Alduais Ahmed, Alfadda Hind
Department of Human Sciences (Psychology), University of Verona, 37129 Verona, Italy.
Department of Curriculum and Instruction, King Saud University, Riyadh 11362, Saudi Arabia.
Brain Sci. 2024 May 24;14(6):540. doi: 10.3390/brainsci14060540.
Childhood apraxia of speech (CAS) represents a significant diagnostic and therapeutic challenge within the field of clinical neuropsychology, characterized by its nuanced presentation and multifactorial nature. The aim of this study was to distil and synthesize the broad spectrum of research into a coherent model for the assessment and diagnosis of CAS. Through a mixed-method design, the quantitative phase analyzed 290 studies, unveiling 10 clusters: developmental apraxia, tabby talk, intellectual disabilities, underlying speech processes, breakpoint localization, speech characteristics, functional characteristics, clinical practice, and treatment outcome. The qualitative phase conducted a thematic analysis on the most cited and recent literature, identifying 10 categories: neurobiological markers, speech motor control, perceptual speech features, auditory processing, prosody and stress patterns, parent- and self-report measures, intervention response, motor learning and generalization, comorbidity analysis, and cultural and linguistic considerations. Integrating these findings, a descriptive and prescriptive model was developed, encapsulating the complexities of CAS and providing a structured approach for clinicians. This model advances the understanding of CAS and supports the development of targeted interventions. This study concludes with a call for evidence-based personalized treatment plans that account for the diverse neurobiological and cultural backgrounds of children with CAS. Its implications for practice include the integration of cutting-edge assessment tools that embrace the heterogeneity of CAS presentations, ensuring that interventions are as unique as the children they aim to support.
儿童言语失用症(CAS)是临床神经心理学领域一项重大的诊断和治疗挑战,其表现细微且具有多因素性质。本研究的目的是将广泛的研究提炼并综合成一个连贯的CAS评估与诊断模型。通过混合方法设计,定量阶段分析了290项研究,揭示了10个聚类:发育性失用症、平板式言语、智力障碍、潜在言语过程、断点定位、言语特征、功能特征、临床实践和治疗结果。定性阶段对被引用最多和最新的文献进行了主题分析,确定了10个类别:神经生物学标志物、言语运动控制、言语感知特征、听觉处理、韵律和重音模式、家长和自我报告测量、干预反应、运动学习与泛化、共病分析以及文化和语言考量。综合这些发现,开发了一个描述性和规范性模型,概括了CAS的复杂性,并为临床医生提供了一种结构化方法。该模型增进了对CAS的理解,并支持针对性干预措施的开发。本研究最后呼吁制定基于证据的个性化治疗计划,以考虑到患有CAS的儿童的不同神经生物学和文化背景。其对实践的影响包括整合前沿评估工具,以涵盖CAS表现的异质性,确保干预措施与它们旨在支持的儿童一样独特。