A Multivariate Analytic Approach to the Differential Diagnosis of Apraxia of Speech

Basilakos, Alexandra; Yourganov, Grigori; Ouden, Dirk-Bart den; Fogerty, Daniel; Rorden, Chris; Feenaughty, Lynda; Fridriksson, Julius

doi:10.1044/2017_jslhr-s-16-0443

Cited by 34 publications

(35 citation statements)

References 63 publications

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“…A fourth potential explanation for the inconsistency found in this review relates to assessment methods in AOS and in particular the lack of a ‘gold standard’ diagnostic test (Basilakos et al . : 1). Just 11 studies referenced the use of a formal assessment for diagnosis of AOS.…”

Section: Discussionmentioning

confidence: 99%

“…, Basilakos et al . ), thus contributing further to variability in the diagnostic process. This issue has been exacerbated by the paucity of valid and reliable measures for quantifying AOS in practice (Strand et al .…”

Section: Introductionmentioning

confidence: 98%

“…, Basilakos et al . ). Amidst this diagnostic uncertainty, concerns have arisen regarding the potential use of diverse diagnostic criteria to select participants for AOS research.…”

Section: Introductionmentioning

confidence: 99%

“…, Basilakos et al . ). The only standardized assessment battery for AOS is the Apraxia Battery for Adults (Dabul ) designed to elicit 15 speech features (considered characteristic of AOS by the developers) in order to determine the presence and severity of the disorder.…”

Section: Introductionmentioning

confidence: 99%

“…The continued lack of a ‘gold standard’ assessment for AOS (Basilakos et al . : 1) has increased reliance on checklists of diagnostic criteria (Mumby et al . ) which are open to subjective interpretation as described above and have been criticized for their lack of empirical validation (Cunningham et al .…”

Section: Introductionmentioning

confidence: 99%

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Use of diverse diagnostic criteria for acquired apraxia of speech: a scoping review

Molloy

Jagoe

2019

Intl J Lang & Comm Disor

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Background: There is a growing body of evidence that speech and language therapy (SLT) intervention is effective in improving communication ability for individuals with non-progressive acquired apraxia of speech (AOS). However, there is no universally agreed diagnostic standard for AOS, and diverging opinions on its diagnostic features. This has led to claims that diverse diagnostic criteria may be used to select participants for AOS research studies. These claims raise concerns for evidence-based practice in AOS but have yet to be systematically investigated. Aims: To determine the presence, nature and extent of diversity in the diagnostic criteria for non-progressive AOS used in both published studies and clinical practice internationally. Methods & Procedures:The study used a scoping review methodology that followed the 2005 framework of Arksey and O'Malley and included a consultation exercise in the form of an online survey of international SLTs. The scoping review included 157 studies involving participants with acquired AOS, published between 1997 and 2017. There were 264 respondents to the online survey of SLTs, with a completion rate of 72%. Respondents came from 15 countries and had varying levels of clinical experience. Main Contribution: This study found that no common set of diagnostic criteria for AOS was used universally across research and practice. Although the diagnostic criteria used to select participants with AOS were reported explicitly in most studies, they varied from study to study. Some studies used directly conflicting criteria. Use of specific diagnostic criteria in studies was influenced by year of publication but not by location. There was a trend towards increasing consistency in diagnostic criteria in recent years. Compared with the research, the survey revealed relatively greater consistency among SLTs on the speech features considered indicative of AOS, although the SLTs who responded to the survey showed variation in how diagnostic criteria were combined into sets. Use of specific diagnostic criteria was not associated with SLTs' location or experience. There were differences between the diagnostic criteria for AOS used most commonly in research studies and those selected most commonly by SLTs in the survey. These findings have implications for the generalizability of AOS research to clinical practice, as well as implications for effective research synthesis. Conclusions & Implications:The claim that research and practice in the field of AOS is characterized by the use of diverse diagnostic criteria is supported by this scoping review. The findings support the need to develop a universal consensus standard for AOS diagnosis to ensure consistency across research and clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

“…, Basilakos et al . ). Amidst this diagnostic uncertainty, concerns have arisen regarding the potential use of diverse diagnostic criteria to select participants for AOS research.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of diverse diagnostic criteria for acquired apraxia of speech: a scoping review

Molloy

Jagoe

2019

Intl J Lang & Comm Disor

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The efficacy of acoustic-based articulatory phenotyping for characterizing and classifying four divergent neurodegenerative diseases using sequential motion rates

et al. 2022

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Despite the impacts of neurodegeneration on speech function, little is known about how to comprehensively characterize the resulting speech abnormalities using a set of objective measures. Quantitative phenotyping of speech motor impairments may have important implications for identifying clinical syndromes and their underlying etiologies, monitoring disease progression over time, and improving treatment efficacy. The goal of this research was to investigate the validity and classification accuracy of comprehensive acoustic-based articulatory phenotypes in speakers with distinct neurodegenerative diseases. Articulatory phenotypes were characterized based on acoustic features that were selected to represent five components of motor performance: Coordination, Consistency, Speed, Precision, and Rate. The phenotypes were first used to characterize the articulatory abnormalities across four progressive neurologic diseases known to have divergent speech motor deficits: amyotrophic lateral sclerosis (ALS), progressive ataxia (PA), Parkinson's disease (PD), and the nonfluent variant of primary progressive aphasia and progressive apraxia of speech (nfPPA+PAOS). We then examined the efficacy of articulatory phenotyping for disease classification. Acoustic analyses were conducted on audio recordings of 217 participants (i.e., 46 ALS, 52 PA, 60 PD, 20 nfPPA+PAOS, and 39 controls) during a sequential speech task. Results revealed evidence of distinct articulatory phenotypes for the four clinical groups and that the phenotypes demonstrated strong classification accuracy for all groups except ALS. Our results highlight the phenotypic variability present across neurodegenerative diseases, which, in turn, may inform (1) the differential diagnosis of neurological diseases and (2) the development of sensitive outcome measures for monitoring disease progression or assessing treatment efficacy.

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Types of motor speech impairments associated with neurologic diseases

Basilakos

Fridriksson

2022

Handbook of Clinical Neurology

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A Multivariate Analytic Approach to the Differential Diagnosis of Apraxia of Speech

Abstract: https://doi.org/10.23641/asha.5611309.

Cited by 34 publications

References 63 publications

Use of diverse diagnostic criteria for acquired apraxia of speech: a scoping review

Use of diverse diagnostic criteria for acquired apraxia of speech: a scoping review

The efficacy of acoustic-based articulatory phenotyping for characterizing and classifying four divergent neurodegenerative diseases using sequential motion rates

Types of motor speech impairments associated with neurologic diseases

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