A new study published this month in the Journal of Developmental and Behavioral Pediatrics confirms current belief that many children with Autism also have Apraxia of Speech.
Cheryl Tierney, MD, MPH of Penn State University, Susan Meyes, PhD and others investigated the efficacy of the Checklist for Autism Spectrum Disorder (CASD), a screening tool developed to determine if children should undergo complete diagnostic testing for autism (1). The researchers found that the screening tool does effectively indicate which children are at risk for autism, but they also came to another interesting conclusion.
Intervention approaches for autism and apraxia address different features of communication, therefore, it is important for clinicians to be aware that kids with autism may have undiagnosed apraxia of speech as well.
Autism spectrum disorders are diagnosed by neuropsychologists and developmental-behavioral pediatricians. Language impairments present in autism are partially characterized by “difficulties with theory of mind [taking the perspective of another person]; difficulty with non-literal language… difficulty with conversation [maintaining a topic]” (2).
Apraxia of Speech, however, is typically diagnosed by a speech-language pathologist, and is characterized by difficulty coordinating volitional motor movements required for clear and intelligible speech.
While autism and apraxia clearly have different features, a child with autism who has profound language delays such that he or she is minimally verbal or non-verbal may have undiagnosed childhood apraxia of speech, masked by his or her language deficits.
The study concluded that “autism and apraxia are highly comorbid. Thus, it is important to monitor all children diagnosed with apraxia for signs of autism and all children diagnosed with autism for signs of apraxia. This will help identify children as early as possible and allow them access to services appropriate to their needs.”
In evaluating children with autism, speech-language pathologists should rule out apraxia of speech. In requesting services or evaluations for their children, parents should also consider the intelligibility of any language the child may produce.
This post was authored by Stephanie Millman-Dorsch, ASF’s Community Relations Manager. Stephanie is a Master’s of Science Candidate in Communicative Sciences and Disorders at NYU, expecting to graduate this December.
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NB: Dr. Mayes, who co-authored the study, is the primary developer of the CASD
References:
(1) CASD: Mayes, S. (2015). Checklist for Autism Spectrum Discorder (CASD). Retrieved October 23, 2015.
(2) DSM-5: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
