Pediatric Speech and Generalized Anxiety Disorders Recent

Pediatric Speech and Generalized Anxiety Disorders Recent Advances in Pediatric Speech Disorders and Anxiety Pediatric Speech Disorders Children suffering from childhood apraxia of speech (CAS) have problems controlling the muscular movements required to produce speech (Worthey et al., 2013). The underlying muscles and neurons are normal, so that involuntary movements of the same muscles are unaffected; therefore, only intentional speech is affected. The defect lies in the conversion of cognitive linguistic information into the correct pattern of muscular control.

The age of onset is between gestation and nine years of age and the causes include comorbidity with other neurological disorders or brain trauma. Adults can also develop speech apraxia, typically incident to stroke or progressive neurological disease. CAS and other verbal disorders tend to run in families, thereby implicating a genetic contribution to the disease (Worthey et al., 2013). A few candidate genes have been studied, such as FOXP2, FOXP1, and CNTNAP2, but not all heritable forms of speech disorders could be attributed to these genes.

Suspecting that there could be a large number of genes contributing to genetic speech disorders, Worthey and colleagues (2013) sequenced the entire exome of 10 patients diagnosed with CAS. The exome represents all gene sequence transcribed into proteins and any mutation altering protein sequence could be potentially pathogenic. The authors of this study identified a total of 20 genetic variants that could be hypothetically responsible for contributing to the etiology of CAS, including FOXP1 and CNTNAP2.

Worthey and colleagues (2013) demonstrated that CAS and other genetic speech disorders could be the result of single or multiple genetic mutations, in addition to the utility of whole-exome sequencing for diagnosing pediatric speech disorders. Based on their analysis, it is much cheaper and more efficient to perform whole-exome sequencing on patients with speech disorders than to sequence specific candidate genes like FOXP2. These findings should make the diagnosis of genetic speech disorders in children as simple as taking a blood sample and for one tenth the cost of sequencing FOXP2.

Such finding will probably also lay the foundation of individualized medicine in the future. Generalized Anxiety Disorder in Children Anxiety disorders in children represent one of the most common psychiatric problems among this age group, with a prevalence rate of around 15% (Breinholst, Esbjorn, Reinholdt-Dunne, & Stallard, 2012). Some of the comorbidities associated with anxiety disorders include depression, substance abuse, suicidal ideation, poor academic performance, social problems, and impaired cognitive development. Compared to non-anxious children, the care costs incurred by society are about 20 times higher.

Researchers and clinicians have long been interested in the interaction between parents and anxious children, such as parental contributions to the child's anxious state, but research findings have been inconclusive and controversial (Breinholst, Esbjorn, Reinholdt-Dunne, & Stallard, 2012). Silk and colleagues (2013) examined the interactions between parents and anxious children receiving cognitive-behavioral therapy (CBT) or child-centered therapy (CCT). Compared to parent-child non-anxious controls, encouragement by parents of children suffering from anxiety disorders was diminished when the child was faced with making a speech in an anxiety-producing situation.

However, the parents of anxious children became more encouraging after the child was treated with CBT and not CCT. Importantly, the parents of anxious children participated in two of the CBT sessions. These.