Using Randomized Variable Practice in the Treatment of Childhood Apraxia of Speech

2014 ◽  
Vol 23 (4) ◽  
pp. 599-611 ◽  
Author(s):  
Steven L. Skelton ◽  
Aubrie Lynn Hagopian
Keyword(s):  
Treatment Program ◽  
Effect Sizes ◽  
Central Component ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Concurrent Treatment ◽  
Percent Correct ◽  
Standard Mean Difference ◽  
Articulation Disorders ◽  
Variable Practice

Purpose The purpose of this study was to determine if randomized variable practice, a central component of concurrent treatment, would be effective and efficient in treating childhood apraxia of speech (CAS). Concurrent treatment is a treatment program that takes the speech task hierarchy and randomizes it so that all tasks are worked on in one session. Previous studies have shown the treatment program to be effective and efficient in treating phonological and articulation disorders. The program was adapted to be used with children with CAS. Method A research design of multiple baselines across participants was used. Probes of generalization to untaught words were administered every fifth session. Three children, ranging in age from 4 to 6 years old, were the participants. Data were collected as percent correct productions during baseline, treatment, and probes of generalization of target sounds to untaught words and three-word phrases. Results All participants showed an increase in correct productions during treatment and during probes. Effect sizes (standard mean difference) for treatment were 3.61–5.00, and for generalization probes, they were 3.15–8.51. Conclusions The results obtained from this study suggest that randomized variable practice as used in concurrent treatment can be adapted for use in treating children with CAS. Replication of this study with other children presenting CAS will be needed to establish generality of the findings.

scholarly journals Model-Driven Treatment of Childhood Apraxia of Speech: Positive Effects of the Speech Motor Learning Approach

2018 ◽  
Vol 27 (1) ◽  
pp. 37-51 ◽  
Author(s):  
Anita van der Merwe ◽  
Mollie Steyn
Keyword(s):  
Motor Learning ◽  
Speech Errors ◽  
Effect Sizes ◽  
Learning Approach ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Age Appropriate ◽  
Speech Motor Learning ◽  
Whole Word ◽  
Speech Motor

Purpose The aim of the study was to propose the speech motor learning approach (Van der Merwe, 2011) as a treatment for childhood apraxia of speech and to determine if it will effect positive change in the ability of a 33-month-old child to produce untreated nonwords and words containing treated age-appropriate consonants (Set 1 sounds), untreated age-appropriate consonants (Set 2), and untreated age-inappropriate consonants (Set 3) and also to determine the nature and number of segmental speech errors before and after treatment. Method An A-B design with multiple target measures and follow-up was implemented to assess the effects of treatment of Set 1. Effect sizes for whole-word accuracy were determined, and two criterion lines were generated following the conservative dual criterion method. Speech errors were judged perceptually. Results Conservative dual criterion analyses indicated no reliable treatment effect due to rising baseline scores. Effect sizes showed significant improvement in whole-word accuracy of untreated nonwords and real words containing age-appropriate treated sounds and real words containing age-appropriate untreated sounds. The number of errors for all three sound sets declined. Sound distortion was the most frequent error type. Conclusions Preliminary evidence suggests potentially positive treatment effects. However, rising baseline scores limit causal inference. Replication with more children of different ages is necessary. Supplemental Materials https://doi.org/10.23641/asha.5596708

A Pilot Single-Case Experimental Design Study of Rapid Syllable Transition Treatment for Italian Children With Childhood Apraxia of Speech

2021 ◽  
pp. 1-15
Author(s):  
Ilaria Scarcella ◽  
Letizia Michelazzo ◽  
Patricia McCabe
Keyword(s):  
Experimental Design ◽  
Single Case ◽  
Lexical Stress ◽  
Effect Sizes ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Treatment Results ◽  
Italian Children ◽  
Treatment Procedures ◽  
Stress Patterns

Background The Rapid Syllable Transition (ReST) treatment is an effective intervention designed to address the planning and programming disorder found in childhood apraxia of speech. To date, no study has considered its use with children who speak languages other than English. Aim This pilot study aimed to examine the use of ReST treatment with Italian children. We hypothesized that the ReST approach would improve the overall accuracy of the targeted behaviors of lexical stress, smoothness, and phonemic accuracy, whereas phonemic and phonetic accuracy of untreated items would remain stable. Method Two monolingual Italian-speaking children with childhood apraxia of speech received therapy in 12 one-hour sessions, 2–3 times per week, using a single-case experimental design. The treatment procedures used in English were replicated in Italian with one change: In English, two stress patterns are treated. Italian commonly uses three stress patterns; therefore, the stimuli were modified accordingly. Accuracy of articulation, lexical stress, and smoothness were assessed at pretreatment and 1 day, 1 week, and 4 months posttreatment in treated and untreated pseudowords and in real words and sentences. Results Both children improved on treated pseudowords and real words with moderate effect sizes, but only one child generalized to untreated pseudowords. Maintenance of treatment results was observed in both participants. Articulation of control phonemes did not change. Conclusions ReST treatment in Italian is feasible, and a treatment effect was found, showing that its use may be valid in languages other than English. Further research is required. Supplemental Material https://doi.org/10.1044/2021_AJSLP-20-00133

