability. The presence, attributes, and severity of signs of oromotor dysfunction were analyzed, as were relative performance on nonspeech and speech tasks and correlations between perceptual speech features and language skills. RESULTS AND CONCLUSIONS Our findings provide evidence of a motor speech disorder in this population, characterized by perceptual speech features including reduced intelligibility, decreased consonant and vowel precision, and impairments of speech coordination and consistency. Speech deficits were more associated with articulation than with other speech subsystems. Speech production was more impaired than nonspeech oromotor abilities in a subgroup of the sample. Oromotor deficits were significantly associated with expressive and receptive language skills. Findings are interpreted in the context of known characteristics of the pediatric motor speech disorders childhood apraxia of speech and childhood dysarthria. These results, if replicated in future studies, have significant potential to improve the early detection of language impairments, inform the development of speech and language interventions, and aid in the identification of neurobiological mechanisms influencing communication development.
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Affiliation(s)
- Marc F Maffei
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Karen V Chenausky
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
- Department of Neurology, Harvard Medical School, Boston, MA
| | - Abigail Haenssler
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Claudia Abbiati
- College of Nursing and Health Sciences, The University of Vermont, Burlington
| | | | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
- Speech and Hearing Bioscience and Technology Program, Harvard University, Cambridge, MA
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Uberti LB, Keske-Soares M, Pagliarin KC. Development of the Digital Speech Assessment Instrument. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1317-1336. [PMID: 38359165 DOI: 10.1044/2024_ajslp-23-00155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE This study aimed to develop a Digital Speech Assessment Instrument to evaluate the phonological and motor speech skills of Brazilian Portuguese-speaking children and adolescents through six tasks: (a) word naming, (b) word imitation, (c) pseudoword imitation, (d) word repetition, (e) pseudoword repetition, and (f) diadochokinesis. METHOD The assessment instrument was developed and validated in a seven-step process, beginning with stimulus selection and ending with Pilot Study 1 (involving children and adolescents with typical speech development) and Pilot Study 2 (involving children and adolescents with speech sound disorders [SSDs]). Participants of the study included expert and nonexpert judges, children, and adolescents. RESULTS The Digital Speech Assessment Instrument contains 91 real words (61 in the naming task, 51 in the imitation task, and five in the repetition task), 26 pseudowords (26 in the imitation task and four in the repetition task), and six stimuli for diadochokinesis. The test contains stimuli in the form of images as well as audio and video recordings and allows for the analysis and storage of participant data in a virtual database. CONCLUSIONS This study described the development of the Digital Speech Assessment Instrument, available in Brazilian Portuguese for the evaluation of several aspects of speech production (including word and pseudoword naming, imitation, and repetition and diadochokinesis). The test was developed for children aged 2;0 (years;months) to 17;11 and is administered fully online. In the future, the instrument can be used to provide a timely and accurate diagnosis of SSDs.
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Affiliation(s)
- Letícia Bitencourt Uberti
- Postgraduate Program in Human Communication Disorders, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - Marcia Keske-Soares
- Department of Speech, Language and Hearing, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - Karina Carlesso Pagliarin
- Department of Speech, Language and Hearing, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
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Tubi R, Ben-David A, Segal O. Characteristics of Lexical Stress in Hebrew-Speaking Children With Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:711-728. [PMID: 38376479 DOI: 10.1044/2023_jslhr-23-00205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
PURPOSE The purpose of the present study was to explore the ability of Hebrew-speaking children with childhood apraxia of speech (CAS) to produce lexical stress. METHOD A total of 36 children aged between 4 and 7 years, 18 children with CAS, and 18 typically developing (TD) children participated in the study. All children completed language and speech assessments. The children imitated 20 weak-strong and strong-weak target words within short sentences and in isolation. Acoustic analysis of the vowels in the stressed and unstressed syllables of the target words and perceptual judgment of the words by six speech-language pathologists were conducted. RESULTS The acoustic analysis showed significant differences in duration, fundamental frequency, and amplitude between stressed and unstressed vowels in weak-strong and strong-weak words and in both groups of children. The total duration for both the stressed and weak syllables was longer in children with CAS compared to TD children. Rated on a Likert scale of 1-5, where 5 indicates correct production, the productions of lexical stress in the CAS group were judged as above 4 on average but were significantly worse compared to the TD group. The target productions of children with CAS were judged as including excessive, equal, or misplaced stress in 10.8% of the productions, whereas 5.8% of the target productions of the TD children were judged as having inappropriate stress. CONCLUSIONS The present findings suggest that Hebrew-speaking children with CAS produce the acoustic characteristics of lexical stress similarly to their peers, and their productions are perceived as having relatively good lexical stress (above 4), although not as good as TD children.
