Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

Abstract

PurposeSpeech-language pathologists report difficulty in the accurate differential diagnosis of complex speech presentations. This paper explores possible reasons for diagnostic uncertainty and reviews new tools and recent approaches to address this concern.Recent FindingsChildren with motor speech disorders often have complex mixed presentations, comprising interacting motor-speech, cognitive-linguistic, and psychosocial factors, which may lead to clinicians having difficulty selecting appropriate interventions. Clinicians are frequently uncertain about differential diagnosis and lack time to complete comprehensive analysis required to understand the children’s complex speech profiles. This review examines papers that deal with this issue through identification of multiple speech disorders [5], consideration of impaired speech processes rather than discrete diagnoses [1], and the impact of new genetic understandings [20]. These insights will help to reduce the impact of this complexity on clinical decision-making.SummaryNew tools are emerging including clinical diagnostic pathways, genetic analysis, and theoretical modelling which may resolve many of the identified issues and improve clinical decision-making for children with complex motor speech disorders.