A Phonomotor Approach to Apraxia of Speech Treatment

2020 ◽  
Vol 29 (4) ◽  
pp. 2109-2130
Author(s):  
Lauren Bislick
Keyword(s):  
Phase I ◽  
Treatment Effects ◽  
Single Case ◽  
Motor Planning ◽  
The Other ◽  
Multimodal Approach ◽  
Apraxia Of Speech ◽  
Duration Of Treatment ◽  
Treatment Gains ◽  
Future Work

Purpose This study continued Phase I investigation of a modified Phonomotor Treatment (PMT) Program on motor planning in two individuals with apraxia of speech (AOS) and aphasia and, with support from prior work, refined Phase I methodology for treatment intensity and duration, a measure of communicative participation, and the use of effect size benchmarks specific to AOS. Method A single-case experimental design with multiple baselines across behaviors and participants was used to examine acquisition, generalization, and maintenance of treatment effects 8–10 weeks posttreatment. Treatment was distributed 3 days a week, and duration of treatment was specific to each participant (criterion based). Experimental stimuli consisted of target sounds or clusters embedded nonwords and real words, specific to each participants' deficit. Results Findings show improved repetition accuracy for targets in trained nonwords, generalization to targets in untrained nonwords and real words, and maintenance of treatment effects at 10 weeks posttreatment for one participant and more variable outcomes for the other participant. Conclusions Results indicate that a modified version of PMT can promote generalization and maintenance of treatment gains for trained speech targets via a multimodal approach emphasizing repeated exposure and practice. While these results are promising, the frequent co-occurrence of AOS and aphasia warrants a treatment that addresses both motor planning and linguistic deficits. Thus, the application of traditional PMT with participant-specific modifications for AOS embedded into the treatment program may be a more effective approach. Future work will continue to examine and maximize improvements in motor planning, while also treating anomia in aphasia.

Treating Childhood Apraxia of Speech With the Kaufman Speech to Language Protocol: A Phase I Pilot Study

2018 ◽  
Vol 49 (3) ◽  
pp. 524-536 ◽  
Author(s):  
Maryane Gomez ◽  
Patricia McCabe ◽  
Kathy Jakielski ◽  
Alison Purcell
Keyword(s):  
Pilot Study ◽  
Phase I ◽  
Single Case ◽  
Maintenance Phase ◽  
Preliminary Evidence ◽  
Multiple Baseline ◽  
Response To Treatment ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Treatment Gains

Purpose A Phase I pilot study was designed to collect preliminary evidence on the use of the Kaufman Speech to Language Protocol (K-SLP; Kaufman, 2014) to treat children with childhood apraxia of speech. We hypothesized that the K-SLP approach would result in more accurate speech production in targeted words, whereas untrained (control) words and speech sounds would remain unchanged. Method A single-case multiple-baseline across behaviors experimental design was used to see if experimental feasibility could be demonstrated. Two children each received a total of 12 1-hr treatment sessions over 3 weeks. The children's response to treatment and experimental control was measured by administering baseline, treatment, and posttreatment probes. Results Both children showed some response to treatment, as measured by percent phonemes correct; however, the response to treatment varied. In general, for the treated words that improved with therapy, accuracy was maintained above baseline level during the maintenance phase. Minimal generalization was observed for this study, with only 1 participant generalizing treatment gains to 2 sets of untrained (similar) words. Conclusion This Phase I pilot study provides limited preliminary evidence for the effectiveness of the K-SLP approach in treating childhood apraxia of speech in some children under the conditions specified in this study. Replication of these results in well-controlled studies is needed before this structured and operationalized version of the K-SLP approach can be recommended for clinical use.

A Randomized Controlled Trial for Children With Childhood Apraxia of Speech Comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme–Third Edition

2015 ◽  
Vol 58 (3) ◽  
pp. 669-686 ◽  
Author(s):  
Elizabeth Murray ◽  
Patricia McCabe ◽  
Kirrie J. Ballard
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Motor Planning ◽  
Apraxia Of Speech ◽  
Multiple Sources ◽  
Childhood Apraxia Of Speech ◽  
Randomized Controlled ◽  
Language Pathology ◽  
Significant Generalization ◽  
Treatment Gains