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Affiliation(s)
- Rachel Tubi
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Avivit Ben-David
- Department of Communication Disorders, Hadassah Academic College, Jerusalem, Israel
| | - Osnat Segal
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Israel
- Sagol School of Neuroscience, Tel Aviv University, Israel
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Long HL, Christensen L, Hayes S, Hustad KC. Vocal Characteristics of Infants at Risk for Speech Motor Involvement: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4432-4460. [PMID: 37850852 PMCID: PMC10715844 DOI: 10.1044/2023_jslhr-23-00336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/13/2023] [Accepted: 08/20/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE The purpose of this scoping review was to (a) summarize methodological characteristics of studies examining vocal characteristics of infants at high risk for neurological speech motor involvement and (b) report the state of the high-quality evidence on vocal characteristic trends of infants diagnosed or at high risk for cerebral palsy (CP). METHOD The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) extension for scoping reviews was followed for reporting our review. Studies measured prelinguistic vocal characteristics of infants under 24 months with birth risk or genetic conditions known to commonly present with speech motor involvement. Fifty-five studies met criteria for Part 1. Eleven studies met criteria for synthesis in Part 2. RESULTS A smaller percentage of studies examined infants with or at risk for CP compared to studies examining genetic conditions such as Down syndrome. The median year of publication was 1999, with a median sample size of nine participants. Most studies were conducted in laboratory settings and used human coding of vocalizations produced during caregiver-child interactions. Substantial methodological differences were noted across all studies. A small number of high-quality studies of infants with or at risk for CP revealed high rates of marginal babbling, low rates of canonical babbling, and limited consonant diversity under 24 months. Mixed findings were noted across studies of general birth risk factors. CONCLUSIONS There is limited evidence available to support the early detection of speech motor involvement. Large methodological differences currently impact the ability to synthesize findings across studies. There is a critical need to conduct longitudinal research with larger sample sizes and advanced, modern technologies to detect vocal precursors of speech impairment to support the accurate diagnosis and prognosis of speech development in infants with CP and other clinical populations.
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Affiliation(s)
| | | | - Sydney Hayes
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | - Katherine C. Hustad
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
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Kuschmann A, Schölderle T, Haas E. Clinical Practice in Childhood Dysarthria: An Online Survey of German-Speaking Speech-Language Pathologists. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2802-2826. [PMID: 37707370 DOI: 10.1044/2023_ajslp-23-00076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE This survey study aimed to establish current clinical practices of German-speaking speech-language pathologists (SLPs) regarding their assessment and treatment of communication disorders in children with neurological conditions, with a particular focus on the management of childhood dysarthria. METHOD A 23-question cross-sectional online survey was disseminated to practicing SLPs in Germany, Austria, and Switzerland via relevant professional bodies. SLPs were invited to provide information on their current assessment and treatment practices. Demographic data including case load and clinical settings were also gathered to contextualize practices. RESULTS One hundred two SLPs responded to the survey, of which 68 valid responses were analyzed. German-speaking SLPs comprehensively assess and treat various aspects of overall communication, language, and swallowing functions in children with neurological conditions. Speech motor aspects did not represent a main intervention focus. In cases where the dysarthric component was targeted, specific approaches for childhood dysarthria were rarely used. Instead, SLPs reported using approaches developed for speech disorders other than dysarthria. CONCLUSIONS German-speaking SLPs working with children with neurological conditions use various assessment and treatment methods to support children's communication. However, dysarthria-specific approaches were not an established part of clinical practice. Results of the survey highlight the need for access to relevant developments in German and for evaluation of current curricula for speech-language pathology students and continuing education opportunities for practicing clinicians.
