Bibliographie: Kindliche Sprechapraxie - Abgrenzung, Diagnostik, Therapie

Inhaltsverzeichnis

I Vorwort

II Differentialdiagnostik

III Diagnostik
Diagnostikkriterien für kindliche Sprachapraxie
Diagnostikverfahren

IV Therapie
Überblicksartikel/ Reviews
Einzelfallstudien: phonologisch orientierte Therapie
Einzelfallstudien: alternative Therapiemethoden

V Autorenverzeichnis

VI Stichwortverzeichnis

I Vorwort

Sprechapraktische Störungen treten im Erwachsenen- als auch im frühen Kindesalter auf.

Jedoch unterscheiden sich die beiden Störungsbilder maßgeblich. Und während die erworbene Sprechapraxie schon ein bereits anerkanntes Störungsbild ist, stellt die kindliche Sprechapraxie einen eher unklaren, unbekannten Befund dar.

Es existieren verschiedene, teilweise differierende Definitionen der kindlichen Sprechapraxie. Allen gemein ist, dass die willkürliche Planung und Programmierung der Sequenzierung von Sprechbewegungen für die Kinder mit Sprechapraxie das Kardinalsymptom darstellt. Aufgrund einer vielfältigen Variation an Begleitsymptomen ist es jedoch sehr wichtig kindliche Sprechapraxie von klinischen Nachbarn abzugrenzen.

Auch eine eindeutige Diagnostik ist maßgeblich für die spätere therapeutische Intervention. Hierfür sind vor allem Kriterien und standardisierte Verfahren zur eindeutigen Identifikation notwendig. Letztendlich sind effektive Therapiemethoden unabdingbar.

Aufgrund der Aktualität und den immer lauter werdenden Forderungen nach evidenzbasierten Therapiemethoden und standardisierten Diagnostikverfahren habe ich mich mit dieser Thematik beschäftigt.

In der folgenden Bibliographie werden aktuellen Ergebnisse aus Wissenschaft und Forschung zum Thema „kindliche Sprechapraxie - Abgrenzung, Diagnostik und Therapie“ dargestellt.

Die Recherche wurde von Februar bis März 2009 durchgeführt.

Begonnen wurde die Suche über den „Reference Manager 11“ mit den Keywords „childhood apraxia of speech“ sowie „verbal dyspraxia“ und „developmental verbal dyspraxia“. Diese Suchbegriffe wurden mit den Konnektoren „AND“ und „OR“ verschiedenartig kombiniert um eine größtmögliche Anzahl von Ergebnisse zu erhalten. Aufgrund der dennoch unzureichenden Resultate wurde die Suche um die Suchbegriffe „dyspraxia“ AND „children“ sowie „therapy „ AND „apraxia of speech“ erweitert. Da auch Ergebnisse aus Diagnostik und Differentialdiagnostik eingebunden werden sollte, wurden die Suchbegriffe „differential“ und „diagnostic“ sowie „assessment“ mit in die Suche eingebunden. Um repräsentativere Ergebnisse aus der gesamten Forschung zu erhalten, wurde die Suche letztendlich noch in anderen Suchmaschinen, wie z.B. gopubmed, googleschoolar und www.sciencedirect.com durchgeführt. In der Suchmaschine gopubmed konnten über die Verlinkung zu Autoren der verschiedenen Artikel weitere essentielle Artikel ausfindig gemacht werden. Die Suchergebnisse wurden mit dem „Reference Manager 11“ verwaltet und formatiert. Aus 42 relevanten Artikeln wurde eine Auswahl der 32 aktuellsten Artikel getroffen. Der Zeitraum der Suche umfasst Artikel von 1994 bis heute um eine genügend große Anthologie zu erhalten. Die Artikel wurden thematisch nach verschiedenen Unterpunkten sortiert, alphabetisch nach Namen des Erstautoren. Auf Grund der überschaubaren Menge an Artikeln, wurde kein Artikel in verschiedene Unterpunkte sortiert.

