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Research for Speech Disorders / Apraxia

Look Who's Talking Now: Speech Disorders and the Therapeutic Role of Essential Fatty Acids

Scientists Help Children With Communication Disorders

First language gene identified
Oct. 3, 2001 — British scientists say they've discovered the first gene tied to a language and speech disorder, raising hopes that the genetics revolution is closer to identifying the biological roots of conscious thought and, perhaps, refining what it means to be human. CALLED FOXP2, the gene produces a protein that turns other genes on and off. Scientists believe it could hold the key to why people suffer from speech problems. It is not specifically a gene that enables us to talk. Instead, researchers say they discovered a mutated form of the gene, which is responsible for a protein that enables the brain's language circuitry to function.
MSNBC NEWS SERVICES

Official Statement from The Scientific Conference, the first for verbal apraxia, which will lead to clinical research for apraxic children

How did this Apraxia /EFA Scientific Conference Come About?

Scientific Organizers

Scientific Panelists

Administrative Organizers

Conference Information/Agenda

EFA Resources

Official Statement from The First Scientific Conference Dedicated to the Therapy of Verbal Apraxia/Dyspraxia! You may want to explore the archives of our grouplist.

The First Scientific Conference on Therapy for Verbal Apraxia/Dyspraxia

Post conference Statement

The First Scientific Conference on Therapy for Verbal Apraxia/Dyspraxia, held on July 23-24, 2001 at the Headquarters Plaza Hotel, Morristown, New Jersey under the auspices of the Cherab Foundation (http://www.apraxia.cc/), focused on "Essential Fatty Acids (EFAs) and Verbal Apraxia: A New Potential Therapeutic Intervention." A panel of scientific experts discussed the evidence presented at the conference in the form of professional anecdotal case reports on improvement of verbal communication ability with EFA supplementation in this population. The panel unanimously agreed that the existing scientific evidence justifies planning and implementing a comprehensive clinical trial to convincingly validate this new potential therapeutic intervention.

The panel discussed various clinical research alternatives including the following:

A controlled case series trial using currently available standardized speech assessment measures or developing new clinical assessment profiles for baseline and post-EFA testing

A randomized, placebo-controlled multicenter clinical trial of EFA and placebo supplementation to be undertaken as soon as possible. For example, if a randomized, placebo-controlled clinical trial would be undertaken, all diagnosed verbal apraxic children, including those with hypotonia and sensory integration disorder, who have not been supplemented with EFAs, would be eligible for randomization. The panel suggested that all randomized children would be supplemented with EFA or placebo in addition to appropriate speech therapy. This took into consideration the potential cooperative or possibly synergistic effect of the combined therapies in the treatment group. The length of the trial is proposed to be 3 months. Improvement in verbal communication skills, or the lack thereof using an assessment protocol as described above, would be the major therapeutic outcome measured, and plasma, as well as erythrocyte membrane EFA levels would be monitored periodically. The two groups would consist of about 20-30 age-matched subjects. ProEFA would be the therapeutic supplement used in the trial based on preliminary successes attained.

In addition the panel noted the potential availability of electrophysiological measuring instruments that could serve as assessment tools of developmental-behavioral characteristics of a verbal apraxic child, and recommended the exploration of such techniques. While the panel refrained from discussing the etiology and pathophysiology of verbal apraxia, it also expressed great interest in what appears to be a presence of verbal apraxia in a percentage of children on the autistic spectrum and a possible association in other disorders and syndromes, such as: hypotonia, sensory integration disorder, dysarthria, attention deficit hyperactivity disorder, Kabuki Syndrome and cerebral palsy. The panel recommended further exploration of these phenomena.

Although no final decision was reached on the nature of the clinical trial/trials to be undertaken, the workshop ended with a commitment from all members to continue debating this issue in close collaboration with the organizers, and to reach a decision within the shortest timeframe possible.

The organizers thank all panel members for their tireless dedication and enthusiastic participation in the Workshop's deliberations, and thank all parents who contributed to the success of the workshop, by requesting the professionals supervising and treating their children to complete a professional anecdotal case report questionnaire on the outcomes of EFA supplementation. This workshop could not have taken place without their assistance.

