Treatment of Childhood Apraxia of Speech: Clinical Decision Making in the Use of Nonspeech Oral Motor Exercises

ABSTRACT

In this article, the authors provide background concerning the nature of childhood apraxia of speech (CAS) and conventional speech-based treatments for it. In addition they discuss a clinical decision-making process within which to consider the appropriateness of nonspeech oral motor exercises (NSOMEs). This process requires clinicians to ask questions of themselves as they interpret clinical observations and consider alternative treatment approaches (including both NSOMEs and speech-oriented treatments). Given a virtual absence of relevant empirical evidence on the question of the value of NSOMEs for children with CAS, clinicians are urged to examine the soundness of theoretical rationales they turn to when making clinical decisions.

Childhood apraxia of speech - nonspeech oral motor exercises (NSOMEs) - treatment - clinical decision making

REFERENCES

• 1 American Speech-Language-Hearing Association .Childhood apraxia of speech [Position paper]. Available at: http://www.asha.org/docs/html/PS2007-00277.html Accessed August 15, 2008
• 2 Hodge M M, Salonka R, Kolllias S. Use of non-speech oral-motor exercises in children's speech therapy. Paper presented at: Annual Meeting of the American Speech-Language-Hearing Association November 2005 San Diego, CA;
• 3 Lof G L, Watson M M. Nationwide survey of non-speech oral motor exercise use: implications for evidence-based practice.  Lang Speech Hear Serv Sch. 2008;  39 392-407
• 4 Strand E A. Childhood apraxia of speech: suggested diagnostic markers for the younger child. In: Shriberg LD, Campbell TF Proceedings of the 2002 Childhood Apraxia of Speech Research Symposium. Carlsbad, CA; The Hendrix Foundation 2003: 75-80
• 5 Strand E A, McCauley R J. Assessment procedures for treatment planning in children with phonologic and motor speech disorders. In: Caruso A, Strand EA Clinical Management of Motor Speech Disorders in Children. New York, NY; Thieme 1999: 73-108
• 6 Strand E A, McCauley R J. Differential diagnosis of severe speech impairment in young children.  The ASHA Leader. 2008;  13 10-13
• 7 Strand E A, Stoeckel R, Baas B. Treatment of severe childhood apraxia of speech: a treatment efficacy study.  J Med Speech Lang Pathol. 2006;  14 297-307
• 8 Schmidt R A, Lee D L. Motor Control and Learning: A Behavioral Emphasis. 5th ed. Champaign, IL; Human Kinetics 2005
• 9 Miller H, Morley M. Discussion on speech defects in children.  Proc R Soc Med. 1950;  43 579-584
• 10 Hayden D A, Square P A. Motor speech treatment hierarchy: a systems approach.  Clin Commun Disord. 1994;  4 162-174
• 11 Square P. Treatment of developmental apraxia of speech: tactile-kinesthetic, rhythmic, and gestural approaches. In: Caruso A, Strand EA Clinical Management of Motor Speech Disorders in Children. New York, NY; Thieme 1999: 149-186
• 12 Bashir A S, Grahamjones F, Bostwick R Y. The touch-cue method of therapy for developmental verbal apraxia.  Semin Speech Lang. 1984;  5 127-137
• 13 Klick S L. Adapted cuing technique for use in treatment of dyspraxia.  Lang Speech Hear Serv Sch. 1985;  16 256-259
• 14 Helfrich-Miller K R. Melodic intonation therapy with developmental apraxic children.  Semin Speech Lang. 1984;  5 119-126
• 15 Strand E A, Skinder A. Treatment of developmental apraxia of speech: integral stimulation methods. In: Caruso A, Strand EA Clinical Management of Motor Speech Disorders in Children. New York, NY; Thieme 1999: 109-148
• 16 Dollaghan C A. The Handbook for Evidence-Based Practice in Communication Disorders. Baltimore, MD; Paul H. Brookes 2007
• 17 Marshalla P. “Oral motor treatment” vs. “non-speech oral motor exercises”: historical clinical evidence of twenty-two fundamental methods. Oral Motor Institute Monograph 2008; 2(2) Available at: http://www.oralmotorinstitute.org/mons/v2n2_marshalla.html Accessed August 17, 2008
• 18 Clark H M. Neuromuscular treatments of speech and swallowing: a tutorial.  Am J Speech Lang Pathol. 2003;  12 400-415
• 19 Forrest K. Are oral-motor exercises useful in the treatment of phonological/articulatory disorders?.  Semin Speech Lang. 2002;  23 15-25
• 20 Arvedson J, Clark H, Lazarus C et al.. The effectiveness of oral-motor exercises: an evidence-based systematic review. Paper presented at: National Convention of the American Speech-Language-Hearing Association November 16, 2007 Boston, MA;
• 21 Lass N J, Pannbacker M. The application of evidence-based practice to non-speech oral motor treatments.  Lang Speech Hear Serv Sch. 2008;  39 408-421
• 22 Ruscello D M. Non-speech oral motor treatment issues related to children with developmental speech sound disorders.  Lang Speech Hear Serv Sch. 2008;  39 380-391