Childhood apraxia of speech (CAS) is an uncommon neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g., abnormal reflexes, abnormal tone). CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known and unknown origin, or as an idiopathic neurogenic speech sound disorder. The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody. Since the identification of CAS, there is no agreed upon standard that can distinguish complex symptoms of the disorder from other speech sound disorders. The gold standard in diagnosis is expert opinion. Purpose: The purpose of this study was to investigate the current knowledge for the diagnosis of CAS by speech and language therapists in Turkey and to compare the speech characteristics and symptoms expressed by therapists in the survey to current body of knowledge in the literature. Method: Participants in this survey were 30 speech and language therapists (SLT) practicing in Turkey. In order to assess their experiences and practical approaches regarding CAS, a structured questionnaire was devised using previous studies in the literature. The survey included 2 sections and 15 questions. The first section, consisted of items regarding the participants' knowledge and clinical experiences on CAS. In the second section, the criteria used by the participants in the diagnosis of CAS were included. Several different response types were used in this survey such as multiple choice questions and a Likert-type scale (with a range of 1-5). The survey was delivered to the participants in printed form. Frequency analysis was used to analyze the data in this survey. Results: The eight speech characteristics used by SLT in Turkey in the diagnosis of CAS were found to be: groping (89%), frequent vowel error/ distortions (87%), motor planning/programming difficulties (87%), effortful productions/struggle (85%), more errors with increased utterance length (85%), reduced intelligibility (84%), being better on automatic speech than voluntary (84%) and difficulty with articulatory coordination for speech (84%). All listed characteristics were consistent with the American Speech Hearing Association (ASHA) consensus based features, Strand’s 10 point checklist and the diagnostic model proposed by Ozanne. Furthermore, according to the participants, the most common disorders that accompany CAS were; regression of word production (75%) and decreased mean length of utterance (74%). Conclusion: The results of this study are similar to those of previous surveys in different languages and similarly there is no agreed upon criteria in the diagnosis of CAS in Turkey.
Keywords
childhood apraxia of speech, differential diagnosis, comorbid deficits, groping
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