Speech problems in adolescents
The goal of this technical report on childhood apraxia of speech (CAS) was to assemble information about this challenging disorder that would be useful for caregivers, speech-language pathologists, and a variety of other health care professionals. Information on CAS has often been the most frequent clinical topic downloaded by visitors to ASHA's Web site. This report addresses four questions most often asked about CAS: (a) Is it a recognized clinical disorder? (b) What are its core characteristics? (c) How should it be assessed? and (d) How should it be treated?
To address these four questions, the Committee undertook a review of the scientific foundations of CAS and trends in professional practice. A preliminary survey of the literature indicated that it would not be feasible to complete a systematic review consistent with evidence-based practice. The primary barriers to such a review were unresolved controversies about the quality rankings for commonly used research designs, as proposed in several evidence-based practice systems. The Committee therefore elected to complete narrative reviews restricted to peer-reviewed literature published since 1995, with additional sources consulted as needed for coverage of certain topics. We developed a template to summarize each study and consensus procedures to evaluate the strength and quality of evidence for research findings in relation to the four questions posed above. Findings from reviews and the consensus evaluation procedures were synthesized to form the bases for the information provided in this document, including recommendations on several key professional issues. The final document incorporated extremely useful information from select and widespread reviewers who responded to invitations to review preliminary drafts of this document, including a draft posted on ASHA's Web site.
In this initial section of the report, we introduce terms and concepts, consider issues associated with the definition of CAS, and discuss scientific and professional information related to the reported increased prevalence of CAS.