Assessment of childhood apraxia of speech characteristics

Otroška govorna apraksija je motorična govorna motnja, pri kateri je moteno načrtovanje in/ali programiranje govornih gibov. V slovenskem prostoru se zaradi odsotnosti ustreznih standardiziranih testov ocenjuje predvsem na podlagi strokovnega mnenja oziroma sodbe strokovnjakov o prisotnosti ali odsotnosti njenih znakov. V teoretičnem delu magistrskega dela je bil na podlagi analize strokovne literature oblikovan protokol za ocenjevanje znakov otroške govorne apraksije, ki vključuje vprašalnik za starše, vprašalnik za logopede, smernice za ocenjevanje in interpretacijo znakov otroške govorne apraksije ter nasvete za starše in vzgojitelje oziroma učitelje. Ker zanesljiva in zadostna kombinacija znakov otroške govorne apraksije še ni uradno opredeljena, protokol zajema ocenjevanje širokega nabora znakov, ki jih opisujejo dosedanje raziskave: nekonsistentnost izgovora, podaljšani in moteni koartikulacijski prehodi, motnje v prozodiji, drugačen zgodnji razvoj govora, omejen fonemski in fonetični repertoar glasov, pogosta izpuščanja soglasnikov, napake v izgovoru samoglasnikov, napake v izgovoru glasov, pri katerih se spremeni več značilnosti, netipični fonološki procesi, prisotnost gibov iskanja pri artikulaciji glasov, prevladujoča raba preprostih besednih oblik in povečano število napak pri kompleksnejših besednih oblikah, slaba razumljivost, lažja izreka avtomatizmov, slabša izvedba diadohokineze, težave pri posnemanju neverbalnih oralnih gibov, govorna regresija, boljši receptivni kot ekspresivni jezik, jezikovne težave, šibke (pred)opismenjevalne veščine in počasen napredek v logopedski terapiji. V empiričnem delu je bil protokol izveden na konkretnem primeru s 7 let starim dečkom s težjo govorno-jezikovno motnjo in sumom na otroško govorno apraksijo. Ugotovljeno je bilo, da deček izkazuje večino znakov, opisanih v strokovni literaturi. Delo predstavlja novost v slovenski logopedski stroki, širi znanje o otroški govorni apraksiji in spodbuja k poglobljenemu ocenjevanju ter oblikovanju lastnih protokolov za ocenjevanje govorno-jezikovnih motenj.Childhood apraxia of speech is a motor speech disorder with impaired planning and/or programming of speech movements. Due to the lack of appropriate standardized tests in Slovenia, it is assessed based on experts’ judgement about the presence or absence of its characteristics. In the theoretical part of the master’s thesis a protocol was developed for assessing the characteristics of Childhood Apraxia of Speech based on the analysis of scientific literature. This protocol includes a questionnaire for parents, a questionnaire for speech and language pathologists, guidelines for the evaluation and interpretation of the characteristics of Childhood Apraxia of Speech, and advice for parents and teachers. A combination of characteristics that are reliable and sufficient signs of CAS has not yet been discovered. That is why this protocol covers an assessment of a wide range of characteristics, which have been described in research so far: speech inconsistencylengthened and disrupted coarticulatory transitionsprosodic disturbancesdifferent early speech developmentlimited phonemic and phonetic inventoryfrequent omissions of consonantsvowel errorsmultiple feature errors in phoneme substitutionsatypical phonological patternsgropingpredominant use of simple word shapes and increased errors as the complexity of the word shape increaseslimited speech intelligibilitybetter performance of automatic speech productionspoor diadochokinesisdifficulty imitating nonspeech oral movementsspeech regressionstronger receptive language than expressive languagelanguage difficultiesweak (pre)literacy skillsand poor progress in speech therapy. In the empirical part of the thesis the protocol was implemented in the case of a 7-year-old boy with a severe speech and language disorder and suspected Childhood Apraxia of Speech. It was established that the boy showed most of the characteristics described in the literature. This thesis is a novelty in Slovenian speech and language pathologyit broadens the knowledge of Childhood Apraxia of Speech, and promotes precise evaluation and development of individual protocols for assessing speech and language disorders