The Quality of Evidence Supporting Different Interventions for CAS

What is it about?

We searched five databases for systematic reviews of treatment research in Childhood Apraxia of Speech (CAS). Six existing reviews met inclusion criteria for quality appraisal. Two examiners coded each article for methodologic rigor and extracted summary data. Only one rigorous systematic review was found, including one randomized controlled trial (Morgan et al., 2018). A second review (Murray et al., 2014) of multiple single participant research designs study was completed with moderate rigor. Multiple types of treatment were summarized, including linguistic, motor-programming, and alternative and augmentative communication approaches (Koehlinger, 2015; Murray et al., 2014). Most reviews identified hour-long treatment sessions delivered one to three times weekly. Five of the six reviews reported improvement in speech production for at least some speech targets following treatment. Better outcomes were reported for high intensity motor programming treatment schedules with a high dose and dose frequency during training (Kaipa & Peterson, 2016).

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Photo by Jason Rosewell on Unsplash

Photo by Jason Rosewell on Unsplash

Why is it important?

A number of studies have examined the effects of speech interventions on outcomes in CAS. Most systematic reviews include all studies on a topic to encompass both the quantity and quality of evidence (Gough, 2007). But without scientific rigor, these reviews may be biased in their recommendations. We appraised the quality of reviews to determine that the most convincing evidence for CAS treatment lies with motor programming treatments, such as Rapid Syllable Transition Treatment (ReST), Dynamic Temporal and Tactile Cueing (DTTC), and Nuffield Dyspraxia Program. We provide links to descriptions and free training for these evidence-based practices.