A Systematic Examination of Practice Amount in Childhood Apraxia of Speech (CAS) Treatment Using an Integral Stimulation Approach
Committee memberReilly, Jamie
Childhood Apraxia of Speech
Motor Speech Disorders
Principles of Motor Learning
Speech Sound Disorders
Permanent link to this recordhttp://hdl.handle.net/20.500.12613/3809
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AbstractThe purpose of this study was to examine how a critical principle of motor learning, practice amount (high number of trials versus a low number of trials), affects speech motor learning in childhood apraxia of speech (CAS). It also sought to contribute to the literature base regarding using an integral stimulation approach for these children. Currently, a limited evidence base exists for decision-making regarding practice amount in CAS treatment. Using a single-case experimental design with two participants, three target sets of utterances (High Amount, Low Amount, and Control) received different amounts of treatment. Outcomes were compared in terms of retention. Targets were scored regarding perceptual (prosodic and segmental) accuracy. Effect sizes were computed to quantify the extent of treatment effects. For both participants, results show some evidence suggesting a higher amount of practice is advantageous and leads to greater learning. A low amount of treatment did not show clear differences compared to not receiving any treatment. Caution should be taken when interpreting these findings due to its small sample size and modest effects. Results suggest that the integral stimulation approach may only be effective if provided with a significantly high amount of practice. Further research is needed to examine how the principles of motor learning and the integral stimulation approach should be sensibly and systematically applied to promote best outcomes for this population.
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Feedback Control in Treatment for Apraxia of SpeechMaas, Edwin; DeDe, Gayle; Kohen, Francine (Temple University. Libraries, 2020)Apraxia of speech (AOS) is a motor speech disorder associated with an impairment in motor planning and programming. It is therefore a logical step to derive treatment of the disorder from the principles of motor learning. Principles of motor learning refer to relatively predictable benefits of certain practice conditions over others (e.g., random practice enhances learning compared to blocked practice). A number of studies have begun to examine principles of motor learning in treatment for AOS (e.g., Austermann Hula et al., 2008; Katz et al., 2010). The current project aims to continue the investigation of motor learning principles and its application to motor speech disorders. In particular, the primary goal of this study is to examine the role of feedback control in treatment for AOS. Two types of feedback control are typically distinguished: self-controlled feedback and clinician-controlled feedback (Chiviacowsky & Wulf, 2004; Chiviacowsky & Wulf, 2007; Janelle, Barba, Frehlich, Tennant, & Cauraugh, 1997; Wulf, 2007). A secondary goal is then to examine the efficacy of script training for AOS. Youmans et al. (2011) provided promising initial evidence supporting its efficacy for AOS, yet no studies have replicated these findings (Ballard et al., 2015). The results of this study suggest that self-controlled feedback is more efficacious in treating adults with AOS than clinician-controlled feedback. Greater improvements of performance for self-controlled feedback were noted especially in accuracy of productions. There was the potential to impact rate of speech as well. Findings across conditions (treated versus untreated scripts) also indicate that script training is an efficacious method of treating adults with AOS.
TREATMENT OF CHILDHOOD APRAXIA OF SPEECH: A SINGLE-CASE EXPERIMENTAL DESIGN STUDY OF INTENSITY OF TREATMENTMaas, Edwin; Kohen, Francine; Reilly, Jamie (Temple University. Libraries, 2017)Childhood Apraxia of Speech (CAS) is a pediatric motor-speech disorder which has been controversial due to its difficulty to diagnose and little progress in treatment. The purpose of the present study was to examine a principle of motor learning (PML) within the context of an evidence-based treatment for this disorder, as a way to improve outcomes for children with CAS. In particular, this study examines the role of intensity, specifically, massed versus distributed practice, when treating CAS using a modified form of Dynamic Temporal Tactile Cueing (DTTC; Strand et al., 2006). Two participants with CAS between the ages of 5 and 11 received massed and distributed practice on individualized targets in an single-case alternating treatments design with multiple baselines. Accuracy of speech targets on probe tasks was judged by blinded listeners. Results were interpreted through inspection of graphs and calculation of effect sizes. The results of the study showed that massed practice had a marginal benefit over distributed practice. Implications from this study suggest the importance of continued research examining the role of PML in CAS treatment and the value of using a massed-treatment approach when treating CAS.
EFFICACY OF A COGNITIVE BEHAVIORAL THERAPY-BASED INTENSIVE SUMMER CAMP FOR AN ADOLESCENT WHO STUTTERS: SINGLE-SUBJECT DATAMartin, Nadine; Banson Sabourin, Kim; Krakow, Rena (Temple University. Libraries, 2016)Clinicians are increasingly incorporating cognitive behavioral therapy (CBT)-based approaches into fluency treatment for children and adolescents who stutter. However, minimal research examines the efficacy of such programs. The present study assesses the efficacy of a CBT-based, intensive, five-day summer camp that promotes self-acceptance and aims to improve the quality of life of adolescents who stutter. Specifically, this study examines whether the camp is effective in reducing state and trait anxiety, decreasing the negative impact of stuttering on daily life, and increasing fluency. A single-subject design on a 14-year old, male adolescent who stutters, LM, and personal interview data with LM’s mother, MM, are utilized. Post-treatment, LM’s scores reflect improvements in self-efficacy surrounding communication situations, as measured by the Self-Efficacy for Adolescents Scale (SEA-Scale), and improvements in overall speaking-related quality of life, as measured by the Overall Assessment of the Speaker’s Experience of Stuttering – Teen (OASES-T). These improvements were maintained at one and three months follow-up. Nonetheless, a large degree of variation in percent syllables stuttered (%SS) and LM’s consistently low rates of state and trait anxiety, as measured by the State-Trait Anxiety Inventory for Children (STAIC), suggest that additional study is warranted before conclusions can be drawn about the efficacy of the summer camp program on reducing stuttering severity and anxiety.