Assessment and Diagnostic Standards of Apraxia of Speech in Chinese-Speaking Adults and Children: A Scoping Review

Wong, Eddy C H; Wong, Min Ney; Velleman, Shelley L.

doi:10.1044/2022_ajslp-21-00355

Cited by 5 publications

(4 citation statements)

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“…Generally, SLPs in Hong Kong report having "a little" or "fair" understanding of CAS. Given that there have been few investigations of Cantonese speakers with CAS [58] and insufficient numbers of trainings or other resources for self-instruction to equip the clinicians, the local clinicians can only rely on their actual clinical experience. As CAS is not a commonly seen speech sound disorder and about half of the respondents (46.8%) had never worked with any children with CAS, the general understanding among clinicians is limited.…”

Section: Principal Resultsmentioning

confidence: 99%

“…Results showed that the respondents did not use any standardized assessments that were specifically designed for children with CAS. This is unsurprising because there are no valid and reliable assessment tools available for Chinese speakers with CAS [58].…”

Section: Principal Resultsmentioning

confidence: 99%

“…Less experienced SLPs had less than ten years of clinical experience, while more experienced SLPs had ten or more years of clinical experience. This cut-off was based on the standard for CAS expertise among Chinese SLPs [58]. In order to examine the contributing factors to self-descriptions of CAS understanding levels, correlation analyses were performed.…”

Section: Discussionmentioning

confidence: 99%

“…Direct investigation of CAS in Cantonese speakers is scarce. In a recent scoping review, a total of four studies with a focus on Cantonese CAS were identified [58]. Wong [42] demonstrated the efficacy of a combined treatment approach of the syllable repetition method and modified DTTC therapy with two Cantonese speakers with CAS.…”

Section: Cas In Cantonese-speaking Populationsmentioning

confidence: 99%

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Clinical practice of childhood apraxia of speech in Hong Kong: A web-based survey study

Wong

Velleman

2023

PLoS ONE

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Background A survey study on clinical practice not only provides insight into the implementation of knowledge, but also informs future investigations. There is a limited understanding of childhood apraxia of speech (CAS) in Cantonese speakers. This study examined the clinical practice of CAS in Hong Kong and discussed future directions of research for better evidence-based practice. Methods Qualified Hong Kong pediatric speech-language pathologists (SLPs) completed the online questionnaire, which had a total of 48 questions regarding their knowledge of and experience with CAS in Cantonese speakers, including assessment, diagnosis, and treatment. Results Seventy-seven responses were received from Hong Kong SLPs. Most of the SLPs (83.2%) rated their understanding of CAS as either “a little” or “fair”. About half (53.2%) of the respondents had worked with children with CAS. No standardized assessment or objective/quantitative measures were used clinically. Instead, seven assessment tasks, including imitation of polysyllabic words and speech and language samples were used commonly. Perceptual judgment of clinical features is still the most popular approach for diagnosis, with a variety of lists in use. Of concern was that, in addition to using some evidence-based approaches, local SLPs treated CAS using approaches that have limited evidence, in the context of less treatment frequency, targeting both speech and language skills within the same session, and with only partial implementation of the approaches. Conclusions The results suggest that the understanding of CAS among local SLPs requires attention. One reason for this is that evidence regarding the assessment, diagnosis, and treatment of Cantonese speakers with CAS is still limited. Future investigations are needed.

