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OFFERING CHOICE: THE ROLE OF AUTONOMY IN TREATMENT FOR CHILDREN WITH CHILDHOOD APRAXIA OF SPEECH
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2024-05
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Communication Sciences
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http://dx.doi.org/10.34944/dspace/10270
Abstract
The purpose of this study was to evaluate the role of client-directed choice in treatment for a child with childhood apraxia of speech (CAS), as compared to a lack of client-directed choice. One way to exercise control over practice conditions is through incidental choices. In studies of non-speech motor learning, offering opportunities for incidental choice to the learner, thus increasing their autonomy, has been shown to enhance learning (Wulf & Lewthwaite, 2016). Increasing client engagement and buy-in could maximize their level of motivation in treatment, and lead to better learning outcomes. This study used a single-case, alternating treatments design consisting of two conditions (Child-choice and Clinician-choice). The treatment employed prosodic variation during speech practice; the speech practice involved the ASSIST protocol (Maas et al., 2022). Options for prosodic variation were presented using the name and vocal characteristics of three different emotional tones (happy, sad, and angry). Each treatment session alternated between two conditions. In the first condition, the participant chose the tone in which to practice each target. In the second condition, the clinician chose the tone. The primary outcome measure was accuracy, as judged by blinded listeners from recordings. Effect sizes were computed and compared between conditions to address the primary research question (Does client-directed choice enhance learning compared to clinician-directed choice?). Comparison between treated item sets and untreated item sets provided a replication of the overall ASSIST protocol. Preliminary results to date showed no clear effects for either autonomy or treated vs. untreated sets.
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