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Developmental motor speech disorder — Clinical Guidelines

Overview

Developmental motor speech disorder encompasses difficulties in the planning, coordination, and execution of speech movements, affecting articulation and fluency in children. 4 10

Diagnosis

Key Diagnostic Criteria: Difficulties in producing speech sounds accurately, often involving motor planning and execution issues. 4 10

Recommended Tests: Phonology assessment using tools like the Diagnostic Evaluation of Articulation and Phonology (DEAP) to measure percentage of consonants correct. 1

Grading: Typically assessed through clinical observation and standardized speech assessments, with no specific grading system universally applied. 1 4

Management

First-Line Treatments: Motor Speech Treatment Protocol (MSTP) integrating multi-sensory approaches and hierarchical goal selection. 4

Adjunctive Treatments: Non-speech oral motor treatments (NSOMT) may be used, though efficacy is controversial and requires further evidence. 3 7

Special Considerations: Tailoring intervention intensity based on individual needs, though direct association between dosage and outcome varies across interventions. 5

Special Populations

Pediatrics: Early intervention is crucial; duration and frequency of pacifier use may influence speech development, though evidence is limited. 1

Comorbidities: Speech-language pathologists must consider dual roles as special educators or related service providers under IDEA, ensuring appropriate service delivery. 6

Key Recommendations

Implement multi-sensory treatment protocols like MSTP for children with severe motor speech disorders to improve speech motor control. (Evidence: Strong 4)

Evaluate the efficacy of non-speech oral motor treatments cautiously, given the current lack of robust evidence supporting their widespread use. (Evidence: Moderate 3 7)

Tailor intervention intensity based on individual child needs, recognizing variability in dosage-effect relationships across different language domains. (Evidence: Moderate 5)

Clarify roles under IDEA to ensure speech-language pathologists function appropriately as special educators or related service providers, aligning with ethical standards and educational goals. (Evidence: Expert opinion 6)

References

1 Strutt C, Khattab G, Willoughby J. Does the duration and frequency of dummy (pacifier) use affect the development of speech?. International journal of language & communication disorders 2021. link 2 Morgan L, Marshall J, Harding S, Powell G, Wren Y, Coad J et al.. 'It depends': Characterizing speech and language therapy for preschool children with developmental speech and language disorders. International journal of language & communication disorders 2019. link 3 Lee AS, Gibbon FE. Non-speech oral motor treatment for children with developmental speech sound disorders. The Cochrane database of systematic reviews 2015. link 4 Namasivayam A, Pukonen M, Hard J, Jahnke R, Kearney E, Kroll R et al.. Motor speech treatment protocol for developmental motor speech disorders. Developmental neurorehabilitation 2015. link 5 Zeng B, Law J, Lindsay G. Characterizing optimal intervention intensity: the relationship between dosage and effect size in interventions for children with developmental speech and language difficulties. International journal of speech-language pathology 2012. link 6 Giangreco MF, Prelock PA, Turnbull HR. An issue hiding in plain sight: when are speech-language pathologists special educators rather than related services providers?. Language, speech, and hearing services in schools 2010. link) 7 Ruscello DM. Nonspeech oral motor treatment issues related to children with developmental speech sound disorders. Language, speech, and hearing services in schools 2008. link) 8 Whitmire K, Dublinske S. Provision of speech-language services in the schools: working with the law. Seminars in speech and language 2003. link 9 Radford NT. A follow-up study of seven siblings with unusual sound preferences. Perceptual and motor skills 1999. link 10 Stackhouse J, Wells B. Psycholinguistic assessment of developmental speech disorders. European journal of disorders of communication : the journal of the College of Speech and Language Therapists, London 1993. link

Developmental motor speech disorder