Es ist kritisch anzumerken, dass nach wie vor ein großer Bedarf an Forschung besteht. Auch wenn die Charakteristik der kindlichen Sprechapraxie (nicht in die Bibliographie eingebunden) schon sehr gut erforscht ist und sich mittlerweile auch standardisierte Diagnostikverfahren etabliert haben, finden sich kaum Artikel der höheren Evidenzstufen wieder. Oft handelt es sich um Einzelfallstudien oder Reviews, welche wiederum Kritik am aktuellen Forschungsstand üben. Vor allem im Bereich der logopädischen Therapie offenbart sich „…a critical lack of well controlled treatment studies addressing treatment efficacy for CAS...” (Morgan, A. T. & Vogel, A. P., 2009.).

II Differentialdiagnostik

1. Bahr, R. H. (2005).

Differential diagnosis of severe speech disorders using speech gestures. Top.Lang.Dis, 25 (3), 254-265.

Keywords: articulatory gestures; articulatory phonology; childhood apraxia of speech; phonological disorder; speech timing

KeyWords Plus: SUSPECTED DEVELOPMENTAL APRAXIA; CHILDHOOD APRAXIA; CHILDREN; STRESS; MARKER; RATIO

Abstract: The differentiation of childhood apraxia of speech from severe phonological disorder is a common clinical problem. This article reports on an attempt to describe speech errors in children with childhood apraxia of speech on the basis of gesture use and acoustic analyses of articulatory gestures. The focus was on the movement of articulators and not on phoneme accuracy exclusively. This procedure was used to assess 15 children, who were either typically developing or diagnosed with either childhood apraxia of speech or phonological disorder (5 in each group). The results indicated that the groups with speech disorders performed significantly worse than did the typically developing group, but they did not differ from one another in terms of number of errors. Further analysis of the data revealed that differences among the groups with speech disorders were related to the use of the velum and the coordination between the lips and other articulatory gestures. The results seem to support the notion that articulatory gesture coordination may be more troublesome for children with childhood apraxia of speech. The relevance of this testing procedure for clinical use is described and therapeutic implications from the analyses are proposed.

LA - eng

PT - Proceedings Paper

2. Davis, B. L., Jakielski, K. J., & Marquardt, T. P. (1998).

Developmental apraxia of speech: determiners of differential diagnosis. Clin.Linguist Phon., 12 (1), 25-45.

Keywords: developmental apraxia of speech; differential diagnosis; clinical

KeyWords Plus: VERBAL DYSPRAXIA; NONLINEAR PHONOLOGY; CHILDREN

Abstract: Developmental apraxia of speech (DAS) is a neurologically based disorder in the programming of sequential articulatory movements. This definition, based purely on motoric limitations, is fraught with controversy concerning aetiology, clinical manifestations, treatment, and even identification of the disorder as a separate clinical entity. An understanding of developmental apraxia depends on consistent utilization of a group of symptoms for diagnosis so that data-based results can be used to generate inferences about the disorder. Results from studies of children who are diagnosed with developmental apraxia, but who may not be apraxic, complicates application to theories attempting to account for observed symptoms. A longitudinal study of children with DAS has been under way at the University of Texas at Austin since 1985. Of 22 children referred as apraxic, a diagnosis has been confirmed in only four. Phonological and language evaluation data for five clients evaluated during this project are presented. One was diagnosed with developmental apraxia of speech. Each of the other four subjects were diagnosed with speech and/or language disorders without the presence of developmental apraxia of speech. Diagnostic results for all five are presented, to illustrate critical features for differential diagnosis of developmental apraxia.

LA - eng

PT - Journal Article

3. Hayden, D. A. (1994).

Differential diagnosis of motor speech dysfunction in children. Clin Commun Disord, 4 (2), 119-41.

Keywords: Apraxias, Child, Preschool, Humans, Speech Production Measurement

Abstract: This test provides data for the differential diagnosis of children with four types of speech

disorders: global motor, oromotor execution, oral and speech motor sequencing, and by exclusion of the preceding three types, phonological disorders.

An experimental version of the Verbal Motor Production Assessment for Children (VMPAC) is presented. This test provides data for the differential diagnosis of children with four types of speech disorders: global motor, oromotor execution, oral and speech motor sequencing, and by exclusion of the preceding three types, phonological disorders. Rationale on which the test is based are given. The test itself, is discussed in detail as are the diagnostic indicators. Profiles for four children illustrate the integration of the VMPAC data with sensory, cognitive, language and social development data. These profiles are discussed in terms of the diagnoses and implications for intervention.