PurposeThis randomized controlled trial compared the experimental Rapid Syllable Transition (ReST) treatment to the Nuffield Dyspraxia Programme–Third Edition (NDP3; Williams & Stephens, 2004), used widely in clinical practice in Australia and the United Kingdom. Both programs aim to improve speech motor planning/programming for children with apraxia of speech (CAS), but they differ in types of stimuli used, level of stimulus complexity at initiation of treatment, and the principles of motor learning that they apply.MethodTreatment was delivered to 26 children with mild to severe CAS aged 4–12 years through trained and supervised speech-language pathology students in 1-hr sessions, 4 days a week for 3 weeks at a university clinic. Articulation and prosodic accuracy were assessed at pretreatment, 1 week, 1 month, and 4 months posttreatment using blinded independent assessors to compare treatment, maintenance, and generalization effects.ResultsThe ReST and NDP3 treatments demonstrated large treatment effects. ReST maintained treatment gains from 1-week to 4-months posttreatment more effectively than the NDP3. Significant generalization to untreated stimuli was observed for both ReST and NDP3.ConclusionsReST and NDP3 have strong evidence of treatment and generalization gains in children with CAS when delivered intensively. Overall, ReST has greater external evidence from multiple sources but both treatments have support for clinical use.

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

The effects of long-term vigorous endurance exercise on the coronary arteries

2019 ◽  
Vol 67 (2) ◽  
Keyword(s):  
Endurance Training ◽  
Coronary Atherosclerosis ◽  
Calcium Score ◽  
The Other ◽  
Disease Phenotype ◽  
Male Athletes ◽  
Artery Disease ◽  
Future Work ◽  
Summary Data

Moderate endurance training is known to improve cardiovascular risk factors, and prolongs life expectancy. On the other hand, there has been some discussion whether “too much” exercise might have a contrarious effect by accelerating coronary atherosclerosis. The goal of this review was to evaluate the current literature on the effects of long-term vigorous endurance training on the coronary vasculature. In summary, data point to an increased calcium score, and a higher burden of atherosclerotic plaque in male athletes compared to sedentary controls. However, the plaques found in athletes were more prone to be calcified. The pathogenesis and clinical relevance of this athlete coronary artery disease phenotype remains incompletely understood and represents an area of important future work.

The effects of long-term vigorous endurance exercise on the coronary arteries

2019 ◽  
Vol 67 (2) ◽  
Keyword(s):  
Endurance Training ◽  
Coronary Atherosclerosis ◽  
Calcium Score ◽  
The Other ◽  
Disease Phenotype ◽  
Male Athletes ◽  
Artery Disease ◽  
Future Work ◽  
Summary Data

Moderate endurance training is known to improve cardiovascular risk factors, and prolongs life expectancy. On the other hand, there has been some discussion whether “too much” exercise might have a contrarious effect by accelerating coronary atherosclerosis. The goal of this review was to evaluate the current literature on the effects of long-term vigorous endurance training on the coronary vasculature. In summary, data point to an increased calcium score, and a higher burden of atherosclerotic plaque in male athletes compared to sedentary controls. However, the plaques found in athletes were more prone to be calcified. The pathogenesis and clinical relevance of this athlete coronary artery disease phenotype remains incompletely understood and represents an area of important future work.

scholarly journals General Environment Description Language

2021 ◽  
Vol 11 (2) ◽  
pp. 740
Author(s):  
Krzysztof Zatwarnicki ◽  
Waldemar Pokuta ◽  
Anna Bryniarska ◽  
Anna Zatwarnicka ◽  
Andrzej Metelski ◽  
...  
Keyword(s):  
Intelligent Systems ◽  
General Purpose ◽  
The Other ◽  
Potential Fields ◽  
General Intelligence ◽  
Language Usage ◽  
Description Language ◽  
It Systems ◽  
New Research ◽  
Future Work

Artificial intelligence has been developed since the beginning of IT systems. Today there are many AI techniques that are successfully applied. Most of the AI field is, however, concerned with the so-called “narrow AI” demonstrating intelligence only in specialized areas. There is a need to work on general AI solutions that would constitute a framework enabling the integration of already developed narrow solutions and contribute to solving general problems. In this work, we present a new language that potentially can become a base for building intelligent systems of general purpose in the future. This language is called the General Environment Description Language (GEDL). We present the motivation for our research based on the other works in the field. Furthermore, there is an overall description of the idea and basic definitions of elements of the language. We also present an example of the GEDL language usage in the JSON notation. The example shows how to store the knowledge and define the problem to be solved, and the solution to the problem itself. In the end, we present potential fields of application and future work. This article is an introduction to new research in the field of Artificial General Intelligence.

