A Systematic Review of Treatment Outcomes for Children With Childhood Apraxia of Speech Purpose To present a systematic review of single-case experimental treatment studies for childhood apraxia of speech (CAS). Method A search of 9 databases was used to find peer-reviewed treatment articles from 1970 to 2012 of all levels of evidence with published communication outcomes for children with CAS. Improvement ... Review Article
Review Article  |   August 01, 2014
A Systematic Review of Treatment Outcomes for Children With Childhood Apraxia of Speech
 
Author Affiliations & Notes
  • Elizabeth Murray
    University of Sydney, New South Wales, Australia
  • Patricia McCabe
    University of Sydney, New South Wales, Australia
  • Kirrie J. Ballard
    University of Sydney, New South Wales, Australia
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Elizabeth Murray: Elizabeth.murray@sydney.edu.au
  • Editor: Carol Scheffner Hammer
    Editor: Carol Scheffner Hammer×
  • Associate Editor: Ken Bleile
    Associate Editor: Ken Bleile×
Article Information
Speech, Voice & Prosodic Disorders / Apraxia of Speech & Childhood Apraxia of Speech / Research Issues, Methods & Evidence-Based Practice / Review Article
Review Article   |   August 01, 2014
A Systematic Review of Treatment Outcomes for Children With Childhood Apraxia of Speech
American Journal of Speech-Language Pathology, August 2014, Vol. 23, 486-504. doi:10.1044/2014_AJSLP-13-0035
History: Received March 27, 2013 , Revised July 7, 2013 , Accepted December 1, 2013
 
American Journal of Speech-Language Pathology, August 2014, Vol. 23, 486-504. doi:10.1044/2014_AJSLP-13-0035
History: Received March 27, 2013; Revised July 7, 2013; Accepted December 1, 2013
Web of Science® Times Cited: 7

Purpose To present a systematic review of single-case experimental treatment studies for childhood apraxia of speech (CAS).

Method A search of 9 databases was used to find peer-reviewed treatment articles from 1970 to 2012 of all levels of evidence with published communication outcomes for children with CAS. Improvement rate differences (IRDs) were calculated for articles with replicated (n > 1), statistically compared treatment and generalization evidence.

Results Forty-two articles representing Phase I and II single-case experimental designs (SCEDs; n = 23) or case series or description studies (n = 19) were analyzed. Six articles showed high CAS diagnosis confidence. Of the 13 approaches within the 23 SCED articles, treatments were primarily for speech motor skills (n = 6), linguistic skills (n = 5), or augmentative and alternative communication (n = 2). Most participants responded positively to treatment, but only 7 of 13 approaches in SCED studies reported maintenance and/or generalization of treatment effects. Three approaches had preponderant evidence (Smith, 1981). IRD effect sizes were calculated for Integral Stimulation/Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition Treatment, and Integrated Phonological Awareness Intervention.

Conclusions At least 3 treatments have sufficient evidence for Phase III trials and interim clinical practice. In the future, efficacy needs to be established via maintenance and generalization measures.

Acknowledgments
This research was supported by the Douglas and Lola Douglas Scholarship on Child and Adolescent Health, the Speech Pathology Australia Nadia Verrall Memorial Research Grant and Postgraduate Research Award, and the University of Sydney James Kentley Memorial Scholarship and Postgraduate Research Support Scheme awarded to the first author. This research was also supported by an Australian Research Council Future Fellowship awarded to the third author. We thank Catherine Mason and Donna Thomas for assistance coding the data and completing reliability.
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