Search

Purpose: While there has been mounting research centered on the diagnosis of childhood apraxia of speech (CAS), little has focused on differentiating CAS from pediatric dysarthria. Because CAS and dysarthria share overlapping speech symptoms and some children have both motor speech disorders, differential diagnosis can be challenging. There is a need for clinical tools that facilitate assessment of both CAS and dysarthria symptoms in children. The goals of this tutorial are to (a) determine confidence levels of clinicians in differentially diagnosing dysarthria and CAS and (b) provide a systematic procedure for differentiating CAS and pediatric dysarthria in children. Method: Evidence related to differential diagnosis of CAS and dysarthria is reviewed. Next, a web-based survey of 359 pediatric speech-language pathologists is used to determine clinical confidence levels in diagnosing CAS and dysarthria. Finally, a checklist of pediatric auditory-perceptual motor speech features is presented along with a procedure to identify CAS and dysarthria in children with suspected motor speech impairments. Case studies illustrate application of this protocol, and treatment implications for complex cases are discussed. Results: The majority (60%) of clinician respondents reported low or no confidence in diagnosing dysarthria in children, and 40% reported they tend not to make this diagnosis as a result. Going forward, clinicians can use the feature checklist and protocol in this tutorial to support the differential diagnosis of CAS and dysarthria in clinical practice. Conclusions: Incorporating this diagnostic protocol into clinical practice should help increase confidence and accuracy in diagnosing motor speech disorders in children. Future research should test the sensitivity and specificity of this protocol in a large sample of children with varying speech sound disorders. Graduate programs and continuing education trainings should provide opportunities to practice rating speech features for children with dysarthria and CAS.

Purpose: This study aimed to examine the contribution of speech motor impairment (SMI), language impairment, and communication modality to communicative and overall participation outcomes in school-age children with cerebral palsy (CP). Method: Eighty-one caregivers of children with CP provided information about their child's speech and language skills, communication modality, and participation through a web-based survey. Caregiver responses to two validated scales were used to quantify children's communicative participation and overall participation. Children were classified into four speech-language profile groups and three communication modality groups for comparison, based on caregiver-reported information regarding their child's communication skills. Results: Children with CP who had co-occurring SMI and language impairment had significantly lower levels of communicative participation and involvement in activities overall, compared to children with SMI alone. Among children with SMI, augmentative and alternative communication (AAC) use was associated with greater overall frequency of participation and involvement in life activities. Conclusion: Children with CP who have both SMI and language impairment and those who are nonspeaking communicators should be prioritized early for communication interventions focused on maximizing participation, including consideration of AAC. [ABSTRACT FROM AUTHOR]