[Incomprehensible speech in children. Childhood apraxia of speech].

BACKGROUND: Some children referred to ENT physicians suffer from severe and seemingly therapy-resistant impairment of the articulation of speech. Apart from classical symptoms of specific language impairment (SLI), such as a delay in the acquisition of syntax or poor lexical competence, these children's speech is sometimes practically incomprehensible. Describing the disorder as SLI although not correct would nevertheless be inappropriate. The term childhood apraxia of speech (CAS) has been coined for such impairment. In this article the background, symptoms, diagnostics and therapy of CAS are reviewed. METHOD: For this systematic review a selective literature search in PubMed was conducted. RESULTS: The etiology of CAS is not well known and genetic factors, neurological diseases and metabolic imbalances are assumed. Symptoms differ significantly among individuals as well as intraindividually. CAS is defined as impairment in planning and controlling articulatory movements, which has a severe impact on the sound production. DISCUSSION: For ENT specialists it is important to be aware that CAS symptoms may lead to a severe impediment of verbal communication and subsequently also interfere with the normal socio-emotional development of an affected child. Thus, an intensive therapy regimen is mandatory. Studies with a high level of evidence concerning the sensitivity and specificity of diagnostic tools, as well as studies regarding the effectiveness and efficiency of therapeutic approaches are needed.