The organizers also wish to acknowledge with thanks the assistance of many dedicated parents in helping with the logistic aspects of the workshop.

Last but not least, the organizers are thankful to the Cherab Foundation's president, Ms. Lisa Geng, for her support of this workshop, and her boundless energy and enthusiasm in the service of verbal apraxic children and their parents.

The Scientific Organizers:

Marilyn Agin, M.D., and Robert Katz, Ph.D.,

Scientific Panel Members:

Marilyn Agin, M.D.
Medical Director, Early Intervention, New York City, NY

Susan E. Carlson, Ph.D.
Professor, University of Kansas, Kansas City, Kansas
Member Consortium for Fatty Acids (CFBFA)

Joseph Hibbeln, M.D.
Chief, Outpatient Clinic
National Institute of Alcoholism and Alcohol Abuse
NIH, Bethesda, Maryland

Robert Katz, Ph.D.
Managing Director, Consortium for Brain Fatty Acids (CFBFA) Omega-3 Research Institute, Inc.

Nancy Kaufman, M.A., CCC/SLP
Director, Kaufman Children's Center for
Speech Language and Sensory Disorders,
West Bloomfield, Michigan

Ann Moser
Director, Peroxisomal Diseases
and Fatty Acid Profiles Clinical Laboratory,
Kennedy Krieger Institute, Baltimore, Maryland
Member CFBFA.

Jennifer Hill-Karrer, Ph.D.
Associate Professor,
University of Kansas Medical Centre, Kansas City, Kansas

Lori Roth M.A., CCC/SLP
Speech Pathologist, Cherab Foundation

Andrew Zimmerman, M.D.
Professor, Johns Hopkins University and
Kennedy Krieger Institute, Baltimore, Maryland

Guest Panelist:

Alexandra J. Richardson, MA, DPhil
Senior Research Fellow in Neuroscience, Imperial College School of Medicine, MRI Unit, Hammersmith Hospital, London; and University Lab. of Physiology, Oxford.

Guest Dinner Speaker:

Hugo W. Moser, M.D.
University Professor, Johns Hopkins University School of Medicine Baltimore, MD Director of Neurogenics Department,
Kennedy Krieger Research Institute Baltimore, MD

The Administrative Organizers:

Cherab Foundation

Lisa Geng, President, Suzanne Smolyar, Executive Vice President, and Glenn W. Geng Executive Director, Treasurer

For scientific details on the Conference please contact Dr. Robert Katz, President, Omega-3 Research Institute, Inc at the following e-mail address: omega3ri@aol.com For all other information, please contact the Cherab Foundation

The Infancy Studies Laboratory The Center for Molecular & Behavioral Neuroscience Of Rutgers University In Newark
Cynthia Rosler M.A. CCC-SLP, a research SLP presented the fascinating work that the Infancy Studies Laboratory of Rutgers University in Newark is involved in at one of our nonprofit's meetings last year. They are a research facility that studies language and cognitive development from infancy to adulthood that has been featured numerous times on ABC, NBC, CNN, BBC, PBS, written up in Time Magazine, NY Times, and so much more. Their on-going work includes a longitudinal investigation of language outcome in both control subjects and children at risk for language difficulties (i.e., those with a family history of problems). This site includes some background on our work as well as opportunities for getting involved in this important research.
Rutger's Baby Lab

First language gene identified
Oct. 3 — British scientists say they've discovered the first gene tied to a language and speech disorder, raising hopes that the genetics revolution is closer to identifying the biological roots of conscious thought and, perhaps, refining what it means to be human. CALLED FOXP2, the gene produces a protein that turns other genes on and off. Scientists believe it could hold the key to why people suffer from speech problems. It is not specifically a gene that enables us to talk. Instead, researchers say they discovered a mutated form of the gene, which is responsible for a protein that enables the brain's language circuitry to function.
MSNBC NEWS SERVICES

Apraxia Survey For Families
More research about Apraxia! Is it possible?!
Apraxia Survey

Research Project By Dr. David Givens
Dr. Givens is from the Center For Nonverbal Studies, home of the nonverbal dictionary.
Apraxia

Research Project By Dr. Thomas Campbell
"In stark contrast, the children with apraxia of speech whose parent stated that three quarters of their child's speech could be understood following treatment, required 151 individual sessions (ranging from 144-168). In other words, the children with apraxia of speech required 81% more individual treatment sessions than the children with severe phonological disorders in order to achieve a similar function outcome." Functional treatment outcomes for young children with motor-speech disorders by Thomas Campbell in Clinical Management of Motor Speech Disorders A.J. Caruso and E.A. Strand 1999.

