Intended Audience
This article is about SLPs assessing the necessities of children who have been diagnosed with childhood apraxia of speech. CAS is very difficult to diagnosis, but the correct diagnosis is extremely important. Throughout this article, it gives a breakdown of various techniques and tests, as well as important aspects in the process of differentiating between CAS and other speech sound disorders. This information is more guided towards SLPs in the pediatric field as a guidance to making the correct diagnosis.
Article Description/Summary
The International Classification of Functioning (ICF) framework was used in order to create a basis for assessing CAS and understanding the underlying features in determining the appropriate diagnosis. There was and currently is an issue in relation to CAS characteristics having impairments that overlay with other disorders causing confident diagnostics to become difficult. There are three components in which the framework uses for characterization purposes: body structure and function, limitations, and restrictions. Other factors may affect the prognosis of individuals with CAS other than what has been included through the framework. Diagnosis of Childhood of Speech is not associated with structural deficits rather than being associated with functional deficits. In order for correct diagnosis, SLPs typically use the following two various tests to collect data on the speech production on single words and repeated words and phrases, and speech connections: Goldman-Fristoe Test of Articulation or the Single Word Tests of Polysyllables. There are several features that are commonly associated with CAS, each broken down with the subsystem and the accuracy in each area of testing in deciphering the prognosis.
According to Iuzzini-Seigel and colleagues, there are several features that accurately were differentiating symptoms. Vowel errors, which are associated with the articulatory subsystem, were proven to have at least one vowel error during testing in children with CAS. In the prosodic subsystem, stress errors had measures that proved 80% accuracy in determining children with CAS and those with non-CAS speech. Another strong main feature is syllable segregation. Studies show that 75% of school-aged children evidenced at least one response of segregation of syllables. In the articulatory subsystem, difficulty achieving initial articulatory configuration and speech sound inconsistency can be considered accurate and precise features in diagnosing Childhood Apraxia of Speech.
However, there were also features that did not give a precise distinction between CAS and other speech sound disorders. In the articulatory subsystem, consonant distortion was prevalent in other disorder types and those with CAS were not specifically associated. Grouping articulatory cannot be a mandatory to receive CAS, due to the other disorders that are also affected under this category. Another feature that did not clearly differentiate between CAS and speech sound disorders is inclusive schwa. Although there was a high prevalence in voicing errors that occurred in children with CAS rather than those who do not have childhood apraxia of speech, it cannot be an accurate representation in determining the disorders because of the overlay. The 18% accuracy in CAS, slow rate is also associated with dysarthria and cannot be a valid distinction. Resonance is another feature that is often related to other disorders and can be considered unreliable.
Conclusions
Overall, when the correct diagnosis is made in a timely manner, there can and will be improvement in children who receive services for childhood apraxia of speech. It is important to test all aspects of speech and language to provide the best treatment option and to assess every aspect of the child’s cognitive and linguistic abilities. The severity of the disorder and the involvement of caretakers or parents have an effect in limitations and restrictions. It is important to consider all aspects when managing children with CAS the personal and environmental factors, as well as the cognitive-linguistic functions. The information presented in this article was extremely helpful in making connections to my observations of CAS throughout this past semester.
References
Iuzzini-Seigel, J. & Murray, E. (2017). Speech Assessment in Children With Childhood Apraxia of Speech. Perspect ASHA SIGs, 2 (SIG 2), 47–60. doi: 10.1044/persp2.SIG2.47