Oral Language and Phonological Skills May Be the Best Predictors for Reading Disorders in Childhood Apraxia of Speech
A new study finds that 65% of children with a history of suspected Childhood Apraxia of Speech (sCAS) are low proficiency readers, suggesting that early literacy intervention is justified for this group of children.
August 17, 2019
Research recently published in the American Journal of Speech Language Pathology (AJSLP) suggests children with sCAS are at increased risk for reading disorders and should receive early intervention targeting early literacy and language skills, along with the speech motor planning component in their speech therapy program.
” The current conceptualization of CAS as primarily a motor speech disorder may encourage interventions that rely largely on habituating accurate motor speech plans with little attention paid to the development of literacy skills. Viewing CAS as a motor speech disorder that commonly includes reading impairment may be more useful to clinicians given the high percentage of children with CAS who exhibit decoding difficulties. “
The study by Miller, Lewis and colleagues had several aims. First, the researchers wanted to identify the frequency of reading disorders in children with sCAS and Speech Sound Disorder (SSD). Also, researchers wanted to learn how children with sCAS differed from one another and also how they differed from children with SSD in various levels of reading proficiency and performance.
Participants were a group of 40 children ranging in age from 7-18 with sCAS and 119 participants ranging in age from 7-18 with SSD. All the study participants were tested and then compared on various measures for speech, language, reading, and cognitive-linguistic skills.
Several findings are of interest:
- Sixty-five percent of children with sCAS were low proficiency readers, which is substantially more than the percentage of low proficiency readers in the general population.
- Specific risk factors for literacy difficulties in children with sCAS were oral language and phonological skills.
- While speech motor skill deficits were identified in all children with sCAS, the participants’ speech difficulties did not predict their reading proficiency.
Overall, the findings indicate that viewing CAS solely as a motor speech disorder may be a disservice as SLP’s might miss out on the opportunity to address the intertwining of speech, language and literacy deficits as early as preschool. The current study provides justification for providing early literacy intervention coupled with appropriate speech and language therapy for children with sCAS to strengthen weak phonological processing skills found in the population and which negatively impact later reading proficiency.
Future research needs to explore the differences or similarities in the trajectory of reading achievement between groups considered resolved or with persistent CAS as well to explore what specific interventions are particularly helpful for kids with CAS and reading impairment.
Sources:
Gabrielle J. Miller, Barbara Lewis, Penelope Benchek, Lisa Freebairn, Jessica Tag, Karlie Budge, Sudha K. Iyengar, Heather Voss-Hoynes, H. Gerry Taylor , Catherine Stein, “Reading Outcomes for Individuals With Histories of Suspected Childhood Apraxia of Speech.” American Journal of Speech-Language Pathology. (August 17, 2019).
https://pubs.asha.org/doi/full/10.1044/2019_AJSLP-18-0132
Laura Smith, M.A. CCC-SLP is a 2014 graduate of Apraxia Kids Boot Camp, has completed the PROMPT Level 1 training, and the Kaufman Speech to Language Protocol (K-SLP). She has lectured throughout the United States on CAS and related issues. Laura is committed to raising and spreading CAS awareness following her own daughter’s diagnosis of CAS and dyspraxia. She is the apraxia walk coordinator for Denver, and writes for various publications including the ASHA wire blog, The Mighty, and on a website she manages slpmommyofapraxia.com. In 2016, Laura was awarded ASHA’s media award for garnering national media attention around apraxia detailing her encounter with UFC fighter Ronda Rousey, and also received ASHA’s ACE award for her continuing education, specifically in the area of childhood motor speech disorders. Currently, Laura is a practicing SLP specializing in apraxia at her clinic A Mile High Speech Therapy in Aurora, Colorado.