Effects of Treatment for Sound Errors in Apraxia of Speech and Aphasia

1998 ◽  
Vol 41 (4) ◽  
pp. 725-743 ◽  
Author(s):  
Julie L. Wambaugh ◽  
Michelene M. Kalinyak-Fliszar ◽  
Joan E. West ◽  
Patrick J. Doyle
Keyword(s):  
Sound Production ◽  
Multiple Baseline ◽  
Stimulus Generalization ◽  
Apraxia Of Speech ◽  
Baseline Design ◽  
Training Techniques ◽  
Response Generalization ◽  
Minimal Contrast ◽  
Treatment Gains ◽  
Cessation Of Treatment

This investigation was designed to examine the acquisition, generalization, and maintenance effects of a treatment for sound errors in speakers with co-occurring apraxia of speech and aphasia. Three speakers with chronic apraxia of speech and aphasia were studied in the context of a multiple baseline design across speakers and behaviors. Treatment combined the use of minimal contrast pairs with traditional sound production training techniques such as integral stimulation and articulatory placement cueing and was applied sequentially to sounds that were determined to be consistently in error before training. Results revealed increased correct sound productions for all speakers in trained and untrained words. Response generalization effects across sounds and stimulus generalization effects varied, but appeared to be limited for most speakers. Although positive maintenance effects were evidenced, some loss of treatment gains was noted following cessation of treatment.

Further Study of the Effects of Treatment Intensity on Outcomes of Sound Production Treatment for Acquired Apraxia of Speech: Does Dose Frequency Matter?

2020 ◽  
Vol 29 (1) ◽  
pp. 263-285 ◽  
Author(s):  
Julie L. Wambaugh ◽  
Sandra Wright ◽  
Christina Nessler ◽  
Shannon C. Mauszycki ◽  
Lisa Bunker ◽  
...  
Keyword(s):  
Treatment Response ◽  
Sound Production ◽  
Positive Response ◽  
Multiple Baseline ◽  
Treatment Intensity ◽  
Apraxia Of Speech ◽  
Dose Frequency ◽  
Response Generalization ◽  
Participant Characteristics

Purpose The aim of this study was to examine the effects of dose frequency, an aspect of treatment intensity, on articulation outcomes of sound production treatment (SPT). Method Twelve speakers with apraxia of speech and aphasia received SPT administered with an intense dose frequency and a nonintense/traditional dose frequency (SPT-T). Each participant received both treatment intensities in the context of multiple baseline designs across behaviors. SPT-Intense was provided for 3 hourly sessions per day/3 days per week; and SPT-T for 1 hour-long session per day/3 days per week. Twenty-seven treatment sessions were completed with each phase of treatment. Articulation accuracy was measured in probes of production of treated and untreated words. Results All participants achieved improved articulation of treated words with both intensities; there were no notable differences in magnitude of improvement associated with dose frequency. Positive response generalization to untrained words was found in 21 of 24 treatment applications; the cases of negligible response generalization occurred with SPT-T words. Conclusions Dose frequency (and corresponding total intervention duration) did not appear to impact treatment response for treated items. Disparate response generalization findings for 3 participants in the current study may relate to participant characteristics such as apraxia of speech severity and/or stimuli factors.

Stimulus Generalization Using Nonvisual Stimuli with a Student Who Has Autism Spectrum Disorder and Visual Impairment

2021 ◽  
Vol 115 (2) ◽  
pp. 121-133
Author(s):  
Robin Arnall ◽  
Yors Garcia ◽  
Annette K. Griffith ◽  
Jack Spear
Keyword(s):  
Visual Impairment ◽  
Private School ◽  
Sensory Input ◽  
Language Skills ◽  
Autism Spectrum ◽  
Multiple Baseline ◽  
Stimulus Generalization ◽  
Baseline Design ◽  
Tactile Stimuli ◽  
Low Levels

Introduction: The main objective of this study was to determine whether stimulus symmetry, or untaught generalized relations among stimuli, could be demonstrated using audio and tactile stimuli (i.e., nonvisual). Methods: A modified alternating treatment within a concurrent multiple baseline design across nonvisual stimulus sets (i.e., tactile and audio) was implemented with Zach, an 11-year-old male diagnosed with autism and visual impairment, to teach two relations (sound–touch and sound–label) among stimuli. Following training, the researcher tested whether Zach could identify stimuli through an untaught relation (touch–label). The study presented here required a week to complete and was conducted at a private school for individuals with behavioral concerns. Results: During baseline, Zach demonstrated low levels of correct responses (average of 7% across all relations) for all skills. In the training phase (for only two of the three targeted skills, sound–touch and sound–label relations), Zach demonstrated proficiency for most stimuli used in the sets (average of 61% across relations). Finally, in the testing phase (the untaught touch–label relation), Zach demonstrated high levels of generalized acquisition (89%). Discussion: Results indicated that the procedure used in this study could be generalized to novel populations, including those with visual impairments, and that different forms of sensory input could be used, including auditory and tactile-based teaching. Implications for practitioners: Individuals working with learners with differing levels of visual impairment could utilize the demonstrated procedure to associate types of stimuli, using methods other than visual input. The procedure outlined would benefit a population that may require assistance with developing language skills but who also may have difficulties using common visual stimuli.