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Affiliation(s)
- Anja Kuschmann
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Theresa Schölderle
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-Universität, Munich, Germany
| | - Elisabet Haas
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-Universität, Munich, Germany
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Vuolo J, Kinross A, DeHart K. Manual Rhythmic Sequencing Skills in Children With Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3773-3790. [PMID: 37672791 DOI: 10.1044/2023_jslhr-23-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE Rhythm is one procedural mechanism that underlies language and motor skill acquisition and has been implicated in children with childhood apraxia of speech (CAS). The purpose of this study is to investigate manual rhythmic sequencing skills in children with a history of or current CAS (hx/CAS) compared to children with typical development (TD). METHOD Thirty-eight children (18 with hx/CAS, 20 with TD), ages 5;0-12;8 (years;months), from across the United States participated in an online study. Participants imitated two rhythms in two different conditions, clapping and tapping. We assessed overall accuracy, mean number of beats, pause marking, and rhythmic sequence variability using the Mann-Whitney U test. Effect sizes were calculated to examine the influence of coordinative complexity on performance. RESULTS Compared to children with TD, children with hx/CAS marked fewer trials with a pause in both conditions of the easier rhythm and showed lower overall accuracy and more variable rhythmic sequences in both rhythms and conditions. The mean number of beats produced by children with hx/CAS and children with TD did not differ in three out of four rhythms/conditions. Unlike children with TD, children with hx/CAS showed little improvement from clapping to tapping across most dependent measures; reducing coordination demands did not improve performance in children with hx/CAS. CONCLUSIONS We found that children with hx/CAS show manual rhythmic deficits that are similar to the deficits they display in speech. These findings provide support for a domain-general cognitive mechanisms account of the rhythmic deficits observed across linguistic and nonlinguistic tasks in children with hx/CAS. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24052821.
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Affiliation(s)
- Janet Vuolo
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | | | - Katlyn DeHart
- Department of Neuroscience, The Ohio State University, Columbus
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Allison K, Stoeckel R, Olsen E, Tallman S, Iuzzini-Seigel J. Motor Speech Phenotypes in Children With Epilepsy: Preliminary Findings. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1912-1922. [PMID: 36827527 DOI: 10.1044/2022_ajslp-22-00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE This exploratory study aimed to characterize motor speech impairments in a small sample of children with epilepsy, both with and without a known seizure etiology. A secondary aim was to evaluate the validity of the Profile for Childhood Apraxia of speech and Dysarthria (ProCAD), a newly developed tool for differential diagnosis of childhood apraxia of speech and dysarthria. METHOD Thirteen children with seizure disorders completed a comprehensive speech and language assessment. Three expert speech-language pathologists rated the presence of auditory-perceptual features of motor speech impairment using the ProCAD. Motor speech features, diagnoses, and standardized test scores were compared between children with a known seizure etiology and children with idiopathic epilepsy. RESULTS Nine of the 13 children exhibited motor speech impairment; dysarthria was the most common diagnosis. Most children (11/13) exhibited language impairment. Group comparisons showed that children with a known seizure etiology had more atypical motor speech features and lower language scores than children with idiopathic seizures. CONCLUSION These preliminary findings suggest a high rate of motor speech impairment among children with epilepsy.
