Recent studies have highlighted the need for children with autism to be screened for apraxia, which is a neurological speech disorder that often goes hand in hand with Autism. A three year long study conducted at Penn State College of Medicine showed that 64% of children initially diagnosed with autism were also found to have apraxia. Research also further validated the use of the Checklist for Autism Spectrum Disorder (CASD) as an accurate tool for diagnosing autism in children with apraxia.
Childhood apraxia of speech refers to difficulties planning and coordinating the tongue, lips, mouth and jaw so they can accurately produce speech sounds. When a child with apraxia tries to produce the same word, it sounds different each time. Experts have noted the frequency of the co-morbidity between apraxia and autism, and with increased recognition and improved evaluation measures for apraxia in patients with autism, more children are being identified with both disorders.
The researchers studied 30 children between the ages of 15 months and five years who were referred to the Penn State Hershey Pediatric Developmental Communication Assessment Clinic for concerns regarding speech, language or autism. After an initial diagnostic screening, follow-up testing showed that 63.6 percent of children initially diagnosed with autism also had apraxia and 36.8 percent of children initially diagnosed with apraxia also had autism.
This study highlights the importance of ongoing apraxia assessment for children with autism in order to provide them with early intervention, as intervention at this stage is linked with improved outcomes for both autism and apraxia. The new study also verified that the CASD (Checklist for Autism Spectrum Disorders), a commonly used assessment tool developed and standardised on children with language disorders and not speech disorders, did not over-diagnose autism in children who have apraxia.
We were concerned that children with childhood apraxia of speech were being mislabeled as having autism when they were being evaluated for it, but we found that this was not the case, Tierney said. CASD is used to diagnose autism, but it can also be used to rule out autism, Tierney said. “We wanted to make sure this tool came out negative in a child that just had apraxia and we found that it really does help us distinguish kids accurately.
Children who had apraxia without autism, children who had autism but not apraxia, or those who had both or neither were picked up accurately. The tool was very sensitive in picking up all those different combinations. And that’s good news because we want the right treatment for the right child for the right diagnosis.
There is a significant difference in the type and nature of intervention for children with Autism compared to those with apraxia therefore it is crucial to make the correct diagnosis in order for intervention to be successful.