4.2 Article

To lump or to split? Possible subtypes of apraxia of speech

Journal

APHASIOLOGY
Volume 35, Issue 4, Pages 592-613

Publisher

ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/02687038.2020.1836319

Keywords

Apraxia of speech; subtype; classification; motor planning

Funding

  1. Moss Rehabilitation Research Institute/University of Pennsylvania postdoctoral training fellowship [NIH 5T32HD071844-07]

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The notion that AOS may consist of different subtypes based on clinical symptomatology, theoretical constructs, and analogy to limb apraxia has been proposed. Future research needs to gather more empirical evidence to support and validate these subtypes, and should consider large sample sizes to better differentiate individual variability.
Background The speculation that apraxia of speech (AOS) is not a unitary diagnosis, but consists of different subtypes instead, has been around for decades. However, attempts to empirically substantiate such a notion remain few and far between. Aims The primary objective of this article is to consider the different bases for identifying subtypes of AOS, review existing evidence regarding subtypes under each classification basis, and provide discussion and implications for future research. Main Contribution AOS subtypes have been proposed on the basis of clinical symptomatology, theoretical constructs, and an analogy to limb apraxia. Different possible subtypes of AOS are reviewed, along with their empirical support and limitations. Empirical evidence, particularly in the context of a progressive disease, supports the idea that AOS diagnosis may capture different underlying impairments of speech motor planning. Future research to advance our understanding of AOS should carefully consider the basis for subtype classification, and include large sample sizes to differentiate individual variability from possible subtypes. Conclusions Several proposed AOS subtypes have found some support in the literature. Further research is needed to determine the validity, coherence and utility of possible AOS subtypes for theoretical and clinical purposes.

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