Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS): A Single-Case Experimental Design Study

2021 ◽  
pp. 1-17
Author(s):  
Molly Beiting ◽  
Edwin Maas
Keyword(s):  
Single Case ◽  
Scientific Evidence ◽  
Speech Sound ◽  
Preliminary Evidence ◽  
Autism Spectrum ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Baseline Design ◽  
Speech Treatment ◽  
Production Accuracy

Purpose A subset of children with autism spectrum disorder (ASD) has speech sound disorders, including childhood apraxia of speech (CAS). To date, virtually all speech treatment studies consider ASD an exclusionary criterion, resulting in little scientific evidence for treatment of CAS for children who also have ASD. This study proposes and tests a novel approach, Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS), as a theoretically and clinically informed speech treatment option for this population. Method Using a multiple-baseline design within and across participants, three children with co-occurring ASD and CAS received 11–18 treatment sessions. Treatment targets were individually designed and matched with untreated control words. Probes were administered at the start of each session to assess speech production accuracy perceptually. Changes in production accuracy were examined through visual inspection and quantified with effect sizes. Results Findings were mixed, with one child showing significant gains for half of the treated targets at follow-up and two children showing no clear improvement. Conclusions Preliminary evidence suggests potentially positive treatment effects for ACT4CAS when implemented as intended, although treatment intensity and disorder severity likely influence treatment outcome. Replication and comparison of ACT4CAS to other speech treatments is needed. Supplemental Material https://doi.org/10.23641/asha.14110445

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.

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

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.

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.

Effects of School-Home Communication With Parent-Implemented Reinforcement on Off-Task Behavior for Students With ASD

2019 ◽  
Vol 57 (2) ◽  
pp. 95-111 ◽  
Author(s):  
Samantha E. Goldman ◽  
Kelli A. Sanderson ◽  
Blair P. Lloyd ◽  
Erin E. Barton
Keyword(s):  
Single Case ◽  
Autism Spectrum ◽  
Future Research ◽  
Single Case Design ◽  
Design Standards ◽  
Baseline Design ◽  
Functional Relations ◽  
Task Behavior ◽  
Students With Autism ◽  
Spectrum Disorders

AbstractSchool-home communication is highly valued for parents of students with autism spectrum disorders (ASD) and other developmental disabilities. However, parents report poor communication as a common barrier to developing partnerships with schools. Using a multiple baseline design, we evaluated the effects of a school-home note intervention with parent-implemented reinforcement for decreasing off-task behavior of students with ASD at school. We also evaluated social validity (i.e., feasibility and acceptability) of the intervention and outcomes. Only two of the four participants showed clear behavior change, which precluded the demonstration of functional relations. However, all participating parents and teachers reported the school-home note and parent-implemented contingent reinforcement were highly feasible and acceptable, and indicated positive outcomes relating to improved family-school partnership and communication. Findings of this study, which meets single-case design standards and quality indicators, are discussed in terms of future research and practice.

scholarly journals Developing a test battery for diagnosis of childhood apraxia of speech in Arabic speakers

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Dalia Abdou ◽  
Omayma Afsah ◽  
Hemmat Baz ◽  
Tamer Abou-Elsaad
Keyword(s):  
Speech Sound ◽  
Test Battery ◽  
Apraxia Of Speech ◽  
Validity And Reliability ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Phonological Disorders ◽  
Arabic Speakers ◽  
Egyptian Children ◽  
Arabic Speaking

Abstract Background Childhood apraxia of speech (CAS) is a speech sound disorder in which the precision and consistency of movements underlying speech are impaired in absence of neuromuscular deficits. It is important to differentiate between language disorders and CAS to avoid misdiagnosis. The objective of this study was to develop a test battery for CAS in order to identify its possible presence in Arabic-speaking children, thus allowing the planning of appropriate therapy programs. The constructed test battery for CAS was administered to 70 monolingual Arabic-speaking Egyptian children including 10 children with suspected CAS, 20 children with phonological disorders, and 40 typically developing children. Participants’ responses were statistically analyzed to assess the validity and reliability, and to evaluate sensitivity and specificity of the test battery. Results Statistically significant differences were found between the three groups as regard all subtotal and total scores of CAS test battery with good validity and reliability of the test. Conclusions The constructed test battery for diagnosis of CAS is a reliable, valid, and sensitive tool that can be used to detect the presence of CAS in Arabic-speaking children and differentiate between it and phonological disorders.

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 Concurrent Validity Between Two Sound Sequencing Tasks Used to Identify Childhood Apraxia of Speech in School-Age Children

2021 ◽  
pp. 1-9
Author(s):  
Jonathan L. Preston ◽  
Nina R. Benway ◽  
Megan C. Leece ◽  
Nicole F. Caballero
Keyword(s):  
Concurrent Validity ◽  
Time Pressure ◽  
Speech Sound ◽  
School Age Children ◽  
Apraxia Of Speech ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Sequencing Errors ◽  
Syllable Repetition ◽  
Task Requirements

Purpose To assess the concurrent validity of two tasks used to inform diagnosis of childhood apraxia of speech (CAS), this study evaluated the agreement between the Syllable Repetition Task (SRT) and the Maximum Repetition Rate of Trisyllables (MRR-Tri). Method A retrospective analysis was conducted with 80 children 7–16 years of age who were referred for treatment studies. All children had a speech sound disorder, and all completed both the SRT and the MRR-Tri. On each task, children were classified as meeting or not meeting the tool's threshold for CAS based on the sound sequencing errors demonstrated. Results The two tasks were in agreement for 47 participants (59% of the sample); both tasks classified 13 children as meeting the threshold for CAS and 34 children as not meeting the threshold for CAS. However, the two tasks disagreed on CAS classification for 33 children (41% of the sample). Overall, the MRR-Tri identified more children as having sound sequencing errors indicative of CAS ( n = 39) than did the SRT ( n = 20). Conclusions These two tasks of sound sequencing differ in the children they identify with CAS, possibly due to aspects of the underlying task requirements (e.g., time pressure). The SRT and the MRR-Tri should not be used in isolation to identify CAS but may be useful as part of a balanced CAS assessment battery that includes additional tasks that inform the nature of the impairment and that aid treatment planning. Supplemental Material https://doi.org/10.23641/asha.14110280

Sign in / Sign up

Export Citation Format

Share Document