scholarly journals Writing Treatment for Aphasia: A Texting Approach

2013 ◽  
Vol 56 (3) ◽  
pp. 945-955 ◽  
Author(s):  
Pélagie M. Beeson ◽  
Kristina Higginson ◽  
Kindle Rising
Keyword(s):  
Text Messaging ◽  
Cell Phone ◽  
Multiple Baseline ◽  
Functional Communication ◽  
Apraxia Of Speech ◽  
New Paradigm ◽  
Baseline Design ◽  
Combined Training ◽  
Functional Value ◽  
A Cell

Purpose Treatment studies have documented the therapeutic and functional value of lexical writing treatment for individuals with severe aphasia. The purpose of this study was to determine whether such retraining could be accomplished using the typing feature of a cellular telephone, with the ultimate goal of using text messaging for communication. Method A 31-year-old man with persistent Broca's aphasia, severe apraxia of speech, global dysgraphia, and right hemiparesis participated in this study. Using a multiple baseline design, relearning and maintenance of single-word spellings (and oral naming) of targeted items were examined in response to traditional Copy and Recall Treatment (CART) for handwriting and a new paradigm using 1-handed typing on a cell phone keyboard (i.e., a texting version of CART referred to as T-CART). Results Marked improvements were documented in spelling and spoken naming trained in either modality, with stronger maintenance for handwriting than cell phone typing. Training resulted in functional use of texting that continued for 2 years after treatment. Conclusions These results suggest that orthographic retraining using a cell phone keyboard has the potential to improve spelling knowledge and provide a means to improve functional communication skills. Combined training with both handwriting and cell phone typing should be considered in order to maximize the durability of treatment effects.

Acquired Apraxia of Speech: Comparison of Electropalatography Treatment and Sound Production Treatment

2020 ◽  
Vol 29 (1S) ◽  
pp. 511-529 ◽  
Author(s):  
Shannon C. Mauszycki ◽  
Julie L. Wambaugh
Keyword(s):  
Behavioral Treatment ◽  
Sound Production ◽  
Small Sample Size ◽  
Small Sample ◽  
Speech Sounds ◽  
Apraxia Of Speech ◽  
Treatment Approaches ◽  
Baseline Design ◽  
Visual Biofeedback ◽  
Kinematic Approach

Purpose This investigation compared 2 treatment approaches for acquired apraxia of speech. The effects of a treatment that uses an articulatory–kinematic approach in conjunction with visual biofeedback (VBFB) via electropalatography (EPG) were compared to Sound Production Treatment (SPT), an established behavioral treatment that is also an articulatory–kinematic approach. Method A multiple baseline design across behaviors and participants was used with 2 participants with chronic apraxia of speech and aphasia. Accuracy of target speech sounds in treated and untreated words or phrases in probe sessions served as the dependent variable. The effects of 2 treatments based on an articulatory–kinematic approach were compared: (a) VBFB via EPG and (b) SPT. The order of treatments was counterbalanced across participants. Results Positive changes in articulatory accuracy were observed for SPT and VBFB treatment via EPG. Generalization to untreated stimulus items composed of treated speech sounds was also positive for both treatments. However, participants achieved greater articulatory accuracy with SPT during treatment and better long-term maintenance. Discussion Both treatment approaches resulted in improved speech production accuracy, but gains were greater for SPT. However, further research with additional participants is needed due to the small sample size included in this investigation.

The Use of Electropalatography in the Treatment of Acquired Apraxia of Speech

2016 ◽  
Vol 25 (4S) ◽  
Author(s):  
Shannon C. Mauszycki ◽  
Sandra Wright ◽  
Nicole Dingus ◽  
Julie L. Wambaugh
Keyword(s):  
Speech Sound ◽  
Multiple Baseline ◽  
Potential Treatment ◽  
Speech Sounds ◽  
Apraxia Of Speech ◽  
Baseline Design ◽  
Visual Biofeedback ◽  
Behavioral Treatments ◽  
Term Maintenance

Purpose This investigation was designed to examine the effects of an articulatory-kinematic treatment in conjunction with visual biofeedback (VBFB) via electropalatography (EPG) on the accuracy of articulation for acquired apraxia of speech (AOS). Method A multiple-baseline design across participants and behaviors was used with 4 individuals with chronic AOS and aphasia. Accuracy of target speech sounds in treated and untreated phrases in probe sessions served as the dependent variable. Participants received an articulatory-kinematic treatment in combination with VBFB, which was sequentially applied to 3 stimulus sets composed of 2-word phrases with a target speech sound for each set. Results Positive changes in articulatory accuracy were observed for participants for the majority of treated speech sounds. Also, there was generalization to untreated phrases for most trained speech sounds. Two participants had better long-term maintenance of treated speech sounds in both trained and untrained stimuli. Conclusions Findings indicate EPG may be a potential treatment tool for AOS. It appears that individuals with AOS can benefit from VBFB via EPG in improving articulatory accuracy. However, further research is needed to determine if VBFB is more advantageous than behavioral treatments that have been proven effective in improving speech production for speakers with AOS.