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Section: Principal Resultsmentioning

confidence: 99%

Section: Principal Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Cas In Cantonese-speaking Populationsmentioning

confidence: 99%

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Clinical practice of childhood apraxia of speech in Hong Kong: A web-based survey study

Wong

Velleman

2023

PLoS ONE

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Discourse Task Type–Specific Linguistic Characteristics in Anomic Aphasia and Healthy Controls: Evidence From Mandarin–Chinese AphasiaBank

Deng,

Gao,

Liang

et al. 2024

Am J Speech Lang Pathol

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Purpose: This study was designed to examine the hypothesis that discourse task types influence language performance in Mandarin Chinese–speaking people and to reveal the discourse task-specific linguistic properties of persons with anomic aphasia compared to neurotypical controls. Method: Language samples from persons with aphasia ( n = 31) and age- and education-matched controls ( n = 31) across four discourse tasks (sequential-picture description, single-picture description, story narrative, and procedural discourse) were collected from Mandarin AphasiaBank. Task-specific distributions of parts of speech were analyzed using mosaic plots. The main effects of tasks in each group and the between-group differences within each task for several typical linguistic variables were evaluated, including the mean length of utterance, tokens, moving-average type-token ratio, words per minute, propositional density, noun–verb ratio, noun percentage, and verb percentage. Results: The results revealed an impact of discourse tasks on most language variables in both groups. In the healthy controls, story narratives yielded the highest total words and lowest verb percentage. In the aphasia group, procedural discourse elicited the fewest total words and densest expressions, whereas their single-picture descriptions had the highest noun–verb ratio. For all tasks, the aphasia group performed worse than the control group in the mean length of utterance, tokens, moving-average type-token ratio, and words per minute. For noun–verb ratio, noun percentage, and verb percentage, only one task (i.e., single-picture description) showed significant between-group differences. Conclusion: The selection of discourse tasks should be addressed in assessments and interventions for Mandarin Chinese–speaking individuals with aphasia to obtain more accurate and feasible outcomes.

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The Reliability of Expert Diagnosis of Childhood Apraxia of Speech

Murray,

Velleman,

Preston

et al. 2023

J Speech Lang Hear Res

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Purpose: The current standard for clinical diagnosis of childhood apraxia of speech (CAS) is expert clinician judgment. The psychometric properties of this standard are not well understood; however, they are important for improving clinical diagnosis. The purpose of this study is to determine the extent to which experts agree on the clinical diagnosis of CAS using two cohorts of children with mixed speech sound disorders (SSDs). Method: Speech samples of children with SSDs were obtained from previous and ongoing research from video recordings of children aged 3–8 years ( n = 36) and audio recordings of children aged 8–17 years ( n = 56). A total of 23 expert, English-speaking clinicians were recruited internationally. Three of these experts rated each speech sample to provide a description of the observed features and a diagnosis. Intrarater reliability was acceptable at 85% agreement. Results: Interrater reliability on the presence or absence of CAS among experts was poor both as a categorical diagnosis (κ = .187, 95% confidence interval [CI] [0.089, 0.286]) and on a continuous “likelihood of CAS” scale (0–100; intraclass correlation = .183, 95% CI [.037, .347]). Reliability was similar across the video-recorded and audio-only samples. There was greater agreement on other diagnoses (such as articulation disorder) than on the diagnosis of CAS, although these too did not meet the predetermined standard. Likelihood of CAS was greater in children who presented with more American Speech-Language-Hearing Association CAS consensus features. Conclusions: Different expert raters had different thresholds for applying the diagnosis of CAS. If expert clinician judgment is to be used for diagnosis of CAS or other SSDs, further standardization and calibration is needed to increase interrater reliability. Diagnosis may require operationalized checklists or reliable measures that operate along a diagnostic continuum. Supplemental Material: https://doi.org/10.23641/asha.23949105

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Assessment and Diagnostic Standards of Apraxia of Speech in Chinese-Speaking Adults and Children: A Scoping Review

Cited by 5 publications

References 51 publications

Clinical practice of childhood apraxia of speech in Hong Kong: A web-based survey study

Clinical practice of childhood apraxia of speech in Hong Kong: A web-based survey study

Discourse Task Type–Specific Linguistic Characteristics in Anomic Aphasia and Healthy Controls: Evidence From Mandarin–Chinese AphasiaBank

The Reliability of Expert Diagnosis of Childhood Apraxia of Speech

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