Development of an oral apraxia diagnostic tool for 4-to-5-year-old children

The majority of children with articulation disorders attending speech therapy centers typically don’t demonstrate the well-known pathologic signs of articulation disorders (such as oral structural abnormity, environmental deprivation, mental retardation, hearing loss, etc). With regard to the fact that there is strong evidence for co-occurrence of articulation disorders and oral apraxia in the literature, it is reasonable to assume the presence of oral apraxia in this population. Therefore, to diagnose oral apraxia in children with articulation disorders, an efficient tool is required.Methods and materials: At first, an oral apraxia checklist with 20 tasks which were frequently recommended for the assessing this disorder in the related literature was developed and its validity and reliability were detected. Then from the population of 4-to-5 year old children, a sample of 74 normal subjects was selected to examine their performance over the above-mentioned tasks and to determine the cut-off point for the checklist. The inclusion criteria was a normal medical history and the ability to successfully pass two tests, namely an phonetic test which assessed the normality and appropriateness of articulator skills and a oropharyagial test which aimed to detect any sensory–motor problems in the oral and facial areas. The cut-off point was established on the basis of the false positive and specificity amounts obtained from the raw data. Performing only 15 tasks of the checklist’s 20 tasks was found to be the cut-off point. This means that every child with an age ranging from 4 to 5 years old, who pass only 15 or less tasks successfully, is affected by oral apraxia. At the cut-off point of 15 tasks, the amount of specificity was 94.5% and false positive was 5.4%. According to the results of this study, the oral apraxia can be validly diagnosed in 4-5-year old children using this newly developed test. Co-occurrence of oral apraxia with articulation disorder implicates planning an efficient intervention management which takes its presence into account.