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High prevalence of developmental coordination disorder risk in childhood apraxia of speech
Şermin Tükel1,2, Emma K Baker1, G Yazgi Tütüncü3
1Centre of Research Excellence in Speech and Language, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Insights
Children with childhood apraxia of speech (CAS) frequently experience motor impairments and developmental coordination disorder (DCD) risk. Early screening for DCD is crucial for effective intervention in CAS.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Speech-Language Pathology
Background:
- Childhood apraxia of speech (CAS) is a complex motor speech disorder.
- Motor impairments are frequently observed in children with CAS.
- Developmental coordination disorder (DCD) shares overlapping symptoms with CAS.
Purpose of the Study:
- To investigate the prevalence of motor impairments and DCD risk in children diagnosed with CAS.
- To identify specific motor deficits associated with DCD in this population.
- To evaluate the effectiveness of current assessment tools for DCD in children with CAS.
Main Methods:
- Prospective cohort study of 105 children (aged 5-15 years) with CAS.
- Utilized the Developmental Coordination Disorder Questionnaire (DCD-Q), visuomotor precision subtest, Vineland Adaptive Behaviour Scales (Vineland-3), and Full-scale IQ (FSIQ) assessments.
- Employed statistical analyses including logistic regression and ROC analyses to identify predictors of DCD risk.
Main Results:
- 82% of children with CAS exhibited motor impairments; 63% screened positive for DCD risk.
- Visuomotor precision deficits were present in 71% of participants.
- The Vineland-3 motor subtest and visuomotor precision were significant predictors of DCD risk (OR=7.17 and OR=4.90, respectively), independent of FSIQ.
Conclusions:
- Children with CAS have a high prevalence of DCD risk and visuomotor impairments, irrespective of intellectual ability.
- The Vineland-3 motor subtest is not recommended for DCD screening in this population.
- Routine screening for DCD is essential for timely and targeted interventions in children with CAS.
Aim:
To explore motor impairments linked to developmental coordination disorder (DCD) in children with childhood apraxia of speech (CAS).
Method:
This prospective cohort study included 105 children (79 male, aged 5-15 years) with CAS. Assessments included the Developmental Coordination Disorder Questionnaire, Revised, the visuomotor precision subtest of the Neuropsychological Assessment, Second Edition, the motor subtest of the Vineland Adaptive Behaviour Scales, Third Edition (Vineland-3), and Full-scale IQ (FSIQ) scores. Data analysis used multiple imputation for missing data, along with descriptive statistics, repeated-measures analysis of variance, multiple binary logistic regression, and receiver operating characteristic (ROC) analyses.
Results:
Eighty-two per cent of participants showed motor impairments; 63% screened positive for DCD risk; and 71% had visuomotor precision impairments. Fine-motor scores were lower than gross-motor and coordination scores. The logistic regression model accurately predicted DCD risk at 73%, identifying the Vineland-3 (odds ratio [OR] = 7.17) and visuomotor precision subtest (OR = 4.90) as significant predictors, whereas the FSIQ was not. The Vineland-3 showed a high false negative rate (46%) for DCD risk, and the ROC analysis suggested a higher cut-off point for improved prediction accuracy.
Interpretation:
This study highlights a high prevalence of DCD risk and visuomotor precision impairments among children with CAS, independent of FSIQ. The Vineland-3 motor subtest is not recommended for DCD assessment, whereas screening for DCD is essential for targeted interventions in CAS.
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