Ultrasound Biofeedback Treatment for Persisting Childhood Apraxia of Speech

2013 ◽  
Vol 22 (4) ◽  
pp. 627-643 ◽  
Author(s):  
Jonathan L. Preston ◽  
Nickole Brick ◽  
Nicole Landi
Keyword(s):  
Treatment Program ◽  
Speech Sound ◽  
Performance Criterion ◽  
Performance Criteria ◽  
Ultrasound Images ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Word Level ◽  
Tongue Movements ◽  
Biofeedback Treatment

Purpose The purpose of this study was to evaluate the efficacy of a treatment program that includes ultrasound biofeedback for children with persisting speech sound errors associated with childhood apraxia of speech (CAS). Method Six children ages 9–15 years participated in a multiple baseline experiment for 18 treatment sessions during which treatment focused on producing sequences involving lingual sounds. Children were cued to modify their tongue movements using visual feedback from real-time ultrasound images. Probe data were collected before, during, and after treatment to assess word-level accuracy for treated and untreated sound sequences. As participants reached preestablished performance criteria, new sequences were introduced into treatment. Results All participants met the performance criterion (80% accuracy for 2 consecutive sessions) on at least 2 treated sound sequences. Across the 6 participants, performance criterion was met for 23 of 31 treated sequences in an average of 5 sessions. Some participants showed no improvement in untreated sequences, whereas others showed generalization to untreated sequences that were phonetically similar to the treated sequences. Most gains were maintained 2 months after the end of treatment. The percentage of phonemes correct increased significantly from pretreatment to the 2-month follow-up. Conclusion A treatment program including ultrasound biofeedback is a viable option for improving speech sound accuracy in children with persisting speech sound errors associated with CAS.

Bang for Your Buck: A Single-Case Experimental Design Study of Practice Amount and Distribution in Treatment for Childhood Apraxia of Speech

2019 ◽  
Vol 62 (9) ◽  
pp. 3160-3182 ◽  
Author(s):  
Edwin Maas ◽  
Christina Gildersleeve-Neumann ◽  
Kathy Jakielski ◽  
Nicolette Kovacs ◽  
Ruth Stoeckel ◽  
...  
Keyword(s):  
Single Case ◽  
Evidence Base ◽  
Distributed Practice ◽  
Single Subject ◽  
Single Subject Design ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Opposite Pattern ◽  
Massed Practice ◽  
Treatment Conditions

Purpose The aim of this study was to examine 2 aspects of treatment intensity in treatment for childhood apraxia of speech (CAS): practice amount and practice distribution. Method Using an alternating-treatments single-subject design with multiple baselines, we compared high versus low amount of practice, and massed versus distributed practice, in 6 children with CAS. Conditions were manipulated in the context of integral stimulation treatment. Changes in perceptual accuracy, scored by blinded analysts, were quantified with effect sizes. Results Four children showed an advantage for high amount of practice, 1 showed an opposite effect, and 1 showed no condition difference. For distribution, 4 children showed a clear advantage for massed over distributed practice post treatment; 1 showed an opposite pattern, and 1 showed no clear difference. Follow-up revealed a similar pattern. All children demonstrated treatment effects (larger gains for treated than untreated items). Conclusions High practice amount and massed practice were associated with more robust speech motor learning in most children with CAS, compared to low amount and distributed practice, respectively. Variation in effects across children warrants further research to determine factors that predict optimal treatment conditions. Finally, this study adds to the evidence base supporting the efficacy of integral stimulation treatment for CAS. Supplemental Material https://doi.org/10.23641/asha.9630599

What Does It Mean to Be Social? Defining the Social Landscape for Children With Childhood Apraxia of Speech

2020 ◽  
Vol 5 (4) ◽  
pp. 843-852 ◽  
Author(s):  
Nancy Tarshis ◽  
Michelle Garcia Winner ◽  
Pamela Crooke
Keyword(s):  
Social Development ◽  
Social Goals ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Social Competencies ◽  
The Social ◽  
Social Landscape ◽  
Communication Challenges ◽  
Primary Focus ◽  
Speech Motor

Purpose What does it mean to be social? In addition, how is that different from behaving socially appropriately? The purpose of this clinical focus article is to tackle these two questions along with taking a deeper look into how communication challenges in childhood apraxia of speech impact social competencies for young children. Through the lens of early social development and social competency, this clinical focus article will explore how speech motor challenges can impact social development and what happens when young learners miss early opportunities to grow socially. While not the primary focus, the clinical focus article will touch upon lingering issues for individuals diagnosed with childhood apraxia of speech as they enter the school-aged years. Conclusion Finally, it will address some foundational aspects of intervention and offer ideas and suggestions for structuring therapy to address both speech and social goals.

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