scholarly journals Bone marrow transplantation for peripheral T-cell lymphoma in children and adolescents

Blood ◽  
1992 ◽  
Vol 80 (11) ◽  
pp. 2938-2942 ◽  
Author(s):  
BG Gordon ◽  
PI Warkentin ◽  
DD Weisenburger ◽  
JM Vose ◽  
WG Sanger ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
T Cell ◽  
Phase I ◽  
Children And Adolescents ◽  
Marrow Transplantation ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
The Other ◽  
Peripheral T Cell Lymphoma

Abstract We report nine children with relapsed (n = 8) or high-risk (n = 1) peripheral T-cell lymphoma (PTCL) who underwent autologous (n = 6) or allogeneic (n = 3) bone marrow transplantation (BMT). These children received transplants as part of a prospective phase I/II study of thioTEPA (TT) and total body irradiation (TBI) with escalating doses of VP-16. The median age of these patients at time of BMT was 6.5 years (range 2.5 years to 14 years). Three were transplanted with active disease after failing salvage chemotherapy. Of the other six, one was transplanted in first complete remission (CR) and five in second or subsequent CR. Of these nine patients, eight are free of disease a median of 25 months after BMT (range, 6 to 48 months), with an estimated 2-year relapse-free survival (RFS) of 89%. Six of these eight patients have been followed for 12 or more months after BMT, and in each their current remission exceeds their longest previous remission duration. The toxicity of the TT/TBI +/- VP-16 regimens was significant but manageable, predominantly consisting of severe mucositis. For a comparison, we reviewed retrospective data on the six additional children and adolescents with PTCL who underwent BMT during the 3-year period preceding this phase I/II study. The median age at BMT of these six patients was 19 years (range 15.5 years to 20 years). These patients were prepared for BMT with a variety of other regimens. One had no response to BMT and the other five relapsed at 1.5 to 5 months after BMT (median, 3 months) with an RFS of 0%. Our data suggest that thioTEPA plus TBI, with or without VP-16, is an effective preparative regimen for BMT for young patients with relapsed or high-stage PTCL and leads to prolonged RFS.

MEASUREMENTS OF GRAVITY IN THE CANADIAN ARCTIC AND GREENLAND

1950 ◽  
Vol 28a (5) ◽  
pp. 535-541
Author(s):  
Michael Beer
Keyword(s):  
Canadian Arctic ◽  
Reference Points ◽  
The Other ◽  
Baffin Island ◽  
Resolute Bay ◽  
Future Work ◽  
Cornwallis Island

Four determinations of gravity were made during the summer of 1948, with the pendulum apparatus of the Dominion Observatory, at Goose Bay, Labrador (latitude 53°), Frobisher Bay, Baffin Island (latitude 64°), Resolute Bay, Cornwallis Island (latitude 75°), and Thule, Greenland (latitude 77°), approximately. The anomalies at the two most northerly stations are comparatively small and those at the other two stations, although larger, do not exceed many that have been observed in other parts of Canada. Norgaard's determination at Thule is confirmed by the author.It is anticipated that these determinations, apart from their immediate interest, will serve as useful reference points for future work in the Canadian Arctic.

Summary of the current state of the pathogenesis of glaucoma

1927 ◽  
Vol 23 (8) ◽  
pp. 839-845
Author(s):  
V. P. Roshchin
Keyword(s):  
Single Case ◽  
Disease Process ◽  
The Other ◽  
Medical Attention ◽  
Blind People ◽  
Current State ◽  
Constant State ◽  
The One

The problem of glaucoma has, for many reasons, occupied and continues to occupy a prominent place in the ophthalmic press. It is enough to recall that 19% of all blind people owe their misfortune to glaucoma to understand why interest in this affliction has never faded among ophthalmologists. Furthermore, no ophthalmologist is quite sure that a certain method of treatment, even if the patient has timely applied for medical attention, can definitely prevent a sad outcome in every single case. This plus the absence of a unified and correct view of the essence of glaucoma keeps ophthalmologists in a constant state of flux, constantly striving to uncover the hidden springs of the disease process on the one hand, and to find a more radical means to combat it on the other.

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