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a single session would be less complementary, and may actually result in interference of motor skill learning in one or the other domain. In summary, there are too few studies, and no well- controlled (i.e., quasi-randomised or RCT) studies, of treatment for childhood-acquired dysarthria. At present, clinicians are heavily reliant upon adapting adult-based dysarthria treatments (e.g., see Academy of Neurologic Communication Disorders and Sciences) for use with children. Using the only available empirical data in the paediatric field, the present overview was designed to illustrate how we might consider recently outlined principles of neural plasticity (Kleim & Jones, 2008; Ludlow et al., 2008) when designing individual treatment programs for children with acquired dysarthria. Summary and conclusions As for many fields within speech pathology, there is an impoverished research evidence base underpinning clinical management of children with acquired dysarthria. The required future directions for research have been discussed elsewhere (Morgan & Vogel, 2008) and are beyond the scope of this clinically focused report. It was the aim of this paper to provide an overview of recent evidence in childhood acquired dysarthria, and its implications for guiding assessment and treatment approaches in clinical practice. The present review supports clinicians to consider the application of a systematic and evidence based approach to management of childhood dysarthria associated with ABI. Acknowledgements Thank you to clinical rehabilitation collaborators for ongoing discussion (Louise Cahill, Queensland Paediatric Rehabilitation Service; Turid Peters, Starship Hospital; Flora Haritou, Maria Fassoulakis, Natalie Weekley, Victorian Paediatric Rehabilitation Service; Candice Brady, Children’s Hospital at Westmead). References Barnes, M. P. (1999). Rehabilitation after traumatic brain injury. British Medical Bulletin , 55 , 927–943. Blakely, R. W. (2001). Screening test for developmental apraxia of speech (2nd Ed.). Austin, TX: Pro-Ed. Darley, F. L., Aronson, A. E., & Brown, J. R. (1975). Motor speech disorders . Philadelphia: WB Saunders. Dodd, B., Hua, Z., Crosbie, S., Holm, A., & Ozanne, A. (2006). Diagnostic evaluation of articulation and phonology . San Antonio, TX: Pearson. Duffy, J. R. (2005). Motor speech disorders: Substrates differential diagnosis and management (2nd Ed.). St Louis, MI: Mosby. Enderby, P. (1983). Frenchay dysarthria assessment . San Diego, CA: College-Hill Press. Goldman, R., & Fristoe, M. (2000). Goldman Fristoe test of articulation (2nd Ed.). Circle Pines, MN: AGS. Hayden, D., & Square, P. (1999). Verbal motor production assessment for children . San Antonio, TX: The Psychological Corporation. Hickman, L. (1997). Apraxia profile . San Antonio, TX: The Psychological Corporation. Hodge, M. (2008). Test of children’s speech plus (TOCS +) . Version 5.3. Alberta, CA: University of Alberta. Jelm, J. M. (2001). Verbal dyspraxia profile . DeKalb, IL: Janelle. Kaufman, N. (1995). Kaufman speech praxis test for children . Detroit, MI: Wayne State University Press.

Kleim, J. A., & Jones, T. A. (2008). Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage. Journal of Speech, Language and Hearing Research , 51 , S225–S239. Ludlow, C., Hoit, J., Kent, R., Ramig, L.O., Shrivastav, R., Strand, E., Yorkston, K., & Sapienza, C.M. (2008). Translating principles of neural plasticity into research on speech motor control recovery and rehabilitation. Journal of Speech, Language and Hearing Research , 51 , S240–S258. McCauley, R. J., & Strand, E. A. (2008). A review of standardized tests of nonverbal oral and speech motor performance in children. American Journal of Speech- Language Pathology , 17 , 81–91. Miscimarra, L., Stein, C., Millard, C., Kluge, A., Cartier, K., Freebairn, L., Hansen, A., Shriberg, L., Taylor, H.G., Lewis, B., & Iyengar, S.K. (2007). Further evidence of pleiotropy influencing speech and language: Analysis of the DYX8 region. Human Heredity , 63 , 47–58. Morgan, A. T., Liegeois, F., & Occomore, L. (2007). Electropalatography treatment for articulation impairment in children with dysarthria post-traumatic brain injury. Brain Injury , 21 (11), 1183–1193. Morgan, A. T., & Skeat, J. (in press). Evaluating service delivery for speech and swallowing problems following paediatric brain injury: an international survey. Journal of Evaluation in Clinical Practice . Morgan, A. T., & Vogel, A. P. (2008). Intervention for dysarthria associated with acquired brain injury in children and adolescents. Cochrane Database of Systematic Reviews , Issue 3. Art. No.: CD006279. DOI: 10.1002/14651858.CD006279, 2008. Morgan, A. T., Ward, E. C., & Murdoch, B. E. (2004). Clinical progression and outcome of pediatric dysphagia following traumatic brain injury. Brain Injury , 18 (4), 359–376. Murdoch, B. E., Pitt, G., Theodoros, D. G., & Ward, E. (1999). Real-time continuous visual biofeedback in the treatment of speech breathing disorders following childhood traumatic brain injury. Pediatric Rehabilitation , 3 , 5–20. Robbins, J., & Klee, T. (1987). Clinical assessment of oropharyngeal motor development in young children. Journal of Speech, Language and Hearing Disorders , 52 , 271–277. St Louis, K. O., & Ruscello, D. (2000). Oral speech mechanism screening examination (3rd Ed.). Austin, TX: Pro-Ed. Stein, C. M., Millard, C., Kluge, A., Miscimarra, L. E., Cartier, K. C., Freebairn, L. A., Hansen, A. J., Shriberg, L. D., Gerry Taylor, H., Lewis, B. A., & Iyengar, S. K. (2006). Speech sound disorder influenced by a Locus in 15q14 region. Behavioural Genetics , 36 , 858–868. Wilcox, K., & Morris, S. (1999). Children’s speech intelligibility measure . San Antonio, TX: The Psychological Corporation. Ziegler, W. (2003). Speech motor control is task specific: Evidence from dysarthria and apraxia of speech. Aphasiology , 17 (1), 3–36. 1. Neural plasticity: “the ability of the central nervous system to change and adapt in response to environmental cues, experience, behaviour, injury, or disease” (Ludlow et al., 2008, p. S240).

Correspondence to: Angela Morgan PhD

Research Fellow, Murdoch Children’s Research Institute Senior Speech Pathologist, Royal Children’s Hospital Lecturer, Department of Paediatrics, University of Melbourne 50 Flemington Road, Parkville 3052 Victoria, Australia phone: +61 (03) 9345 4215 email: angela.morgan@mcri.edu.au

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ACQ Volume 12, Number 1 2010

www.speechpathologyaustralia.org.au