Summary of the Systematic Review

Article Citation

A Systematic Review of Treatment Outcomes for Children with Childhood Apraxia of Speech

Murray, E., McCabe, P., et al. (2014).
American Journal of Speech-Language Pathology, 23, 486-504.
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Sponsoring Body

Douglas and Lola Douglas Scholarship on Child and Adolescent Health; Speech Pathology Australia Nadia Verrall Memorial Research Grant and Postgraduate Research Award; University of Sydney James Kentley Memorial Scholarship and Postgraduate Research Support Scheme; Australian Research Council Future Fellowship

Article Quality Ratings

Read about Our Rating Process

Indicators of Review Quality

  • Yes The review states a clearly focused question/aim.
  • Yes Criteria for inclusion of studies are provided.
  • Yes Search strategy described in sufficient detail for replication.
  • Yes Included studies are assessed for study quality.
  • No Quality assessments are reproducible.
  • Yes Characteristics of the included studies are provided.

Article Details

Description

This is a systematic review of the published literature, specifically single-case experimental design (SCED) studies, investigating the efficacy of treatment approaches for childhood apraxia of speech (CAS).

Questions/Aims Addressed

Four aims were specified:
  1. To describe the study quality, research phase, and level of evidence of included studies
  2. To define treatment procedures, goals, and structure of treatment (e.g., frequency/intensity of treatment) for each study
  3. To examine treatment, maintenance, and generalization outcomes
  4. To determine the level of certainty for each treatment approach and to determine effect sizes as appropriate

Population

Children (less than 18 years of age) with suspected or diagnosed CAS

Intervention/Assessment

Interventions were categorized as primarily motor, linguistic/phonological, or augmentative and alternative communication (AAC) 

Number of Studies Included

23

Years Included

1970-October 2012

Evidence Ratings for This Document

Certainty of evidence was classified as conclusive, preponderant, or suggestive based on a number of features including level of evidence, research design, confidence in diagnosis, and possible intervention effects.

Conclusions from This Systematic Review

What are Conclusions?

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Treatment

Interventions with suggestive evidence include AAC, some combined cueing/motor approaches, rate control, and some combined linguistic/motor treatments.

Keywords: Augmentative and Alternative Communication (AAC), Diagnosis/Condition, Age, Rate Control, School-Age Children, Apraxia of Speech

The three treatments with demonstrated treatment effects (i.e., Integral Stimulation/Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition, and Integrated Phonological Awareness Intervention) "are best suited to interim clinical use, with sessions at least twice a week and dose above 60 trials per session" (p. 501).

Keywords: Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition Treatment, Dosage (Intensity/Duration), Dosage, Integrated Phonological Awareness Intervention, Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

"Intensive treatment delivery in impairment-based intervention appears crucial for obtaining positive treatment outcomes" (p. 501).

Keywords: Dosage, Dosage (Intensity/Duration), Apraxia of Speech (Childhood)

"DTTC [Dynamic Temporal and Tacticle Cueing] appears to work better for clients with more severe CAS, Integrated Phonological Awareness Intervention appears to work better for children 4–7 years of age with mild to severe CAS, and ReST [Rapid Syllable Transition Treatment] appears to work better for children 7–10 years of age with mild-to-moderate CAS" (p. 501).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Timing (e.g. Pre- and Post-Op), Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

Two motor treatments (Integral Stimulation/Dynamic Temporal and Tactile Cueing and Rapid Syllable Transition) and one linguistic treatment (Integrated Phonological Awareness Intervention) were considered to have preponderant evidence to support their efficacy due to positive treatment and generalization effects. According to the authors these "three treatments have sufficient evidence for Phase III trials and interim clinical practice" (p. 486).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Generalization/Maintenance, Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

Service Delivery

The three treatments with demonstrated treatment effects (i.e., Integral Stimulation/Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition, and Integrated Phonological Awareness Intervention) "are best suited to interim clinical use, with sessions at least twice a week and dose above 60 trials per session" (p. 501).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Dosage, Dosage (Intensity/Duration), Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

"Intensive treatment delivery in impairment-based intervention appears crucial for obtaining positive treatment outcomes" (p. 501).

Keywords: Dosage, Dosage (Intensity/Duration), Apraxia of Speech (Childhood)

Go to Map

Treatment

Interventions with suggestive evidence include AAC, some combined cueing/motor approaches, rate control, and some combined linguistic/motor treatments.

Keywords: Augmentative and Alternative Communication (AAC), Rate Control, Age, Diagnosis/Condition, School-Age Children, Apraxia of Speech

Go to Map

Treatment

The three treatments with demonstrated treatment effects (i.e., Integral Stimulation/Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition, and Integrated Phonological Awareness Intervention) "are best suited to interim clinical use, with sessions at least twice a week and dose above 60 trials per session" (p. 501).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Dosage, Dosage (Intensity/Duration), Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

"Intensive treatment delivery in impairment-based intervention appears crucial for obtaining positive treatment outcomes" (p. 501).

Keywords: Dosage, Dosage (Intensity/Duration), Apraxia of Speech (Childhood)

"DTTC [Dynamic Temporal and Tacticle Cueing] appears to work better for clients with more severe CAS, Integrated Phonological Awareness Intervention appears to work better for children 4–7 years of age with mild to severe CAS, and ReST [Rapid Syllable Transition Treatment] appears to work better for children 7–10 years of age with mild-to-moderate CAS" (p. 501).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Timing (e.g. Pre- and Post-Op), Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

Two motor treatments (Integral Stimulation/Dynamic Temporal and Tactile Cueing and Rapid Syllable Transition) and one linguistic treatment (Integrated Phonological Awareness Intervention) were considered to have preponderant evidence to support their efficacy due to positive treatment and generalization effects. According to the authors these "three treatments have sufficient evidence for Phase III trials and interim clinical practice" (p. 486).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Generalization/Maintenance, Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

Service Delivery

The three treatments with demonstrated treatment effects (i.e., Integral Stimulation/Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition, and Integrated Phonological Awareness Intervention) "are best suited to interim clinical use, with sessions at least twice a week and dose above 60 trials per session" (p. 501).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Dosage, Dosage (Intensity/Duration), Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

"Intensive treatment delivery in impairment-based intervention appears crucial for obtaining positive treatment outcomes" (p. 501).

Keywords: Dosage, Dosage (Intensity/Duration), Apraxia of Speech (Childhood)

"DTTC [Dynamic Temporal and Tacticle Cueing] appears to work better for clients with more severe CAS, Integrated Phonological Awareness Intervention appears to work better for children 4–7 years of age with mild to severe CAS, and ReST [Rapid Syllable Transition Treatment] appears to work better for children 7–10 years of age with mild-to-moderate CAS" (p. 501).

Keywords: Dynamic Temporal and Tactile Cueing, Integrated Phonological Awareness Intervention, Rapid Syllable Transition Treatment, Timing (e.g. Pre- and Post-Op), Apraxia of Speech (Childhood), Motor Planning, Phonological Awareness Intervention

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