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Affiliation(s)
| | - Ruth Stoeckel
- Division of Neurology, Department of Speech Pathology, Mayo Clinic (retired), Rochester, MN
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Iuzzini-Seigel J, Case J, Grigos MI, Velleman SL, Thomas D, Murray E. Dose frequency randomized controlled trial for Dynamic Temporal and Tactile Cueing (DTTC) treatment for childhood apraxia of speech: protocol paper. BMC Pediatr 2023; 23:263. [PMID: 37226208 PMCID: PMC10208915 DOI: 10.1186/s12887-023-04066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/10/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Childhood apraxia of speech (CAS) is a pediatric motor-based speech sound disorder that requires a specialized approach to intervention. The extant literature on the treatment of CAS commonly recommends intensive treatment using a motor-based approach, with some of the best evidence supporting the use of Dynamic Temporal and Tactile Cueing (DTTC). To date, a rigorous and systematic comparison of high and low dose frequency (i.e., frequency of therapy sessions) has not been undertaken for DTTC, resulting in a lack of evidence to guide decisions about the optimal treatment schedule for this intervention. The current study aims to fill this gap in knowledge by comparing treatment outcomes when dose frequency is varied. METHODS A randomized controlled trial will be conducted to examine the efficacy of low versus high dose frequency on DTTC treatment outcomes in children with CAS. A target of 60 children, 2;6-7;11 years of age, will be recruited to participate in this study. Treatment will be provided in the community setting by speech-language pathologists who have completed specialized training administering DTTC in a research reliable manner. True randomization with concealed allocation will be used to assign children to either the low or high dose frequency group. Treatment will be administered in 1-h sessions either 4 times per week over a 6-week period (high dose) or 2 times per week over a 12-week period (low dose). To measure treatment gains, probe data will be collected before treatment, during treatment, and 1 day, 1 week, 4 weeks, and 12 weeks post-treatment. Probe data will consist of customized treated words and a standard set of untreated words to assess generalization of treatment gains. The primary outcome variable will be whole word accuracy, encompassing segmental, phonotactic, and suprasegmental accuracy. DISCUSSION This will be the first randomized controlled trial to evaluate dose frequency for DTTC treatment in children with CAS. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT05675306, January 6, 2023.
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Affiliation(s)
- Jenya Iuzzini-Seigel
- Department of Speech Pathology and Audiology, Marquette University, PO Box 1881, Harriet Barker Cramer Hall, Milwaukee, WI, 53201, USA.
| | - Julie Case
- Speech-Language-Hearing Sciences, Hofstra University, Davison Hall 106B, 110, Hempstead, NY, 11549, USA
| | - Maria I Grigos
- Communicative Sciences and Disorders, New York University, 665 Broadway, 9th floor, New York, NY, 10012, USA
| | - Shelley L Velleman
- University of Vermont, Pomeroy Hall, 489 Main St, Burlington, VT, 05405, USA
| | - Donna Thomas
- University of Sydney, Susan Wakil Health Building, Western Avenue, Camperdown, NSW, 2006, Australia
| | - Elizabeth Murray
- University of Sydney, Susan Wakil Health Building, Western Avenue, Camperdown, NSW, 2006, Australia
- Remarkable Speech and Movement, 52 Anderson Avenue, Panania, NSW, 2213, Australia
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Maffei MF, Chenausky KV, Gill SV, Tager-Flusberg H, Green JR. Oromotor skills in autism spectrum disorder: A scoping review. Autism Res 2023; 16:879-917. [PMID: 37010327 PMCID: PMC10365059 DOI: 10.1002/aur.2923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
Oromotor functioning plays a foundational role in spoken communication and feeding, two areas of significant difficulty for many autistic individuals. However, despite years of research and established differences in gross and fine motor skills in this population, there is currently no clear consensus regarding the presence or nature of oral motor control deficits in autistic individuals. In this scoping review, we summarize research published between 1994 and 2022 to answer the following research questions: (1) What methods have been used to investigate oromotor functioning in autistic individuals? (2) Which oromotor behaviors have been investigated in this population? and (3) What conclusions can be drawn regarding oromotor skills in this population? Seven online databases were searched resulting in 107 studies meeting our inclusion criteria. Included studies varied widely in sample characteristics, behaviors analyzed, and research methodology. The large majority (81%) of included studies report a significant oromotor abnormality related to speech production, nonspeech oromotor skills, or feeding within a sample of autistic individuals based on age norms or in comparison to a control group. We examine these findings to identify trends, address methodological aspects hindering cross-study synthesis and generalization, and provide suggestions for future research.
