Through the magnifying glass: Underlying literacy deficits and remediation potential in Childhood Apraxia of Speech

Communication Disorders, 358 N. Pleasant St., University of Massachusetts Amherst, Amherst, MA 01003-9296, USA.
International Journal of Speech-Language Pathology (Impact Factor: 1.24). 02/2010; 12(1):58-68. DOI: 10.3109/17549500903216720
Source: PubMed


Interactions among psycholinguistic deficits and literacy difficulties in childhood apraxia of speech (CAS) have been inadequately studied. Comparisons with other disorders (Specific Language Impairment (SLI) and phonological dyslexia) and the possibility of reading remediation in CAS warrant further research. This case study describes the speech, language, cognitive, and literacy deficits and therapy gains in a girl aged 11;6 with severe CAS and borderline IQ. A comprehensive assessment of literacy-related cognitive skills, including phonological memory and working memory capacity, language, speech production and reading skills, was administered. Treatment from 6;0 to 11;6 targeted speech sounds, oral sequencing, phonological awareness (PA), speech-print connections, syllabic structure, and real and non-word decoding. Phonological memory was similar to that of children with SLI, but working memory was significantly worse. Unlike children with phonological dyslexia, our participant demonstrated relative strength in letter-sound correspondence rules. Despite deficits, she made progress in literacy with intensive long-term intervention. Results suggest that the underlying cognitive-linguistic profile of children with CAS may differ from those of children with SLI or dyslexia. Our results also show that long-term intensive intervention promotes acquisition of adequate literacy skills even in a child with a severe motor speech disorder and borderline IQ.

34 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although not the focus of her article, phonological development in young children with speech sound disorders of various types is highly germane to Stoel-Gammon's discussion (this issue) for at least two primary reasons. Most obvious is that typical processes and milestones of phonological development are the standards and benchmarks against which we measure disorder and delay. Factors that impact children without disorders may suggest underlying causes or co-occurring symptoms of speech sound deficits, prognostic indicators of improvement, appropriate remediation strategies or some combination of these. Equally important is the fact that studying children with disorders can help us to verify and, in some cases, even unpack relationships among factors that are so closely interwoven in children who develop their phonologies at the typically very rapid rate that their individual influences cannot be discerned. Childhood Apraxia of Speech (CAS) is a particularly interesting case in point because, while it is universally accepted to be a motor speech disorder, symptoms include deficits in speech perception and often in literacy-related skills as well.
    No preview · Article · Oct 2010 · Journal of Child Language
  • [Show abstract] [Hide abstract]
    ABSTRACT: Impaired lexical stress production characterizes multiple pediatric speech disorders. Effective remediation strategies are not available, and little is known about the normal process of learning to assign and produce lexical stress. This study examined whether typically developing (TD) children can be trained to produce lexical stress on bisyllabic pseudowords that are orthographically biased to a strong-weak or weak-strong pattern (e.g., MAMbey or beDOON), in combination with the principles of motor learning (PML). Fourteen TD children ages 5;0 (years;months) to 13;0 were randomly assigned to a training or control group using concealed allocation within blocks. A pre- to posttraining group design was used to examine the acquisition, retention, and generalization of lexical stress production. The training group learned to produce appropriate lexical stress for the pseudowords with strong maintenance and generalization to related untrained stimuli. Accuracy of stress production did not change in the control group. TD children can learn to produce lexical stress patterns for orthographically biased pseudowords via explicit training methods. Findings have relevance for the study of languages other than English and for a range of prosodic disorders.
    No preview · Article · Mar 2012 · American Journal of Speech-Language Pathology
  • [Show abstract] [Hide abstract]
    ABSTRACT: The gold standard for diagnosing childhood apraxia of speech (CAS) is expert judgment of perceptual features. The aim of this study was to identify a set of objective measures that differentiate CAS from other speech disorders. Seventy-two children (4-12 years) diagnosed with suspected CAS by community speech-language pathologists were screened. Forty-seven participants underwent diagnostic assessment including presence/absence of perceptual CAS features. Twenty-eight children met 2 sets of diagnostic criteria for CAS (ASHA, 2007b; Shriberg, Potter & Strand, 2009); another 4 met the CAS criteria with co-morbidity. Fifteen were categorized as non-CAS with phonological impairment, submucous cleft, or dysarthria. Following this, 24 different measures from the diagnostic assessment were rated by blinded raters. Multivariate discriminant function analysis was used to identify the combination of measures that best predicted expert diagnoses. The discriminant function analysis model, including syllable segregation, lexical stress matches, and percent phonemes correct from a polysyllabic picture-naming task, and articulatory accuracy on repetition of /pətəkə/, reached 91% diagnostic accuracy against expert diagnosis. Polysyllabic production accuracy and an oral motor examination that includes diadochokinesis may be sufficient to reliably identify CAS and rule out structural abnormality or dysarthria. Testing with a larger unselected sample is required.
    No preview · Article · Dec 2014 · Journal of Speech Language and Hearing Research