Maas Edwin
Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA.
J Speech Lang Hear Res. 2024 Sep 26;67(9S):3495-3520. doi: 10.1044/2024_JSLHR-23-00233. Epub 2024 May 20.
The purposes of this review article were to provide an introduction to and "bird's-eye" overview of the current evidence base for treatment of childhood apraxia of speech (CAS), identify some gaps and trends in this rapidly growing literature, and formulate some future research directions, in order to advance the evidence base and clinical practice for children with CAS.
Following a brief introduction outlining important concepts, a narrative review of the CAS treatment literature is provided, and trends and future directions are identified based on this review. The review is organized around four fundamental treatment research questions: (a) "Does Treatment X work?", (b) "Does Treatment X work better than Treatment Y?", (c) "For whom does Treatment X work?", and (d) "What does 'work' mean, anyway?"
A wide range of CAS treatments with varying degrees of evidence for efficacy exists. Research is beginning to emerge that compares different treatments and seeks to determine optimal treatment parameters. Few studies to date have explored child-level predictors of treatment response, and the evidence base currently is limited in scope with respect to populations and outcomes studied.
A growing evidence base supports the efficacy of a number of treatments for CAS. However, many important gaps in the literature were identified that warrant redoubled and sustained research attention. Research is beginning to emerge that addresses treatment optimization, comparison, candidacy, and outcomes. Suggestions for future research are offered, and the concept of a hypothesized pathway was applied to CAS to illustrate how components of an intervention can effect change in a clinical goal and can help guide development and refinement of treatments for children with CAS.
这篇综述文章的目的是介绍并“鸟瞰”目前关于儿童言语失用症（CAS）治疗的证据基础，识别这一快速发展的文献中的一些差距和趋势，并制定一些未来的研究方向，以推进针对患有CAS儿童的证据基础和临床实践。
在简要介绍重要概念之后，提供了对CAS治疗文献的叙述性综述，并基于此综述确定趋势和未来方向。该综述围绕四个基本治疗研究问题展开：（a）“治疗X有效吗？”，（b）“治疗X比治疗Y更有效吗？”，（c）“治疗X对谁有效？”，以及（d）“‘有效’到底是什么意思？”
存在多种对疗效有不同程度证据支持的CAS治疗方法。开始有研究比较不同治疗方法并试图确定最佳治疗参数。迄今为止，很少有研究探讨治疗反应的儿童水平预测因素，并且目前的证据基础在研究的人群和结果方面范围有限。
越来越多的证据支持多种治疗CAS方法的疗效。然而，文献中发现了许多重要差距，值得加倍并持续的研究关注。开始有研究涉及治疗优化、比较、候选资格和结果。提供了未来研究的建议，并将假设途径的概念应用于CAS，以说明干预的组成部分如何影响临床目标的变化，并有助于指导针对患有CAS儿童的治疗方法的开发和完善。
