The First Scientific Conference on Therapy for Verbal Apraxia/Dyspraxia

Post conference Statement

  The First Scientific Conference on Therapy for Verbal Apraxia/Dyspraxia, held on July 23-24, 2001 at the Headquarters Plaza Hotel, Morristown, New Jersey under the auspices of the CHERAB Foundation (http://www.apraxia.cc), focused on "Essential Fatty Acids (EFAs) and Verbal Apraxia:  A New Potential Therapeutic Intervention."  A panel of scientific experts discussed  the evidence presented  at the conference in the form of professional anecdotal case reports on improvement of verbal communication ability with EFA supplementation in this population.   The panel unanimously agreed that the existing scientific evidence justifies planning and implementing a comprehensive clinical trial to convincingly validate this new potential therapeutic intervention.

  The panel discussed various clinical research alternatives including the following:

       A controlled case series trial using currently available standardized speech assessment measures  or developing new clinical assessment profiles for baseline and post-EFA testing

      A randomized, placebo-controlled multicenter clinical trial of EFA and placebo supplementation to be undertaken as soon as possible.  For example, if a randomized, placebo-controlled clinical trial would be undertaken, all diagnosed verbal apraxic children, including those with hypotonia and sensory integration disorder, who have not been supplemented with EFAs, would be eligible for randomization.  The panel suggested that all randomized children would  be supplemented with EFA or placebo in addition to appropriate speech therapy.  This took into consideration the potential cooperative or possibly synergistic effect of the combined therapies in the treatment group.  The length of the trial is proposed to be 3 months.  Improvement in verbal communication skills, or the lack thereof using an assessment protocol as described above, would be the major therapeutic outcome measured, and plasma, as well as erythrocyte membrane EFA levels would be monitored periodically.  The two groups would consist of about 20-30 age-matched subjects. ProEFA would be the therapeutic supplement used in the trial based on preliminary successes attained.

  In addition the panel noted the potential availability of electrophysiological measuring instruments that could serve as assessment tools of developmental-behavioral characteristics of a verbal apraxic child, and recommended the exploration of such techniques.  While the panel refrained from discussing the etiology and pathophysiology of verbal apraxia, it also expressed great interest in what appears to be a presence of verbal apraxia in a percentage of children on the autistic spectrum   and a possible association in other disorders and syndromes, such as: hypotonia, sensory integration disorder, dysarthria, attention deficit hyperactivity disorder, Kabuki Syndrome and cerebral palsy.  The panel recommended further exploration of these phenomena.

  Although no final decision was reached on the nature of the clinical trial/trials to be undertaken, the workshop ended with a commitment from all members to continue debating this issue in close collaboration with the organizers, and to reach a decision within the shortest timeframe possible.  

The organizers thank all panel members for their tireless dedication and enthusiastic participation in the Workshop's deliberations, and thank all parents who contributed to the success of the workshop, by requesting the professionals supervising and treating their children to complete a professional anecdotal case report questionnaire on the outcomes of EFA supplementation.  This workshop could not have taken place without their assistance.

  The organizers also wish to acknowledge with thanks the assistance of many dedicated parents in helping with the logistic aspects of the workshop.

  Last but not least, the organizers are thankful to the CHERAB Foundation's president, Ms. Lisa Geng, for her support of this workshop, and her boundless energy and enthusiasm in the service of verbal apraxic children and their parents.

The Scientific Organizers:

Marilyn Agin, M.D., and Robert Katz, Ph.D.,

  Scientific Panel Members:  

Marilyn Agin, M.D.
Medical Director, Early Intervention, New York City, NY

  Susan E. Carlson, Ph.D.
Professor, University of Kansas, Kansas City, Kansas
Member Consortium for Fatty Acids (CFBFA)

  Joseph Hibbeln, M.D.
Chief, Outpatient Clinic
National Institute of Alcoholism and Alcohol Abuse
NIH, Bethesda, Maryland

Robert Katz, Ph.D.
Managing Director, Consortium for Brain Fatty Acids (CFBFA) Omega-3 Research Institute, Inc.

  Nancy Kaufman, M.A., CCC/SLP
Director, Kaufman Children's Center for
Speech Language and Sensory Disorders,
West Bloomfield,  Michigan

  Ann Moser
Director, Peroxisomal Diseases
and Fatty Acid Profiles Clinical Laboratory,
Kennedy Krieger Institute, Baltimore, Maryland
Member CFBFA.

Jennifer Hill-Karrer, Ph.D.
Associate Professor,
University of Kansas Medical Centre, Kansas City, Kansas

  Lori Roth M.A., CCC/SLP
Speech Pathologist, CHERAB Foundation

  Andrew Zimmerman, M.D.
Professor, Johns Hopkins University and
Kennedy Krieger Institute, Baltimore, Maryland

  Guest Panelist:

  Alexandra J. Richardson, MA, DPhil
Senior Research Fellow in Neuroscience, Imperial College School of Medicine, MRI Unit, Hammersmith Hospital, London; and University Lab. of Physiology, Oxford.

Guest Dinner Speaker:

  Hugo W. Moser, M.D.
University Professor, Johns Hopkins University School of Medicine Baltimore, MD Director of Neurogenics Department,
Kennedy Krieger Research Institute Baltimore, MD

For scientific details on the Conference please contact Dr. Robert Katz, President, Omega-3 Research Institute, Inc at the following e-mail address: omega3ri@aol.com  For all other information, please contact the CHERAB Foundation