This is an exciting article to include as a “throwback pub," because it’s quite new (2014), and arguably the most thorough evaluation of childhood apraxia of speech (CAS) treatment options to date. When someone says, “I need a research study to help me decide among treatment strategies for CAS”, send them this!
This systematic review covers “…all levels of evidence that may be critical to inform clinical practice…” from the 1970s through 2012. From over 1000 studies, detailed inclusion/exclusion criteria were employed to narrow it down to 23. One issue that arose across studies was consistency in the definition of CAS (see ASHA’s 2007 consensus). The authors found that, “The most commonly overlooked CAS characteristic across studies was dysprosody…” Other studies were excluded for lack of clearly-reported treatment outcomes. Of the final 23 studies, most were motor approaches, with some linguistic and two AAC approaches. All delivered treatment individually, with a range in treatment schedule and dose.
So, what did the authors of this systematic review conclude? They found that:
“… currently two motor treatments (Integral Stimulation/DTTC and ReST [Rapid Syllable Transition]) and one linguistic treatment (Integrated Phonological Awareness Intervention) are best suited to interim clinical use…”
And, voilà—from there you start. Want another paper? Try this one. Maas et al. also examined the evidence behind several treatment approaches, and suggest that, “At present, a DTTC-type integral stimulation approach has the strongest evidence base…”
So—exciting as it is to know where you should start with these clients, I know what you all are thinking: Do either of these articles tell me how to "do" these techniques? How do I implement DTTC in the therapy room? Well... unfortunately, that's beyond the purpose of these papers (<sigh>). But, I know you all need this. So let's talk where to go next in the comments section, below. I'll show you what I've found, and you all chime in, too! We should be able to crowd-source some of the best current resources for SLPs (extra credit for web-based continuing ed courses, folks!)
See: Murray, E., McCabe, P., & Ballard, K.J. (2014). A Systematic Review of Treatment Outcomes for Children With Childhood Apraxia of Speech. American Journal of Speech-Language Pathology, 23, 486–504.
Want more information on the CAS treatment? Try this this Cochrane Review. It shows that even though we have some nice research on childhood apraxia of speech, it’s still not a very strong evidence base. And we definitely don’t have enough evidence to recommend one CAS treatment approach over another.