Efficacy of treatment intensity in German-speaking children with childhood apraxia of speech

2021 ◽  
pp. 026565902110351
Author(s):  
Sabine Leonhartsberger ◽  
Eva Huber ◽  
German Brandstötter ◽  
Ruth Stoeckel ◽  
Becky Baas ◽  
...  
Keyword(s):  
Evidence Base ◽  
Single Subject ◽  
Treatment Intensity ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Treatment Frequency ◽  
Treatment Conditions ◽  
German Speaking ◽  
Total Therapy ◽  
Learning Principles

Motor learning principles guide treatment of childhood apraxia of speech (CAS). Previous studies found children to benefit from higher-intensity conditions; however, they did not control for the total amount of therapy time. The aims of the article are to examine the effects of high versus low treatment frequency in intervention for CAS in German-speaking children. An alternating single-subject design with multiple baselines was applied to compare frequent, short sessions with fewer, longer sessions in terms of speech production accuracy in four children with CAS while keeping the total therapy time constant. We administered a version of integral stimulation treatment. Despite inter-individual differences, changes under both treatment conditions showed similar positive trajectories for all four children. Untreated control targets also improved across participants and conditions. Maintenance and generalization to untreated targets were observed two weeks and three months post treatment, independent of treatment intensity. Our results show no significant advantage of more intensive treatment when the total therapy time is held constant. This study contributes to the evidence base for the use of integral stimulation in treating children with CAS, and in particular those who speak languages other than English.

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

Speech Intervention Effects for Childhood Apraxia of Speech: Quality Appraisal of Systematic Reviews

2020 ◽  
Vol 5 (3) ◽  
pp. 646-653
Author(s):  
Alisha P. Springle ◽  
Amber Breeden ◽  
Anastasia M. Raymer
Keyword(s):  
Systematic Reviews ◽  
Controlled Trial ◽  
Evidence Base ◽  
Motor Programming ◽  
Measurement Tool ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Positive Effects ◽  
Treatment Research ◽  
Meta Analyses

Purpose A number of justification have examined the effects of speech interventions on outcomes in childhood apraxia of speech (CAS). The findings have been summarized in the form of systematic reviews (SRs) and meta-analyses, which are used to support evidence-based clinical practice decisions. Yet without acceptable rigor, SRs/meta-analyses may be biased in their recommendations. We appraised the quality of existing SRs for CAS treatment using a tool developed within epidemiology, the AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews). Method A search of five databases to identify published SRs that coalesced treatment research for CAS revealed six systematic reviews that met inclusion criteria. Two examiners coded each article with the AMSTAR-2 to rate the methodologic rigor of the SRs and extracted summary data. Results One rigorous systematic review included only one randomized controlled trial. A second moderately rigorous review examined multiple single participant research designs. The weight of high-quality evidence supported the positive effects of motor programming treatments for children with CAS. Conclusions Findings of six systematic reviews, two of which were conducted with relative rigor, suggest that motor programming treatments have the best evidence base for treatment decisions pertaining to CAS. Clinicians are referred to online resources to implement these treatments according to published protocols.

The Effect of Hand Gesture Cues Within the Treatment of /r/ for a College-Aged Adult With Persisting Childhood Apraxia of Speech

2017 ◽  
Vol 26 (4) ◽  
pp. 1236-1243 ◽  
Author(s):  
Heather Leavy Rusiewicz ◽  
Jessica Lynch Rivera
Keyword(s):  
Speech Sound ◽  
Single Subject ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Visual Modeling ◽  
Verbal Instructions ◽  
Spatiotemporal Parameters ◽  
Withdrawal Design ◽  
Preliminary Support

Purpose Despite the widespread use of hand movements as visual and kinesthetic cues to facilitate accurate speech produced by individuals with speech sound disorders (SSDs), no experimental investigation of gestural cues that mimic that spatiotemporal parameters of speech sounds (e.g., holding fingers and thumb together and “popping” them to cue /p/) currently exists. The purpose of this study was to examine the effectiveness of manual mimicry cues within a multisensory intervention of persisting childhood apraxia of speech (CAS). Method A single-subject ABAB withdrawal design was implemented to assess the accuracy of vowel + /r/ combinations produced by a 21-year-old woman with persisting CAS. The effect of manual mimicry gestures paired with multisensory therapy consisting of verbal instructions and visual modeling was assessed via clinician and naïve listener ratings of target sound accuracy. Results According to the perceptual ratings of the treating clinician and 28 naïve listeners, the participant demonstrated improved speech sound accuracy as a function of the manual mimicry/multisensory therapy. Conclusions These data offer preliminary support for the incorporation of gestural cues in therapy for CAS and other SSDs. The need for continued research on the interaction of speech and manual movements for individuals with SSDs is discussed.

scholarly journals Treatment intensity and childhood apraxia of speech

2015 ◽  
Vol 50 (4) ◽  
pp. 529-546 ◽  
Author(s):  
Aravind K. Namasivayam ◽  
Margit Pukonen ◽  
Debra Goshulak ◽  
Jennifer Hard ◽  
Frank Rudzicz ◽  
...  
Keyword(s):  
Treatment Intensity ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech

What Does It Mean to Be Social? Defining the Social Landscape for Children With Childhood Apraxia of Speech

2020 ◽  
Vol 5 (4) ◽  
pp. 843-852 ◽  
Author(s):  
Nancy Tarshis ◽  
Michelle Garcia Winner ◽  
Pamela Crooke
Keyword(s):  
Social Development ◽  
Social Goals ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Social Competencies ◽  
The Social ◽  
Social Landscape ◽  
Communication Challenges ◽  
Primary Focus ◽  
Speech Motor

Purpose What does it mean to be social? In addition, how is that different from behaving socially appropriately? The purpose of this clinical focus article is to tackle these two questions along with taking a deeper look into how communication challenges in childhood apraxia of speech impact social competencies for young children. Through the lens of early social development and social competency, this clinical focus article will explore how speech motor challenges can impact social development and what happens when young learners miss early opportunities to grow socially. While not the primary focus, the clinical focus article will touch upon lingering issues for individuals diagnosed with childhood apraxia of speech as they enter the school-aged years. Conclusion Finally, it will address some foundational aspects of intervention and offer ideas and suggestions for structuring therapy to address both speech and social goals.

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