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.

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.

scholarly journals Childhood Apraxia of Speech. Developmental Speech Patterns. A Wide Retrospective Study

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 54-68
Author(s):  
Elad Vashdi ◽  
◽  
Amit Avramov ◽  
Špela Falatov ◽  
Huang Yi-Chen ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Sound Production ◽  
Speech Disorder ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Entry Level ◽  
Motor Speech Disorder ◽  
Speech Patterns

Patterns of a phenomenon define the entity. If one understands the patterns of the maze, he can find his way there. Patterns of colors on a dress will hold its characters and soul. Understanding the expressive patterns of a developmental syndrome enables treating it with success. It is true for treating Childhood Apraxia of speech (CAS) as well. CAS as motor-speech disorder involves difficulties in sounds production for speech purposes. The difficulties can be demonstrated in patterns that would be specific to CAS. These patterns can distinguish one phenomenon from another. A retrospective research was conducted based on 277 entry level evaluations of children diagnosed with CAS or suspected of CAS who visited a private clinic between 2006 and 2013. The analysis included speech variables alongside background and environmental variables. This article is dealing with speech patterns of children with motor speech disorder. Among the patterns examined are vowels ladder, single syllable ladder, Blowing and SSP (single sound production), Oral motor and SSP, Consonant group ladder and Consonants Exploratory factor analysis. The findings demonstrated the relationship and order of vowels, consonants and single syllables among Hebrew speaking children diagnosed with motor speech disorder. The Consonants Exploratory factor analysis gave validity to the existence of unique consonant groups. Further discussion regarding every result and its implication is included. Understanding the unique patterns of consonants and vowels strength among children with CAS can help clinicians in the decision-making process and goals targeting.

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

scholarly journals A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

2017 ◽  
Vol 60 (4) ◽  
Author(s):  
Lawrence D. Shriberg ◽  
Edythe A. Strand ◽  
Marios Fourakis ◽  
Kathy J. Jakielski ◽  
Sheryl D. Hall ◽  
...  
Keyword(s):  
Classification System ◽  
Diagnostic Marker ◽  
Speech Disorders ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Cross Classification ◽  
Classification Procedures

Purpose The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay. Method The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed. Results The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided. Conclusions The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

scholarly journals Estimates of the Prevalence of Speech and Motor Speech Disorders in Youth With 22q11.2 Deletion Syndrome

2019 ◽  
Vol 28 (1) ◽  
pp. 53-82 ◽  
Author(s):  
Adriane L. Baylis ◽  
Lawrence D. Shriberg
Keyword(s):  
22Q11.2 Deletion Syndrome ◽  
Speech Disorders ◽  
Deletion Syndrome ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
22Q11.2 Deletion ◽  
Motor Speech Disorders ◽  
Motor Delay ◽  
Speech Motor

Purpose Speech sound disorders and velopharyngeal dysfunction are frequent features of 22q11.2 deletion syndrome (22q). We report the first estimate of the prevalence of motor speech disorders (MSDs) in youth with 22q. Method Seventeen children and adolescents with 22q completed an assessment protocol that included a conversational speech sample. Data reduction included phonetic transcription, perceptual speech ratings, prosody-voice coding, and acoustic analyses. Data analyses included 3 motor speech measures and a cross-classification analytic. Prevalence estimates of speech and MSDs in youth with 22q were compared with estimates in speakers with other complex neurodevelopmental disorders: Down syndrome, fragile X syndrome, and galactosemia. Results Results indicated that 58.8% of the participants with 22q met criteria for speech delay, and 82.4% of the participants met criteria for MSDs, including 29.4% with speech motor delay, 29.4% with childhood dysarthria, 11.8% with childhood apraxia of speech, and 11.8% with concurrent childhood dysarthria and childhood apraxia of speech. MSDs were not significantly associated with velopharyngeal dysfunction. Conclusions In summary, 82.4% of the participants with 22q met criteria for 1 of 4 MSDs, predominantly speech motor delay and childhood dysarthria. Cross-validation of the present findings would support viewing MSDs as a core phenotypic feature of 22q.

scholarly journals Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series

2021 ◽  
pp. 088307382110158
Author(s):  
Simona Fiori ◽  
Kerstin Pannek ◽  
Irina Podda ◽  
Paola Cipriani ◽  
V. Lorenzoni ◽  
...  
Keyword(s):  
Fractional Anisotropy ◽  
Brain Mri ◽  
Case Series ◽  
Mean Diffusivity ◽  
Treated Group ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Corticobulbar Tract ◽  
Speech Motor

We report a case series of children with childhood apraxia of speech, by describing behavioral and white matter microstructural changes following 2 different treatment approaches. Five children with childhood apraxia of speech were assigned to a motor speech treatment (PROMPT) and 5 to a language, nonspeech oral motor treatment. Speech assessment and brain MRI were performed pre- and post-treatment. The ventral (tongue/larynx) and dorsal (lips) corticobulbar tracts were reconstructed in each subject. Mean fractional anisotropy and mean diffusivity were extracted. The hand corticospinal tract was assessed as a control pathway. In both groups speech improvements paralleled changes in the left ventral corticobulbar tract fractional anisotropy. The PROMPT treated group also showed fractional anisotropy increase and mean diffusivity decrease in the left dorsal corticobulbar tract. No changes were detected in the hand tract. Our results may provide preliminary support to the possible neurobiologic effect of a multimodal speech motor treatment in childhood apraxia of speech.

Rapid Syllable Transition Treatment—A Treatment for Childhood Apraxia of Speech and Other Pediatric Motor Speech Disorders

2020 ◽  
Vol 5 (4) ◽  
pp. 821-830 ◽  
Author(s):  
Patricia McCabe ◽  
Donna Claire Thomas ◽  
Elizabeth Murray
Keyword(s):  
Ad Hoc ◽  
Single Case ◽  
Controlled Trial ◽  
Speech Disorders ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Treatment Data ◽  
Core Features

Purpose Childhood apraxia of speech (CAS) is a speech disorder that many generalist speech-language pathologists feel underqualified to treat. For children with CAS, this may result in ad hoc interventions resulting in slower progress. Research evidence for various CAS treatments is primarily limited to single-case experimental design studies; however, two treatments (Rapid Syllable Transition Treatment [ReST] and the Nuffield Dyspraxia Programme, Third Edition) have been compared in a single randomized controlled trial. Conclusion This tutorial describes one of those treatments: ReST which was designed to address the three consensus core features of CAS simultaneously: consistency and accuracy of sounds, sequencing, and prosody. The treatment uses nonwords to help children build and store accurate motor plans and programs using principles of motor learning. Treatment data are described, and commonly reported clinical issues are discussed. Recommendations for which children may be suitable for ReST and for evidence-based practice are described.

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