Combined aphasia and apraxia of speech treatment (CAAST): Systematic replications in the development of a novel treatment

2017 ◽  
Vol 20 (2) ◽  
pp. 247-261 ◽  
Author(s):  
Julie L. Wambaugh ◽  
Sandra Wright ◽  
Shannon C. Mauszycki ◽  
Christina Nessler ◽  
Dallin Bailey
Keyword(s):  
Apraxia Of Speech ◽  
Novel Treatment ◽  
Speech Treatment

Gestural Facilitation in Treatment of Apraxia of Speech

2010 ◽  
Vol 20 (3) ◽  
pp. 94-98
Author(s):  
Anastasia M. Raymer ◽  
Beth McHose ◽  
Kimberly Graham
Keyword(s):  
Systematic Review ◽  
Review Literature ◽  
Cognitive System ◽  
Apraxia Of Speech ◽  
Recent Systematic Review ◽  
Training Paradigm ◽  
Limb Apraxia ◽  
Speech Treatment ◽  
Verbal Production

Purpose: Luria (1970) proposed the use of intersystemic reorganization to use an intact system to facilitate improvements in a damaged cognitive system. In this article, we review literature examining the effects of gesture as a modality to promote reorganization to improve verbal production in apraxia of speech and anomia. Methods: A gestural facilitation training paradigm is described and results of a recent systematic review of apraxia of speech treatment are reviewed. The interplay between apraxia of speech and anomia are considered in response to gestural facilitation training. Results & Conclusions: Gestural facilitation effects are strongest in individuals with moderate apraxia of speech. Several factors appear to mitigate the effects of gestural facilitation for verbal production, including severe apraxia of speech and semantic anomia. Severe limb apraxia, which often accompanies severe apraxia of speech, appears to be amenable to gestural treatment, providing improvements in gesture use for communication when verbal production gains are not evident.

scholarly journals Feasibility of A Novel Treatment of Abstract Verbs in Aphasia and Apraxia of Speech

2015 ◽  
Vol 6 ◽  
Author(s):  
Bailey Dallin ◽  
Berggren Kiera ◽  
Nessler Christina ◽  
Wambaugh Julie
Keyword(s):  
Apraxia Of Speech ◽  
Novel Treatment ◽  
Abstract Verbs

Combined Aphasia and Apraxia of Speech Treatment (CAAST): Effects of a Novel Therapy

2014 ◽  
Vol 57 (6) ◽  
pp. 2191-2207 ◽  
Author(s):  
Julie L. Wambaugh ◽  
Sandra Wright ◽  
Christina Nessler ◽  
Shannon C. Mauszycki
Keyword(s):  
Speech Production ◽  
Speech Intelligibility ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Novel Therapy ◽  
Verbal Language ◽  
Treatment Techniques ◽  
Dependent Variables ◽  
Picture Stimuli ◽  
Speech Treatment

Purpose This investigation was designed to examine the effects of a newly developed treatment for aphasia and acquired apraxia of speech (AOS). Combined Aphasia and Apraxia of Speech Treatment (CAAST) targets language and speech production simultaneously, with treatment techniques derived from Response Elaboration Training (Kearns, 1985) and Sound Production Treatment (Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998). The purpose of this study was to determine whether CAAST was associated with positive changes in verbal language and speech production with speakers with aphasia and AOS. Method Four participants with chronic aphasia and AOS received CAAST applied sequentially to sets of pictures in the context of multiple baseline designs. CAAST entailed elaboration of participant-initiated utterances, with sound production training applied as needed to the elaborated productions. The dependent variables were (a) production of correct information units (CIUs; Nicholas & Brookshire, 1993) in response to experimental picture stimuli, (b) percentage of consonants correct in sentence repetition, and (c) speech intelligibility. Results and Conclusions CAAST was associated with increased CIU production in trained and untrained picture sets for all participants. Gains in sound production accuracy and speech intelligibility varied across participants; a modification of CAAST to provide additional speech production treatment may be desirable.

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

Language Changes Following Combined Aphasia and Apraxia of Speech Treatment

2018 ◽  
Vol 27 (1S) ◽  
pp. 323-335 ◽  
Author(s):  
Lisa D. Bunker ◽  
Sandra Wright ◽  
Julie L. Wambaugh
Keyword(s):  
Clinical Application ◽  
Narrative Discourse ◽  
Apraxia Of Speech ◽  
Lexical Diversity ◽  
Nonfluent Aphasia ◽  
Positive Treatment ◽  
Response Profiles ◽  
Speech Treatment ◽  
Post Hoc ◽  
Language Output

Purpose Combined Aphasia and Apraxia of Speech Treatment (CAAST) is a newly developed treatment shown to increase production of accurate content in narrative discourse for persons with aphasia and apraxia of speech. The purpose of this post hoc study was to further describe lexical and morphosyntactic changes associated with changes in content production. Method Existing probe data from 8 persons with aphasia who had completed CAAST were used to complete analyses of morphosyntactic production, lexical diversity, and novelty of content. Language analyses were completed using discourse samples obtained at numerous pretreatment and posttreatment intervals. Results All participants demonstrated gains in morphosyntactic language output for treated items, which extended to untreated sets for 7 participants. All 8 increased in production of novel content. Lexical diversity increases were evident for most participants. Although there were some similarities in language changes, there was substantial variability across response profiles. Conclusion CAAST, previously associated with positive treatment effects for production of accurate content, also appears to facilitate acquisition and generalization of morphosyntactic complexity, lexical diversity, and novelty of content for individuals with nonfluent aphasia. Further investigation is needed to determine causality and appropriate clinical application. Supplemental Material https://doi.org/10.23641/asha.5912530

Perceptual Characteristics of Consonant Production in Apraxia of Speech and Aphasia

2019 ◽  
Vol 28 (4) ◽  
pp. 1411-1431 ◽  
Author(s):  
Lauren Bislick ◽  
William D. Hula
Keyword(s):  
Error Rate ◽  
Error Rates ◽  
Group Differences ◽  
Diagnostic Process ◽  
Apraxia Of Speech ◽  
Contextual Variables ◽  
Error Type ◽  
Type Distribution ◽  
Phonetic Features ◽  
Syllable Position

Purpose This retrospective analysis examined group differences in error rate across 4 contextual variables (clusters vs. singletons, syllable position, number of syllables, and articulatory phonetic features) in adults with apraxia of speech (AOS) and adults with aphasia only. Group differences in the distribution of error type across contextual variables were also examined. Method Ten individuals with acquired AOS and aphasia and 11 individuals with aphasia participated in this study. In the context of a 2-group experimental design, the influence of 4 contextual variables on error rate and error type distribution was examined via repetition of 29 multisyllabic words. Error rates were analyzed using Bayesian methods, whereas distribution of error type was examined via descriptive statistics. Results There were 4 findings of robust differences between the 2 groups. These differences were found for syllable position, number of syllables, manner of articulation, and voicing. Group differences were less robust for clusters versus singletons and place of articulation. Results of error type distribution show a high proportion of distortion and substitution errors in speakers with AOS and a high proportion of substitution and omission errors in speakers with aphasia. Conclusion Findings add to the continued effort to improve the understanding and assessment of AOS and aphasia. Several contextual variables more consistently influenced breakdown in participants with AOS compared to participants with aphasia and should be considered during the diagnostic process. Supplemental Material https://doi.org/10.23641/asha.9701690

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

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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