A diagnostic marker to discriminate childhood apraxia of speech from speech delay: Iii. theoretical coherence of the pause marker with speech processing deficits in childhood apraxia of speech

Purpose: Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS. Method: PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay. Results: Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings. Conclusions: Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM’s pause-speech elements with these deficits.