[CAS -- R012] Prevalence study

上一個post 講咗Motor Speech Disorders (MSD) 嘅新分類，接住落嚟就要講下Prevalence 喇。Shriberg, Kwiatkowski, & Mabie (2019) 報告咗MSD喺idiopathic Speech Delay (SD)入面嘅prevalence。要注意，MSD 唔一定只係idiopathic SD入面搵到，有一啲Complex Neurodevelopmental Disorders (例如 Down syndrome, fragile X syndrome, Galactosemia 等)都會有。呢篇文章只注視idiopathic SD，另外有一啲文章係注視一啲complex neurodevelopmental disorders 嘅 (e.g., Baylis & Shriberg, 2018; Shriberg, Strand, Jakielski, & Mabie, 2019).

研究搵咗415 有idiopathic SD 嘅小朋友，同佢地進行motor speech assessment，然後將佢地分類。數字如圖一。

之後，再進行估算一下prevalence，結果在圖二。

結論： 1) SMD 相對地係較CAS同CD為多。 2) 雖然CD&CAS 係數字上面係0, 但研究人員都認為係有啲種情況嘅。事實上，喺一啲研究報告入面都有提及呢類嘅情況 (e.g., Murray et al., 2015)。 3) CAS 嘅prevalence 同之前嘅研究類似(Shriberg et al., 1997)。

個人意見： 1) 可能你會覺得知道一個數字對於臨床工作沒有太大的影響，但我就覺得數字俾到一啲槪念前線工作嘅治療師，亦可方便與家長溝通。 2) 呢啲數字對於寫research fund 嘅proposal 好重要。無funding嘅support，好多研究都做唔成，呢個係事實。

Reference: Baylis, A. L., & Shriberg, L. D. (2018). Estimates of the prevalence of speech and motor speech disorders in youth with 22q11.2 Deletion syndrome. American Journal of Speech-Language Pathology. Advance online publication. doi: 10.1044/2018_AJSLP-18-0037.

Murray, E., McCabe, P., Heard, R. & Ballard, K. J. (2015). Differential diagnosis of children with suspected childhood apraxia of speech. Journal of Speech, Language and Hearing Research, 58(1), 43-60.

Shriberg, L. D., Aram, D., & Kwiatkowski, J. (1997). Developmental apraxia of speech: I. Descriptive and theoretical perspectives. Journal of Speech, Language, and Hearing Research, 40, 273–285.

Shriberg, L. D., Kwiatkowski, J. & Mabie, H. L. (2019). Estimates of the prevalence of motor speech disorders in children with idiopathic speech delay. Clinical Linguistics & Phonetics. DOI: 10.1080/02699206.2019.1595731

Shriberg, L. D., Strand, E. A., Jakielski, K. J., & Mabie, H. L. (2019). Estimates of the prevalence of speech and motor speech disorders in persons with complex neurodevelopmental disorders. Clinical Linguistics & Phonetics.

#兒童言語失用症 #失用症 #言語治療 #語言治療 #運動性構音障礙 #發音 #構音障礙

[CAS -- R011] Motor Speech Delay 2

上一次分享咗一篇文章，講Speech Motor Delay (SMD) 呢個新嘅clinical term嘅。今次就講下Speech Disorders Classification System (SDCS) 裡面講嘅Motor Speech Disorders (MSD)

SDCS 係一個research framework，由上個世紀開始發展，經過多過二十五年後，喺2019年發佈了finalize version (Shriberg, Kwiatkowski, & Mabie, 2019)。簡單嚟講，Speech Sound Disorders 分為三類：1) Speech Delay (SD), 2) Speech Errors (SE) 及3) Motor Speech Disorders (MSD)。

而喺MSD 入面，分為四種，包括: 1) Speech Motor Delay (SMD), 2) Childhood dysarthria (CD), 3) Childhood Apraxia of Speech (CAS) 及 4) CD & CAS。

以上嘅分類，係根據一啲diagnostic markers 進行嘅，包括：Precision-Stability index (PSI: Shriberg & Wren, 2019), Dysarthria Subtype Index (DI) 及 Pause Marker (PM; Shriberg et al., 2017)。詳細嘅內容，可以參考相關嘅文獻。同之前嘅版本唔同，SMD係一個新clinical term，取代咗之前嘅Motor Speech Disorder-Not Otherwise Specified (MSD-NOS; Shriberg et al., 2010)。

個人意見： 1) 一個新的clinical term，帶來了新的認知。將本來被認為是非黑即白嘅Motor Speech Disorders 帶來了更合適的描述。臨床工作上，總會遇到既不CAS，又不CD，但又真切確實地有motor speech 問題的個案。現在我們可以根據研究結果把他們放在SMD一類中，並繼續以motor speech 的角度來處理。 2) 能夠用一啲objective 嘅方法去診斷病童為不同類形的MSD, 對於臨床工作是非常非常重要的。如果言語治療師能夠將研究結果轉化為臨床應用，相信會有令更多人受恵。 3) 需要提醒一下，MSD 與 Phonological Disorder可以同時存在，SDCS 嘅分類未有詳細描述此類情況。

#兒童言語失用症 #言語治療 #失用症 #語言治療 #運動性構音障礙 #兒童構音障礙 #發音

Reference: Shriberg, L. D., Fourakis, M., Hall, S., Karlsson, H. B., Lohmeier, H. L., McSweeny, J. L., ... Wilson, D. L. (2010). Extensions to the Speech Disorders Classification System (SDCS). Clinical Linguistics & Phonetics, 24, 795–824. doi:10.3109/02699206.2010.503006

Shriberg, L. D., Kwiatkowski, J. & Mabie, H. L. (2019). Estimates of the prevalence of motor speech disorders in children with idiopathic speech delay. Clinical Linguistics & Phonetics. DOI: 10.1080/02699206.2019.1595731

Shriberg, L. D., Strand, E. A., Fourakis, M., Jakielski, K. J., Hall, S. D., Karlsson, H. B., Mabie, H. L., McSweeny, J. L., Tilkens, C. M., & Wilson, D. L. (2017). A diagnostic marker to discriminate childhood apraxia of speech from speech delay: Introduction. Journal of Speech, Language, and Hearing Research, 60, S1094-S1095. doi:10.1044/2016_JSLHR-S-16-0148

Shriberg, L. D., & Wren, Y. E. (2019). A frequent acoustic sign of Speech Motor Delay (SMD). Clinical Linguistics & Phonetics. doi:10.1080/02699206.2019.1595734.

[CAS -- R010] Motor Speech Delay 1

A new clinical term "speech motor delay (SMD)" is proposed to label children who have a delay in the development of speech motor control.

"Lengthened mid-vowels and diphthongs" is a frequent sign of SMD in children with idiopathic speech delay, complex neurodevelopmental disorders, and persistent idiopathic speech delay.

So, we can now classify children who do not meet the criteria of CAS, but with some signs of speech motor impairment.

https://www.tandfonline.com/doi/full/10.1080/02699206.2019.1595734?fbclid=IwAR12q4ArmogWchsY66YRLqyW9-In4W93Z7xz0lzm3Pw6rVGKwjlfmX5M0R0