4. Korkman, M. & Hakkinen-Rihu, P. (1994).

A new classification of developmental language disorders (DLD). Brain Lang, 47, 96-116.

Keywords: Articulation Disorders/Auditory Perception/Child/Dyslexia/complications/Factor Analysis,Statistical/Female/Humans/Language Development

Disorders/classification/diagnosis/Male/Neuropsychological Tests/ standards/Phonetics/ Reproducibility of Results/ Semantics

Abstract: Eighty children with DLD were examined with 18 language tests, mainly derived from a neuropsychological investigation called NEPSY (NEuroPSYchological Investigation for Children). The children were 6-0 to 7-9 years old and attended kindergarten. The test profiles of the first 40 children, Group 1, were utilized for the elaboration of a classification of DLD. The test profiles were grouped into five subgroups with the aid of a Q-type factor analysis. Then the classification was modified to suit clinical application by collapsing two pairs of subgroups. The resulting categories were called: the Global Subtype, the Specific Dyspraxia Subtype, and the Specific Comprehension Subtype. The classification was validated, first, by a follow-up study. It was predicted that spelling problems would occur in the Global and the Specific Comprehension Subtypes, but not in the Specific Dyspraxia Subtype. At follow-up, 3 years later, the hit rate was found to be 80.5%. In a second validation procedure, the classification was tried out on the 40 children examined later, Group 2. The coverage of the classification was 85%. Five outliers (12.5%) seemed to form a fourth category, called the Specific Dysnomia Subtype. An expressive subtype was not observed

LA - eng

PT - Journal Article

5. Maassen, B. (2002).

Issues contrasting adult acquired versus developmental apraxia of speech. Semin.Speech Lang, 23, 257-266.

Keywords:

Adult/Apraxias/diagnosis/therapy/Child/Diagnosis,Differential/Humans/Phonetics/Psycholinguistics/met hods/Severity of Illness Index/Speech Production Measurement/Speech Therapy/Verbal Learning Abstract: Acquired and developmental apraxia of speech (AOS and DAS) are defined as disorders of the transition from an abstract phonological code into motor commands. However, the natural course of these disorders differs substantially because of the fundamental difference in the developmental stage at which the apraxia expresses itself. In normal and pathological development alike, development of language and speech is an interactive process, involving speech motor control, perception, and psycholinguistic processes. Infant speech develops from random babbling and sensomotoric learning, followed by more abstract phonological acquisition. Supposing that the core deficit of DAS comprises a reduced sensomotoric learning capacity explains a large part of the symptomatology of DAS in the psycholinguistic domain because of the impact on phonological, perceptual, and higher-level processes. This contrasts with adults with AOS, who already have acquired stable top-down processes. Implications for clinical management are discussed

LA - eng

PT - Comparative Study

PT - Journal Article

PT - Review

6. Shriberg, L. D., Aram, D. M., & Kwiatkowski, J. (1997).

Developmental apraxia of speech: I. Descriptive and theoretical perspectives. J.Speech Lang Hear.Res., 40, 273-285.

Keywords: Adolescent/Age of

Onset/Apraxias/classification/diagnosis/epidemiology/Child/Child,Preschool/Female/Humans/Incidenc e/Language Development Disorders/Linguistics/Male/Models,Theoretical/Perceptual Disorders/Phonetics/Prevalence/Sex Factors/Speech Disorders/Terminology as Topic/Time Factors Abstract: Developmental apraxia of speech (DAS) is a putative diagnostic category for children whose speech errors presumedly (a) differ from the errors of children with developmental speech delay (SD) and (b) resemble the errors of adults with acquired apraxia of speech. The studies reported in this series (Shriberg, Aram, & Kwiatkowski, 1997a, 1997b) concern both premises, with primary focus on the first--that children with DAS can be differentiated from children with SD on the basis of one or more reliable differences in their speech error profiles. Immediate goals are to identify a diagnostic marker for DAS and to consider implications for research and clinical practice. A long-term goal is to identify the phenotype marker for DAS, on the assumption that it may be a genetically transmitted disorder. This first paper reviews relevant descriptive and theoretical perspectives. Findings from a local ascertainment study support the clinical functionality of the term suspected DAS

LA - eng

PT - Journal Article

PT - Research Support, U.S. Gov't, P.H.S

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