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

Abstract

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.

Childhood Apraxia of Speech: A Descriptive and Prescriptive Model of Assessment and Diagnosis

“… A pilot randomized control trial comparing ReST and ultrasound biofeedback treatment outcomes in children with CAS. 10 [ 67 ] The research aimed to examine the clinical practice of CAS in Hong Kong to inform future research and evidence-based practice. The study found that local SLPs’ understanding of CAS was limited and that evidence for the assessment, diagnosis, and treatment of Cantonese speakers with CAS was lacking.…”

“…Such collaboration underscores the need for a unified clinical language and fosters a holistic approach to addressing the multifarious challenges faced by children with CAS. Furthermore, the cultural and linguistic context within which CAS is assessed cannot be overstated, as it shapes both the interpretation of symptoms and the subsequent intervention strategies [ 59 , 67 ]. This is of particular salience in multilingual societies, where the nuances of different languages and cultural norms must be carefully negotiated to ensure equitable and effective diagnostic and therapeutic practices.…”

“…The apex of the model is characterized by the cultural and linguistic dimensions of CAS assessment. This tier recognizes the diversity in speech patterns across languages and cultures and emphasizes the need for diagnostic measures that are culturally and linguistically sensitive (e.g., ASRS, DEMSS) [ 59 , 67 ]. The model ends with a dynamic integration of these tiers, with feedback loops which allow for the continual refinement of the diagnostic process.…”

“…Studies acknowledged the need for culturally and linguistically appropriate diagnostic measures for CAS, especially in multilingual contexts. [59,67] The multifaceted nature of CAS necessitates a diagnostic and assessment approach that is both comprehensive and nuanced. The neurobiological underpinnings of CAS, for instance, have been a focal point of recent research endeavors [37].…”