Treating Speech Subsystems in Childhood Apraxia of Speech With Tactual Input: The PROMPT Approach

2013 ◽  
Vol 22 (4) ◽  
pp. 644-661 ◽  
Author(s):  
Philip S. Dale ◽  
Deborah A. Hayden
Keyword(s):  
Standardized Tests ◽  
Treatment Approach ◽  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Within Subjects ◽  
Speech Control ◽  
Criterion Referenced

Purpose Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT; Hayden, 2004; Hayden, Eigen, Walker, & Olsen, 2010)—a treatment approach for the improvement of speech sound disorders in children—uses tactile-kinesthetic-proprioceptive (TKP) cues to support and shape movements of the oral articulators. No research to date has systematically examined the efficacy of PROMPT for children with childhood apraxia of speech (CAS). Method Four children (ages 3;6 [years;months] to 4;8), all meeting the American Speech-Language-Hearing Association (2007) criteria for CAS, were treated using PROMPT. All children received 8 weeks of 2 × per week treatment, including at least 4 weeks of full PROMPT treatment that included TKP cues. During the first 4 weeks, 2 of the 4 children received treatment that included all PROMPT components except TKP cues. This design permitted both between-subjects and within-subjects comparisons to evaluate the effect of TKP cues. Gains in treatment were measured by standardized tests and by criterion-referenced measures based on the production of untreated probe words, reflecting change in speech movements and auditory perceptual accuracy. Results All 4 children made significant gains during treatment, but measures of motor speech control and untreated word probes provided evidence for more gain when TKP cues were included. Conclusion PROMPT as a whole appears to be effective for treating children with CAS, and the inclusion of TKP cues appears to facilitate greater effect.

Speech Sound Disorders: What's Motor Got To Do With It?

2016 ◽  
Vol 1 (1) ◽  
pp. 75-87 ◽  
Author(s):  
Maria I. Grigos
Keyword(s):  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Impairment ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Sound System ◽  
Motor Speech Disorder ◽  
The Relationship ◽  
Speech Motor

Speech sound disorders (SSDs) are commonly viewed as involving impaired articulation and/or phonological skills. Speech language pathologists working with individuals with (SSDs) assess the articulation of speech sounds and the coordination of articulatory structures with other components of the speech mechanism, including the phonatory, respiratory, and resonatory subsystems. The sound system of the language and the rules that govern how phonemes are combined are equally critical for clinicians to explore. While the terms “articulation” and “phonology” provide clinicians with a framework for classification, children who are broadly identified with (SSDs) may also display characteristics of a motor speech impairment, which can obscure the decision making process with respect to both diagnosis and treatment. One such motor speech disorder is childhood apraxia of speech (CAS). The focus of this paper is to discuss motor speech deficits in children and to review research that aims to distinguish motor speech patterns in children with (SSDs) with and without CAS. We will also address the relationship between emerging speech motor and linguistic skills.

Lexical and phonological development in children with childhood apraxia of speech – a commentary on Stoel-Gammon's ‘Relationships between lexical and phonological development in young children’*

2010 ◽  
Vol 38 (1) ◽  
pp. 82-86 ◽  
Author(s):  
SHELLEY L. VELLEMAN
Keyword(s):  
Young Children ◽  
Speech Sound ◽  
Interesting Case ◽  
Prognostic Indicators ◽  
Phonological Development ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech Disorder ◽  
Remediation Strategies

Although not the focus of her article, phonological development in young children with speech sound disorders of various types is highly germane to Stoel-Gammon's discussion (this issue) for at least two primary reasons. Most obvious is that typical processes and milestones of phonological development are the standards and benchmarks against which we measure disorder and delay. Factors that impact children without disorders may suggest underlying causes or co-occurring symptoms of speech sound deficits, prognostic indicators of improvement, appropriate remediation strategies or some combination of these. Equally important is the fact that studying children with disorders can help us to verify and, in some cases, even unpack relationships among factors that are so closely interwoven in children who develop their phonologies at the typically very rapid rate that their individual influences cannot be discerned. Childhood Apraxia of Speech (CAS) is a particularly interesting case in point because, while it is universally accepted to be a motor speech disorder, symptoms include deficits in speech perception and often in literacy-related skills as well.

scholarly journals Language Skill Mediates the Relationship Between Language Load and Articulatory Variability in Children With Language and Speech Sound Disorders

2018 ◽  
Vol 61 (12) ◽  
pp. 3010-3022 ◽  
Author(s):  
Janet Vuolo ◽  
Lisa Goffman
Keyword(s):  
Language Impairment ◽  
Specific Language Impairment ◽  
Language Disorder ◽  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Retrieval Task ◽  
The Relationship

