What does the research tell us about NDT – Neurodevelopmental Treatment for childhood apraxia of speech (CAS)?
In short: NOTHING
You can now go about your day. If you are interested in reading more, I will summarize the research below.
What is NDT?
NDT stands for neurodevelopmental treatment. It was created by a physical therapist named Berta Bobath and her husband as a treatment for cerebral pasly (NDTA, 2005). According to (Paris, B. Theoretical Base of NDT), the Bobath’s believed that movement is not learned. Rather sensations of movement are what help children learn effectively.
What does the research say?
Since that time, it’s been researched since it’s conception primarily in the physical and occupational therapy realms. More specifically, with cerebral palsy and gross motor skills. I found no information related to NDT for childhood apraxia of speech. There was one paper that did a relational study looking at the effectiveness of NDT on gross motor function with children who had cerebral palsy and a general developmental delay. The criteria for developmental delay though was loose and it’s not clear if these children had a diagnosed motor planning disorder as in developmental coordination disorder (Lee K.H. et al, 2017)
The most recent and up to date summary article on NDT was done in 2018 by Besios and colleagues. The conclusion,
This does not even address children with dyspraxia, developmental coordination disorder or CAS.
Do children with CAS need PT and OT?
Research does show that many children with CAS can be at risk for motor impairments (Iuzzini-Seigel, 2019). However, it is out of the scope of a PT or OT to be treating childhood apraxia of speech.
What does the research show is the best way to treat CAS?
In a 2014 systematic speech review by Murray et.al, it states,
Speech production is a complex motor skill with extraordinary spatiotemporal demands, requiring coordination across many different muscle groups.
The review looked at 42 articles and 90% made explicit reference to utilizing the principles of motor learning.
A recent 2020 review done by Springle and colleagues found,
Findings of six systematic reviews, two of which were conducted with relative rigor, suggest that motor programming treatments have the best evidence base for treatment decisions pertaining to CAS. Clinicians are referred to online resources to implement these treatments according to published protocols.
In short, NDT is not a recognized treatment in childhood apraxia of speech. CAS is a lifelong neurological disorder affecting the planning and programming of the movements needed for speech. As such, the best approach according to available research is treatment incorporating the principles of motor learning.
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 is the author of Overcoming Apraxia and has lectured throughout the United States on CAS and related issues. Currently, Laura is a practicing SLP specializing in apraxia at her clinic A Mile High Speech Therapy in Aurora, Colorado.