Copy of email from Children's Apraxia Network's Pediatric OT Moira Kowalczyk about apraxia research

"I will refer you to a fantastic book entitled "Developmental Motor Speech Disorders" written by Michael Crary. it is available through Therapy Skill Builders Catalog which is a subsidiary of Psychological Corporation. I'm sure you can find them on the web some how. if not, contact me directly and I can give you more specifics. I have been an OT for 15 years and I can tell you that the concept of Apraxia was well known when I was just beginning. In fact, it has always been a particular interest of mine. when I worked in NY I remember having a GIGANTIC file on the subject!!

In the Crary book there are tons of references and many chapters are devoted to explaining and sifting through the conflicting research related to diagnosis and treatment of verbal apraxia. Crary has a rather unique look a apraxia that I have not seen written in exactly the way that he does in any other book so far. He proposes a model that represents an attempt to accommodate relationships between oral motor and motor speech deficits and clinical variations within each function. One of the position statements that lay the foundation for this way of thinking is that there are:

#1"overlapping motor and speech-language functions that exist within
the left-hemisphere "language areas", meaning that although motor and speech dysfunctions may occur independently, there are cases in which dysfunctions in BOTH areas may occur.

#2.Along the "anterior-posterior dimension" (referring to anatomical locations in the brain) within the left hemisphere there are various steps or levels in information processing that pertain to both motor a speech-language functions.

Therefore, Crary feels that deficits in the more frontal areas, (anterior) would result in more motoric/"executive" (motor execution) deficits of speech and oral movement where as the posterior (temporal-parietal areas of the brain) are responsible for the more linguistic and/or "planning" aspects. therefore the "purest executive (anterior/frontal) deficit would be DYSARTHRIA secondary to abnormal function within the primary motor system. this disorder is felt to be at the extreme motor execution end of the continuum. Deficits in the far posterior end of the continuum would not be expected to show significant pure motor speech impairments but rather sequencing deficits might be seen on various "motor/language" tasks related to deficits in selection and serial ordering. Such communicative impairments might be classified as "specific language impairments". moving forward on the continuum would enter those areas where non-dysarthric motor speech disorders, specifically apraxias of speech, might be expected. these disorders are proposed to be the result of when motor AND language functions overlap. Motor speech disorders at the 'posterior' end of the continuum would be expected to reflect impaired planning in BOTH MOTOR and SPEECH-LANGUAGE functions. (that is why we frequently see disordered language in these guys with apraxia even though it is thought of as a "motor speech disorder'. doesn't that make sense guys?!!)

Anyway, this is a great book for hard core data and lots and lots of research studies and their interpretation and relevance as seen by CRARY. I love this book, but it is quite the DRY, (and I mean DRY!!!) read. However, one will without fail, end up with a MUCH greater and in-depth understanding of the many fascinating aspects of DEVELOPMENTAL MOTOR SPEECH DISORDERS.

I hope this little excerpt of info from Crary'sbook entices all who have read this post to go out and get his book. it is by far the most extensive and exhaustive piece of literature that I have read on the subject of motor speech disorders to date!!!! Russell Love's recent re-publication of "Childhood motor Speech Disorders' although good, is like Fluffernutter to Crary'sbook. th-th-th-that's all folks!!!!

Good luck on your research. please contact me if I can be of any
assistance!!!!"

Talking Page
OK, so this is not an "official" research site, but it's the only one like it where you can hear various children with apraxia on the web! Apraxia ranges from mild to severe. That's why it's great to be able to listen to various children (young adults too) with apraxia talk, to compare to your own child. Great website for watching the 2 year progress of Brandon who was first diagnosed with apraxia at 5 (After a hospital evaluation diagnosed him with a "moderate delay of speech" at 3 when he only had 4 or 5 words!)
Talking Page