Purpose The aim of the study was to investigate the relationship between language load and articulatory variability in children with language and speech sound disorders, including childhood apraxia of speech. Method Forty-six children, ages 48–92 months, participated in the current study, including children with speech sound disorder, developmental language disorder (aka specific language impairment), childhood apraxia of speech, and typical development. Children imitated (low language load task) then retrieved (high language load task) agent + action phrases. Articulatory variability was quantified using speech kinematics. We assessed language status and speech status (typical vs. impaired) in relation to articulatory variability. Results All children showed increased articulatory variability in the retrieval task compared with the imitation task. However, only children with language impairment showed a disproportionate increase in articulatory variability in the retrieval task relative to peers with typical language skills. Conclusion Higher-level language processes affect lower-level speech motor control processes, and this relationship appears to be more strongly mediated by language than speech skill.

scholarly journals Standardized Tests and the Diagnosis of Speech Sound Disorders

2019 ◽  
Vol 4 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Leah Fabiano-Smith
Keyword(s):  
Standardized Tests ◽  
Relevant Literature ◽  
Speech Sound ◽  
Speech Sound Disorders ◽  
Speech Language Pathologists ◽  
Resource Guide ◽  
Criterion Referenced ◽  
Diagnostic Pitfalls

Purpose The purpose of this tutorial is to provide speech-language pathologists with the knowledge and tools to (a) evaluate standardized tests of articulation and phonology and (b) utilize criterion-referenced approaches to assessment in the absence of psychometrically strong standardized tests. Method Relevant literature on psychometrics of standardized tests used to diagnose speech sound disorders in children is discussed. Norm-referenced and criterion-referenced approaches to assessment are reviewed, and a step-by-step guide to a criterion-referenced assessment is provided. Published criterion references are provided as a quick and easy resource guide for professionals. Results Few psychometrically strong standardized tests exist for the evaluation of speech sound disorders for monolingual and bilingual populations. The use of criterion-referenced testing is encouraged to avoid diagnostic pitfalls. Discussion Speech-language pathologists who increase their use of criterion-referenced measures and decrease their use of standardized tests will arrive at more accurate diagnoses of speech sound disorders.

Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech

2020 ◽  
Vol 29 (1) ◽  
pp. 30-48 ◽  
Author(s):  
Edythe A. Strand
Keyword(s):  
Motor Learning ◽  
Treatment Approach ◽  
Essential Elements ◽  
Clear Understanding ◽  
Neural Processing ◽  
Clinical Decisions ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Essential Information

Purpose The purpose of this article is to describe a treatment approach, Dynamic Temporal and Tactile Cueing (DTTC), and to provide clinicians and clinical researchers a clear understanding of the theory and principles that contributed to the design of the treatment as well as the clinical decisions that must be made when implementing it. While brief descriptions of DTTC have been provided in textbooks, a complete summary of the rationale, essential elements, method, and procedures has not yet been published. Such a summary is important so that clinicians can gain a better understanding of and more confidence in using the method for appropriate children. Furthermore, this article provides clinicians and clinical researchers essential information for measurement of fidelity. Method The important elements of the DTTC method with rationale for their inclusion are described. The temporal hierarchy of DTTC is depicted, and the dynamic procedure is described in detail, with suggestions for fidelity measurement. Finally, a discussion of important decisions clinicians must make when implementing DTTC is presented. Conclusions The goal of DTTC is to improve the efficiency of neural processing for the development and refinement of sensorimotor planning and programming. The rationale for DTTC in general, as well as the key elements important to its administration, are supported by models of speech production and theories of motor learning. Important clinical decisions regarding stimuli, organization of practice, and feedback are based on principles of motor learning in order to facilitate acquisition, retention, and continued improvement of motor speech skills.

scholarly journals Differences Between School-Age Children With Apraxia of Speech and Other Speech Sound Disorders on Multisyllable Repetition

2020 ◽  
Vol 5 (4) ◽  
pp. 794-808 ◽  
Author(s):  
Nina R. Benway ◽  
Jonathan L. Preston
Keyword(s):  
Speech Sound ◽  
Previous Literature ◽  
School Age Children ◽  
School Age ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Speech Corpus ◽  
Word Structure ◽  
Speech Features

Purpose The aim of the study was to evaluate whether features of childhood apraxia of speech (CAS) identified in previous literature could be replicated in a sample of school-age children. Method A literature review was conducted to identify candidate speech features that have been previously considered when differentiating CAS from other types of speech sound disorders (SSDs). The candidate features recoverable from blinded transcriptions of multisyllable word repetitions (MSWRs) were applied to a cohort of 61 children aged 7–17 years, previously classified as having CAS ( n = 21) or non-CAS SSD ( n = 40). Results One hundred and ninety-four features had been explored in previous literature to assess their ability to differentiate CAS from other SSDs. Fifteen perceptual features were selected from this list to be applied to performance on the MSWR. In this sample, children with CAS differed from children with SSD on the prevalence of voicing changes, percentage of structurally correct words, correct lexical stress, and syllable deletions within a speech corpus derived from the MSWR task. Conclusion Although previous literature points to numerous features as differentiating CAS from other SSDs, only a portion of those features were replicated in this sample of school-age children. Features of CAS that affect segmental accuracy, prosody, and word structure may be likely to persist into late childhood and early adolescence.

