Vowel errors are more common, and more persistent in CAS The ad-hoc CAS committee acknowledged that an affected child’s speech characteristics may change over time, and that the three features ‘are not proposed to be the necessary and sufficient signs of CAS’ (ASHA, 2007b, p. 2). A number of additional features often observed in CAS are discussed in detail within the report. Syllable structure processes: ICD, FCD, CR, WSD and reduplication Use a process analysis (e.g., DEAP (Dodd et al., 2002), HAPP-3 (Hodson, 2004), The Quick Screener (QS) (Bowen, 1996)) and/or a Conversation Sample. Motor speech examination worksheet Chantelle Highman: Keeping up to date with the literature The direction of causality remains opaque and it may not be possible to fully determine the causal relationships between the different components of a symptom complex like CAS. Assessment may range from a list of the child’s words and/or word approximations, to a Structural Analysis, right up to demanding standardised language batteries. Suprasegmental (prosodic) characteristics of CAS Reactive personality? Silent posturing? Chapter 6 Phonological disorder and CAS: Characteristics, goals and treatment Marking But, in a sense, that does not matter. Against this background, we found it difficult to ignore the notion that CAS might in fact involve a representational component. It is also generally agreed that many ‘CAS characteristics’ can be found in children with other subtypes of SSD, and that CAS and phonological disorder can co-occur in an individual child. Look for stable PCC and stable percentage of occurrence of processes over time (6–12 weeks should do). Do vowels ‘wander’? However, the report provided guidance on treatment approaches and supporting efficacy data, where available, including discussions on intensity of intervention and funding issues. Making use of sources that have already synthesised information for you, such as review articles, book chapters, meta-analyses and databases of interventions (e.g., speechBITE. Joining the associated discussion groups to receive posts, which often include relevant abstracts, is a time-efficient way of staying connected with clinical and research issues. By some quirky synchronicity, Dr. Highman completed her literature review just as the final draft of the ASHA Draft Technical Report on CAS was circulated for comment. Chantelle Highman: Staying current with published research The committee suggested that the term CAS be applied to the idiopathic form as well as those occurring in the context of neurological and neurobehavioural disorders, and suggests using the qualifier suspected (i.e., suspected Childhood Apraxia of Speech, sCAS) in cases where the diagnosis is provisional. In considering whether CAS might in fact involve a representational component, we had recourse to literature from several distinct (though related) disciplines: foundational understanding of typical phonological development and representation; the neuroscientific literature on phonological processing, specifically the mismatch negativity (MMN) component; and previous studies that had examined acoustic parameters in acquired apraxia of speech (AOS) in adults. Such implications impact the assessment and intervention process, right from the opening moments of the initial consultation or case history interview. There were three males in the comparison group, four males in the CAS group; and the children were between 5;1 and 8;9 years of age, with normal hearing. Increased accuracy of production of target structures. Making use of the information available on reputable websites (e.g., Bowen, 1998; Childhood Apraxia of Speech Association of North America, CASANA site (www.apraxia-kids.org), see Gretz, A7). tʃəˈɹatˌsɪst Descriptive and single subject experimental designs provided preliminary support for the use of augmentative and alternative communication (AAC) devices to improve overall communicative competence in children with severely compromised speech production abilities (e.g., Bornman, Alant & Meiring, 2001, cited in ASHA, 2007a). Figure 6.1 Debbie’s 10 long clinically useful words. Dogil and Mayer suggested that these changes could be related to ‘over-specification’ at the phonological level, leading to difficulties in transferring phonological representations to phonetic (articulatory) gestures. The characteristics that can be evident in either disorder, or that may be present when CAS and phonological disorder co-occur in the same child, are Use a process analysis (e.g., DEAP (Dodd et al., 2002), HAPP-3 (Hodson, 2004), The Quick Screener (QS) (Bowen, 1996)) and/or a Conversation Sample. For example, the ASHA (2007a) CAS Technical Report and the Royal College of Speech and Language Therapists’ policy statement on Developmental Verbal Dyspraxia (DVD) (RCSLT, 2011) provide syntheses of the relevant literature relating to CAS/DVD. Phonological awareness difficulties – school-aged children. Some of these contain not only the presentations, but also transcripts of frank discussions between the top researchers in the field, affording a more in-depth understanding of topic areas. As with the assessment prompt (Table 6.2), the procedures in Table 6.3 overlap, and not all will be done with every client. For example, the ASHA (2007a) CAS Technical Report and the Royal College of Speech and Language Therapists’ policy statement on Developmental Verbal Dyspraxia (DVD) (RCSLT, 2011) provide syntheses of the relevant literature relating to CAS/DVD. If they do not, it may be an indicator of a phonological disorder. ... S. Felsenfeld, P.A. A child with this type of disorder is unable to use correct word order. Results: The results revealed no dominant theoretical framework for long-term goals, whereas short-term goals largely reflected a sensory-motor framework. expansion of phonetic inventory Our attempt to examine the neural underpinnings of CAS using neurophysiological methods was undertaken against a backdrop of conflicting research showing lack of agreement with regards to the aetiology, symptoms, and most effective treatment of CAS (e.g., Davis et al., 1998; Forrest, 2003; Shriberg, Aram & Kwiatkowski, 1997b). Allowing your focus to be directed by clinical cases and questions can be particularly motivating. single [speech] postures versus sequences of postures. One perspective on this tuning process is that, as native phonology develops, fine-tuning of the native-language sound system results in under-specification of particular features in the phonological system of the language (Bauman-Waengler, 2004; Bernhardt & Stoel-Gammon, 1994). It just breaks my heart when they look at me and say Mom will I ever speak normal.. My heart just sinks. Simplifications in the form of syllable structure processes and phonotactic errors: e.g., ICD, FCD, CR, WSD. 1. Inconsistent phonological disorder: children’s phonological. Our participants were groups of right-handed children who were monolingual English speakers, five each in two groups: typically developing (TD) children, and children with a CAS diagnosis. Interestingly, a positive-going MisMatch component has been reported previously in infants, and has been taken to indicate an immature or underdeveloped response to phonemic speech sound contrasts (Dehaene-Lambertz & Dehaene, 1994; Friederici, 2002; Leppänen, Pihko, Eklund & Lyytinen, 1999; Pihko et al., 1999;Rivera-Gaxiola, Silva-Pereyra & Kuhl, 2005; Weber, Hahne, Friedrich & Friederici, 2004). For our experiment, we selected pairs of speech sounds that are phonemically and allophonically distinct in English phonology (/pa/ vs. /ba/, and /pa/ vs. /pʰa/). the use of simple, but not complex, syllable and word shapes. In contrast to the ASHA CAS Technical Report, the RCSLT policy statement recommended the term DVD should only apply to idiopathic cases, where there is not an associated known neurological or neurobehavioural disorder. repetitions of the same stimuli versus repetitions of varying stimuli (e.g., sequential motion rates vs. alternating motion rates), and For example, an articulatory feature that is non-contrastive in a specific language (e.g., aspiration in English stops), gradually ceases to be specified, whereas the same feature value is retained in a linguistic system that treats it as contrastive (e.g., aspiration in Hindi stops). Table 6.3 Motor Speech Examination Worksheet I have two sons one 14 and one 12 they both have a Phonological Disorder since they were little.. Articulatory struggle and silent posturing Long-term outcome of schizoaffective disorder. 8. Cross-cultural features and presentations Excessive and equal stress This preview shows page 1 - 2 out of 2 pages. Can’t say own name. Look for unusual error-types: systematic sound preference – ‘favourite sound’/‘favourite place’/‘favourite manner’ of articulation. By the time a child is three and a half years old, he/she should have eliminated: fronting and stop… Delayed syllable/word structure development. This can come as a shock to parents and requires sensitive handling – don’t assume they ‘know’. EEG is a non-invasive method for measuring electrical potentials generated in the brain, by measuring voltage fluctuations at the scalp via electrodes that are connected to highly sensitive amplification and digital recording equipment. ERPs therefore represent the electrical potentials that are time-locked to particular cognitive processes. Subsequently, specific treatment appro- aches have been investigated using progressively stronger levels of rigour. Making use of sources that have already synthesised information for you, such as review articles, book chapters, meta-analyses and databases of interventions (e.g., speechBITE, www.speechBITE.com). Such work should be considered a prerequisite to the development of finely tuned and efficacious therapeutic protocols that can be used to attenuate the impact of speech sound disorders on social participation and educational attainment in affected children. List vowel inventory/constraints and calculate Percentage of Vowels Correct (PVC) if applicable. 4. SODA, process errors, and segmental complexity errors increase as contexts become more difficult. inappropriate prosody, especially in the realisation of lexical or phrasal stress. Procedures and observations vary with the child’s age and stage. Simultaneous production needed Neurophysiological methods with high temporal precision, such as EEG, can capitalise on the very fine temporal distinctions between different domains of language processing (Osterhout, 2000), and the ERP method has been successfully used to isolate specific neural responses implicated in distinct linguistic processes, including syntax, semantics and phonology (Rugg & Coles, 1995; see Friederici, 2000 for an overview). Intervention goals that are common to phonological disorder and CAS Prosodic differences Neurophysiological methods with high temporal precision, such as EEG, can capitalise on the very fine temporal distinctions between different domains of language processing (Osterhout, 2000), and the ERP method has been successfully used to isolate specific neural responses implicated in distinct linguistic processes, including syntax, semantics and phonology (Rugg & Coles, 1995; see Friederici, 2000 for an overview). The phonological disorder theory suggests that dyslexia affects a person's ability to represent the smallest units of speech sound (phonemes). Phonological awareness difficulties – school-aged children View full document. These include lack of time, lack of ready access to published literature and lack of skill in evaluating the evidence (e.g., Bernstein Ratner, 2006; Gosling & Westbrook, 2004; Jansen, Rasekaba, Presnell & Holland, 2012; Johnson, 2006; Roddam & Skeat, 2010; Rose & Baldac, 2004; Vallino-Napoli & Reilly, 2004). Development Drawing on the suggestions provided by Johnson (2006) and Reilly et al. 3. tʃəɹɪnᵈ Among the first steps in the PhD process (Mewburn, 2013; Petre & Rugg, 2010) are choosing both a topic area and a research question or questions. Table 6.2 provides ‘assessment prompt’ notes, developed over many years, that clinicians can use, and potentially modify, for case history-taking when they suspect that a child has CAS. 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