engleski

Typical characteristic for identification and assessment of childhood apraxia of speech in Croatia

Background and aims: Childhood apraxia of speech (CAS) is childhood speech disorder with core deficit in child's ability to convert abstract phonological codes to motor speech commands. To date there is no validated list of diagnostic features that differentiates CAS from other speech sound disorders. Since there is no unique behavioral or neurological marker of CAS, the disorder is usually recognized by general characteristics of CAS proposed by ASHA (2007). Still, consensus about typical speech characteristics of CAS has not been reached. Because of that, clinicians and researchers may use different diagnostic criteria in identification and assessment of this disorder. Several clinical studies have investigated key characteristics for CAS reported by speech-language pathologists based on English speaking (Forrest, 2003 ; Joffe, Pring 2008) and Swedish speaking children (Malmenholt et al., 2017). In fact, Forrest (2003) reported high degrees of clinical disagreement among practicing SLPs in their criteria for diagnosing CAS which can consequently lead to misdiagnosing false positives or false negatives. Being a controversial diagnosis, cross-linguistic studies are necessary for agreement upon standard in diagnosing and treating CAS, so the primary goal of this study was to examine which characteristics do Croatian SLPs find typical for CAS and do they agree upon diagnostic criteria for identification and assessment. Consequently, are those characteristics similar to those found in other languages. Secondly, we wanted to examine the relationship between years spent in practice and confidence in assessing children with CAS. Subjects and methods: Simple summaries about sample and measures were given through descriptive statistics. Data about typical symptoms of CAS was obtained through an anonymous web-based questionnaire, completed by Croatian SLPs (N=72). In order to identify indicative groups of behaviors of CAS and compare them with other proposed diagnostic models (Ozzane, 1995), cluster-analysis was conducted. Also, to examine the relation between years of clinical work and confidence in assessing children with CAS, Spearman's correlation was conducted. Results and discussion: Top five characteristics reported by Croatian SLPs are motor- programming deficits (87.5%), inconsistent production (77, 8%), speech errors (75%), lengthened and disrupted coarticulatory transitions (75%) and sequencing difficulties (68.1%). These results support Malmenholt et al. (2017) findings as well as behavioral domains commonly associated with CAS by ASHA (2007). According to cluster-analysis of 18 behaviors thought to reflect the underlying characteristics of CAS, three clusters have emerged which similarly to the The “Ozanne Model” reflect problems with phonetic programming, oro-motor control and phonological planning but language difficulties as well. Also, there is no significant correlation between years spent in practice and clinician’s confidence in assessing children with CAS (p>0.01). Based on this finding, it seems that clinicians in Croatia are generally unsecure in assessing children with CAS, regardless of their work experience.

childhood apraxia of speech ; speech sound disorders ; assesment ; diagnostic criteria ; speech-language pathologists

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