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.

scholarly journals Sound Production Treatment: Synthesis and Quantification of Outcomes

2015 ◽  
Vol 24 (4) ◽  
Author(s):  
Dallin J. Bailey ◽  
Kelly Eatchel ◽  
Julie Wambaugh
Keyword(s):  
Sound Production ◽  
Single Case ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Apraxia Of Speech ◽  
Treatment Performance ◽  
Response Generalization ◽  
End Of Treatment ◽  
Treatment Data

Purpose This investigation was designed to provide a quantification and synthesis of a series of single-case experimental design investigations into the effects of sound production treatment, an articulatory-kinematic treatment for acquired apraxia of speech (AOS). The main purpose was to perform a meta-analysis of aggregated sound production treatment data in order to provide benchmarks to serve as indicators of magnitude of change. Additional analyses explored various factors influencing effect sizes and level of performance. Method Effect sizes were calculated for treated and untreated items for 24 participants across 10 investigations. Benchmarks were calculated as the quartiles of the distributions of the effect sizes. Correlational analyses were performed to examine (a) end-of-treatment performance relative to follow-up performance, (b) response of trained items relative to untrained items, and (c) effect size relative to participant variables. Results Effect sizes were predominantly large and positive; benchmarks for treated items were larger than those for untreated items. End of treatment and follow-up performance were positively correlated, and response generalization was positively correlated with AOS severity. Conclusion These benchmarks may assist in evaluating the effects of interventions for individuals with AOS utilizing similar outcome measures in both clinical and research settings.

Within-Clinic versus Outside-of-Clinic Self-Monitoring of Articulation to Promote Generalization

1988 ◽  
Vol 53 (4) ◽  
pp. 392-399 ◽  
Author(s):  
Robert L. Koegel ◽  
Lynn Kern Koegel ◽  
Janis Costello Ingham ◽  
Karen Van Voy
Keyword(s):  
Sound Production ◽  
Additional Data ◽  
Study Data ◽  
Multiple Baseline ◽  
Multiple Baseline Design ◽  
Self Monitoring ◽  
Baseline Design ◽  
Target Sound ◽  
Clinic Setting ◽  
Correct Target

The purpose of this study was to assess the generalization of correct articulation to nontreatment environments when self-monitoring procedures were implemented within versus outside of the clinic setting. Seven children who substituted δ/and /ð/ for /s/ and /z/ participated in this study. Data were collected in the context of a multiple baseline design replicated across subjects. The children initially self-monitored their correct articulation during conversation in the clinic setting where treatment was implemented. Then, after varying intervals, self-monitoring outside of the clinic setting was introduced as well. The results showed that when the children monitored their speech within the clinic setting only, no generalization of correct target sound production outside of the clinic setting occurred. However, after the children were required to monitor their speech outside of the clinic setting, rapid and widespread generalization was measured. These results are discussed in relation to practical and theoretieal implications. Additional data collected on number of responses, the accuracy of the children's monitoring, and the percentage of correct responses are also discussed.

Effects of Phonological Decoding Training on Children's Word Recognition of CVC, CV, and VC Structures

1996 ◽  
Vol 5 (1) ◽  
pp. 67-78 ◽  
Author(s):  
Kenyatta O. Rivers ◽  
Linda J. Lombardino ◽  
Cynthia K. Thompson
Keyword(s):  
Word Recognition ◽  
Multiple Baseline ◽  
Single Subject ◽  
Group Training ◽  
Complex Structures ◽  
Multiple Baseline Design ◽  
Baseline Design ◽  
Phonological Decoding ◽  
The Third ◽  
Letter Sound

The effects of training in letter-sound correspondences and phonemic decoding (segmenting and blending skills) on three kindergartners' word recognition abilities were examined using a single-subject multiple-baseline design across behaviors and subjects. Whereas CVC pseudowords were trained, generalization to untrained CVC pseudowords, untrained CVC real words, untrained CV and VC pseudowords, and untrained CV and VC real words were assessed. Generalization occurred to all of the untrained constructions for two of the three subjects. The third subject did not show the same degree of generalization to VC pseudowords and real words; however, after three training sessions, this subject read all VC constructions with 100% accuracy. Findings are consistent with group training studies that have shown the benefits of decoding training on word recognition and spelling skills and with studies that have demonstrated the effects of generalization to less complex structures when more complex structures are trained.

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.

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