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Affiliation(s)
- Marc F. Maffei
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Karen V. Chenausky
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Neurology Department, Harvard Medical School, Boston, Massachusetts, USA
| | - Simone V. Gill
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, Massachusetts, USA
| | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Jordan R. Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Speech and Hearing Biosciences and Technology Program, Harvard University, Cambridge, Massachusetts, USA
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Grønbæk JK, Boeg Thomsen D, Persson K, Mathiasen R, Juhler M. The Cerebellar Mutism Syndrome: Risk Assessment, Prevention and Treatment. Adv Tech Stand Neurosurg 2023; 46:65-94. [PMID: 37318570 DOI: 10.1007/978-3-031-28202-7_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Cerebellar mutism syndrome (CMS) has received increasing attention over the last decades as a complication of posterior fossa tumour surgery in children. Risk factors, aetiological aspects, and treatment measures of the syndrome have been investigated, yet the incidence of CMS remains unchanged. Overall, we are currently able to identify patients at risk, but we are unable to prevent it from occurring.Once CMS sets in, several symptomatic pharmacological treatments have been suggested, but only in smaller case series and not in randomized controlled trials, and it is not clear whether the treatment or time itself had a helpful effect.Within weeks to months, most patients regain their ability to speak after a phase with mutism or severely reduced speech; however, many patients continue to have speech and language deficits. At this point, anti-cancer treatment with chemotherapy and radiotherapy may be of focus more than the prognosis of CMS; however, many patients continue to have speech and language problems for months and years to come, and they are at high risk of other neurocognitive sequelae as well.Without reliable measures to prevent or treat the syndrome, we may look towards improving the prognosis of speech and neurocognitive functioning in these patients. As speech and language impairment is the cardinal symptom and late effect of CMS, the effect of intense and early-onset speech and language therapy as a standard of care in these patients should be investigated in relation to its effect on regaining speech capacity.
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Affiliation(s)
- Jonathan Kjær Grønbæk
- Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Ditte Boeg Thomsen
- Department of Cross-Cultural and Regional Studies, University of Copenhagen, Copenhagen, Denmark
| | - Karin Persson
- Department of Health Sciences, Lund University, Lund, Sweden
- Child and Youth Rehabilitation Services, Lund, Sweden
| | - René Mathiasen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Marianne Juhler
- Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
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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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Iuzzini-Seigel J, Moorer L, Tamplain P. An Investigation of Developmental Coordination Disorder Characteristics in Children With Childhood Apraxia of Speech. Lang Speech Hear Serv Sch 2022; 53:1006-1021. [PMID: 36041512 DOI: 10.1044/2022_lshss-21-00163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Children with childhood apraxia of speech (CAS) evidence a high rate of co-occurring fine and gross motor deficits. This clinical focus article reports a preliminary investigation of characteristics of developmental coordination disorder (DCD), a neurodevelopmental disorder categorized by poor motor proficiency and functional limitations, in this population. METHOD Children with CAS underwent a comprehensive motor evaluation using the Movement Assessment Battery for Children-Second Edition, the Developmental Coordination Disorder Questionnaire, and a developmental history questionnaire to determine if they met criteria for a DCD diagnosis as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). RESULTS Six out of seven participants met DCD criteria based on the DSM-5 criteria. Four of these children had a co-occurring diagnosis of developmental language disorder, and all met criteria for DCD. CONCLUSIONS Consistent with previous research, the majority of participants demonstrated motor deficits and 85% met criteria for DCD. Despite this high rate of motor deficits, only 57% had previously undergone a physical/occupational therapy evaluation and intervention and only one had a previous diagnosis of DCD. These findings suggest that formal movement assessments are essential for children with a CAS diagnosis. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20540193.
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