The Effect of Hand Gesture Cues Within the Treatment of /r/ for a College-Aged Adult With Persisting Childhood Apraxia of Speech

2017 ◽  
Vol 26 (4) ◽  
pp. 1236-1243 ◽  
Author(s):  
Heather Leavy Rusiewicz ◽  
Jessica Lynch Rivera
Keyword(s):  
Speech Sound ◽  
Single Subject ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Visual Modeling ◽  
Verbal Instructions ◽  
Spatiotemporal Parameters ◽  
Withdrawal Design ◽  
Preliminary Support

Purpose Despite the widespread use of hand movements as visual and kinesthetic cues to facilitate accurate speech produced by individuals with speech sound disorders (SSDs), no experimental investigation of gestural cues that mimic that spatiotemporal parameters of speech sounds (e.g., holding fingers and thumb together and “popping” them to cue /p/) currently exists. The purpose of this study was to examine the effectiveness of manual mimicry cues within a multisensory intervention of persisting childhood apraxia of speech (CAS). Method A single-subject ABAB withdrawal design was implemented to assess the accuracy of vowel + /r/ combinations produced by a 21-year-old woman with persisting CAS. The effect of manual mimicry gestures paired with multisensory therapy consisting of verbal instructions and visual modeling was assessed via clinician and naïve listener ratings of target sound accuracy. Results According to the perceptual ratings of the treating clinician and 28 naïve listeners, the participant demonstrated improved speech sound accuracy as a function of the manual mimicry/multisensory therapy. Conclusions These data offer preliminary support for the incorporation of gestural cues in therapy for CAS and other SSDs. The need for continued research on the interaction of speech and manual movements for individuals with SSDs is discussed.

scholarly journals Atraso motor de fala não especificado: revisão integrativa

2020 ◽  
Vol 9 (10) ◽  
pp. e2249108480
Author(s):  
Gabriela Brum dos Santos ◽  
Marileda Barichello Gubiani ◽  
Leticia Arruda Nóro ◽  
Helena Bolli Mota
Keyword(s):  
Motor Control ◽  
Speech Sound ◽  
Speech Disorders ◽  
Speech Motor Control ◽  
Apraxia Of Speech ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Speech Motor

Objetivo: realizar uma revisão bibliográfica sobre o atraso motor de fala não especificado, como ele é avaliado e ainda como se diferencia de outras desordens motoras da fala. Estratégia de pesquisa: Trata-se de uma revisão integrativa da literatura. Realizou-se a busca nas bases SciELO, PubMed, Medine e Scopus no mês de novembro de 2019. Para as quatro bases foram utilizados os seguintes construtos e descritores: “motor speech disorders” OR “childhood apraxia of speech” OR “childhood apraxia of speech cas” OR “developmental dyspraxia” OR “speech sound disorder” AND “speech motor control”, além da utilização de dois filtros: sujeitos até 18 anos e humanos. Critérios de seleção: Artigos publicados em português, inglês ou espanhol foram incluídos, sendo ou não de periódicos de acesso livre. Foram excluídos artigos que não estavam relacionados ao atraso motor de fala não especificado e estudos de revisão de literatura. Resultados: Foram encontrados56 artigos nas bases de dados, sendo 33 da base Scopus, 19 da PubMed, 3 da SciElo e 1 da Medline. Após análise e seleção pelos critérios de inclusão, foram selecionados 14 estudos. Posteriormente a leitura integral dos artigos, 8 estudos foram excluídos, pois não respondiam as perguntas norteadoras da pesquisa, obtendo-se um n de 6 estudos. Conclusão: Muitas crianças com atraso significativo na fala são diagnosticadas erroneamente, sendo o DMS-NOS a desordem de maior prevalência na infância.

Apraxia of Speech in Children and Adolescents: Applications of Neuroscience to Differential Diagnosis and Intervention

2011 ◽  
Vol 21 (1) ◽  
pp. 15-32 ◽  
Author(s):  
Martha S. Burns
Keyword(s):  
Speech Sound ◽  
Outcome Study ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Initial Attempt ◽  
Phonological Disorders ◽  
Neuroscience Research ◽  
Longitudinal Case Studies ◽  
Production Characteristics

This paper presents an overview of clinical and neuroscience research that is relevant to distinguishing characteristics of childhood apraxia of speech (CAS) from perceptual/phonological disorders (PPD) in children with speech sound disorders. An initial attempt at developing a clinical checklist of as few as seven speech production characteristics, based on a literature review, may be useful for distinguishing CAS from PPD. Data on 11 children seen for intensive speech language intervention in 2008 are presented. The paper also provides longitudinal data on four children seen over two decades that presented with CAS vs. PPD. Clinical implications of a treatment outcome study, the CAS checklist, and longitudinal case studies are discussed.

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