Differential Diagnostic Patterns of Acquired Motor Speech Disorders in Children: A Preliminary Investigation of Four Case Studies.

Abstract

Purpose: This clinical focus article aimed to explore how motor speech disorders (MSDs) manifest in children with acquired brain injury (ABI) and determine if an adult diagnostic system, such as the Mayo Clinic System, applies to pediatric cases.

Method: Four children with ABI with differing loci of impairment were evaluated to compare perceptual speech features and how they align or diverge from expected adult profiles with similar loci of impairment. Two expert speech-language pathologists identified perceptual speech features from the recorded motor speech evaluations and determined motor speech disorder diagnosis and severity based on consensus.

Results: Three out of the four children had clear motor speech disorder diagnoses (flaccid dysarthria, ataxic dysarthria, and apraxia). The one child with a less clear diagnosis had mixed dysarthria from diffuse traumatic brain injury. Regardless, the perceptual speech and nonspeech features identified per child matched with expected findings from neuroimaging and expected motor speech profiles from the Mayo Clinic System.

Conclusions: From this preliminary study, children with ABI fit into expected motor speech subgroups based on the Mayo Clinic classification system. Differential diagnosis in pediatric MSDs in the hospital setting has clinical implications for evaluation, treatment, and interdisciplinary communication with other health care providers.