Family pedigrees of children with suspected childhood apraxia of speech

Abstract

Forty-two children (29 boys and 13 girls), ages 3-10 years, were referred from the caseloads of clinical speech-language pathologists for suspected childhood apraxia of speech (CAS). According to results from tests of speech and oral motor skills, 22 children met criteria for CAS, including a severely limited consonant and vowel repertoire, difficulty sequencing syllables, and inconsistent and unusual errors. Family pedigrees for these children were constructed through parent interviews and direct testing of nuclear family members. Familial aggregation for speech-sound and language disorders was demonstrated with 86% reporting at least one nuclear family member affected. Based on parent report, 13 of the 22 children (59%) had at least one affected parent. However, CAS was evident in only two siblings of probands with CAS and two probands with other speech-sound disorders. Based on testing, overall affection rates of speech-sound/language disorders were higher in families of children with CAS than in families of children with other speech-sound disorders.Mothers of children with CAS demonstrated a higher affection rate than mothers of children with other speech-sound disorders. A sex-related threshold model of transmission was also supported with brothers more often affected than sisters for male probands only. If our inclusionary criteria for CAS are valid, these findings support a general verbal trait deficit hypothesis. Learning outcomes: (1) As a result of this activity, the participant will understand potential familial risk factors for CAS; (2) will differentiate aggregation for speech-sound and language disorders in families with CAS from families of children who have other speech-sound disorders; (3) will

Effectiveness of an integrated phonological awareness approach for children with childhood apraxia of speech (CAS)

“…Preliminary findings indicate that children with the disorder are more likely than children with other speech-language disorders to experience written language deficits (Lewis et al, 2004;McNeill et al, in press). McNeill et al (in press) compared the phonological awareness, decoding, and letter knowledge ability of children with CAS (n = 12), children with inconsistent speech disorder without oro-motor impairment (n = 12), and typical speech-language development (n = 12).…”

“…The CAS group exhibited inferior phonological awareness and had more participants performing below the average range on standardised letter knowledge and decoding measures than the comparison groups. Lewis et al (2004) described the written language abilities of children with CAS (n = 10), children who displayed an isolated speech disorder (n = 15) and children who presented with a combined speech-language disorder (n = 14). These participants were assessed at age 4 to 6 years and again at age 8 to 10 years.…”

“…Campbell (1999) reported that children with CAS require 81% more therapy than children with phonological impairment to produce a functional change in speech production. Preliminary research has also indicated that children with CAS are likely to experience severe written language deficits (i.e., reading and spelling deficits) (Gillon & Moriarty, 2007;Lewis, Freebairn, Hansen, Iyengar, & Taylor, 2004; McNeill, Gillon, & Dodd, in press). Despite the negative consequences of persistent oral and written language impairment and the financial cost of providing long periods of treatment, there is a scarcity of intervention studies for CAS.…”

“…Commonly cited speech characteristics in the disorder include inconsistent speech errors, sound sequencing difficulty, vowel errors, articulatory groping, and prosodic disturbances (Davis, Jakielski, & Marquardt, 1998). Linguistic features associated with CAS include expressive and receptive language impairment, phonological awareness deficits, and written language disorder (Lewis et al, 2004). The diverse nature of symptoms in CAS challenges clinicians to provide efficient and effective intervention targeting multiple skill areas.…”

Implicações do discurso parental no desvio fonológico

“…Alguns autores têm apontado o núcleo familiar como um dos principais fatores influentes na etiologia do desvio fonológico (Lewis et al, 2004;Mota, 2004;Pagliarin, Keske-Soares, & Mota, 2009;Wertzner & Papp, 2006;Wertzner, Pagan, Galea, & Papp, 2007). A Psicanálise entende isso como o lugar simbólico, dado tanto à criança quanto ao distúrbio da fala por meio do discurso parental, onde vão se inscrevendo uma rede de significantes os quais tecem a subjetivação da criança.…”