The Active Ingredients of Integral Stimulation Treatment: The Efficacy of Auditory, Visual, and Auditory-Visual Cues for Treatment of Childhood Apraxia of Speech

Abstract

The purpose of this study was to determine the relative efficacy of cueing modalities employed in Integral Stimulation (IS) treatment for childhood apraxia of speech (CAS). Previous literature has supported the use of IS for children with CAS, though there are no studies that evaluate the active ingredients of IS. This study aimed to examine the efficacy of single- and multi-modality cues in IS treatment. The experiment was administered as a single-case, alternating treatments design consisting of three conditions (auditory-only, visual-only, and simultaneous auditory and visual). Two participants with CAS received IS treatment in every condition during each session. Probes were administered prior to starting every other session (once per week), consisting of practiced and control targets that were balanced for complexity and functionality. Perceptual accuracy of productions was rated on a 3-point scale and standardized effect sizes were calculated for each condition. Each participant demonstrated different effects in regard to modality and treatment effects. The visual-only condition yielded the greatest effect for one participant, followed by the auditory-only cues. The other participant displayed no significant effects in any condition nor a treatment effect. The results of this study suggest that single-modality cues may be more beneficial for some children with CAS than the clinically used simultaneous auditory-visual multi-modality cue. The significant effect of the visual-only condition in one participant indicates that visual-only cues may bypass an impaired auditory feedback system and support speech motor learning, though more research is required.