New Treatments for Patients with Down Syndrome
A study recently printed in the International Journal of Speech-Language Pathology indicates that the beliefs surrounding motor speech deficits in patients with Down syndrome may have caused those patients to not receive the most beneficial treatment.
Historically, it was believed that patients with Down syndrome would have either Childhood Dysarthria (CD) or Childhood Apraxia of Speech (CAS). CD was believed to be the prominent issue and when it was diagnosed CAS was discounted. This study has led to the realization that the motor speech disorders that so frequently accompany Down syndrome are far more complex than originally believed.
Dysarthria is a term used to describe a speech impairment caused by neurological damage, or other condition, which has caused the muscles utilized during speech to not function properly. There are numerous forms, including: Spastic, Flaccid, Ataxic, Hyperkinetic, Mixed, and Hypokinetic.
Because these speech deficits are the result of issues with the muscle’s ability to produce the shapes necessary for linguistic sounds therapy often revolves around strengthening these muscles. While this is extremely effective for patient’s with a form of dysarthria, it is less effective and potentially ineffective, in patient’s who have other underlying issues.
Childhood Apraxia of Speech
Childhood Apraxia of Speech also involves the patient not being able to form words, but this is not because of a muscular issue; rather, it has to go with the ability of the brain to transition the knowledge that an individual wants to say something to the muscles that make the action possible. CAS can be difficult to diagnose because the presentation of symptoms can vary so radically between patients. Making the diagnosis even more difficult was the assumption that patients with Down syndrome had dysarthria, and that the two diagnosis were mutually exclusive.
The treatment for apraxia is completely different than the treatment for dysarthria, and the strengthening exercises will have no impact on the need to improve planning and sequencing which a patient with apraxia requires. The child with apraxia will need more intensive, and more frequent, individual therapy. They will also require additional practice at home.
Due to the new information provided in the study, there is significant potential benefit in reassessing patients with Down syndrome who are receiving speech therapy. The addition of therapy methods for the other motor speech disorder may significantly improve the speech ability of these patients.