Speech Characteristics of Childhood Apraxia of Speech in Hebrew-Speaking Children

Purpose: Childhood apraxia of speech (CAS) is a motor speech disorder characterized by deficits in speech planning and programming. However, current diagnostic frameworks have been developed primarily from studies of English-speaking children, raising questions regarding their applicability to other languages. This study examined the common and diagnostic speech characteristics of Hebrew-speaking children with CAS as perceived by Israeli speech-language pathologists (SLPs). Method: Two hundred Israeli SLPs with experience diagnosing and/or treating children with CAS completed an online questionnaire. Participants rated 26 speech characteristics on 7-point scales reflecting their perceived frequency and diagnostic specificity in Hebrew-speaking children with CAS. Descriptive analyses included mean ratings and the percentage of clinicians endorsing each characteristic. Results: Increased difficulty with multisyllabic words (M = 6.37) and inconsistent errors (M = 6.32) received the highest frequency ratings and were endorsed by 87.0% and 84.0% of clinicians, respectively, as common characteristics of CAS. Inconsistent errors received the highest diagnostic specificity rating (M = 6.12), followed by groping movements (M = 5.73) and difficulty sequencing syllables (M = 5.48). Prosodic features, including lexical stress errors (M = 3.72) and equal stress patterns (M = 3.73), received ratings at or below the midpoint of the scale and were endorsed by fewer than 20% of clinicians as common characteristics of CAS. Breathy voice (M = 3.11) and consistent hypernasality (M = 2.79), two control characteristics not typically associated with CAS, received the lowest ratings. Conclusions: Israeli SLPs identified syllable sequencing difficulties and inconsistency as the most salient and diagnostically informative characteristics of CAS in Hebrew-speaking children. In contrast, prosodic features, particularly lexical stress errors, were perceived as less common and less central to diagnosis than suggested by English-based diagnostic frameworks. These findings suggest that the clinical manifestation of CAS may be influenced by language-specific phonological and prosodic properties and underscore the need for direct investigation of CAS characteristics in Hebrew-speaking children.