Effects of Childhood Apraxia of Speech Treatment on Functional Communication Outcomes

Abstract

The goal of this research was to determine if Integral Stimulation (IS), a treatment used for children with childhood apraxia of speech (CAS), resulted in improvements in functional communication outcomes. In previous research, success or progress in CAS treatment focuses on articulatory precision, but this research aimed to look at progress from a more functional standpoint within the context of the World Health Organization’s International Classification of Functioning Disability and Health (ICF). The WHO ICF breaks down functioning, and in this case communicative functioning, into components that interact in a nonlinear fashion. These components are “body functions and structures”, “activities”, and “participation”. By looking at measures across these domains, we are able to obtain a more holistic view of the impact of treatment. The research was completed via a retrospective analysis of data obtained from the families of two children with CAS. As part of a study on the effectiveness of IS treatment, the families completed two indirect measures of communicative function —namely the Focus on Outcomes of Communication Under Six (FOCUS-34) and the Intelligibility in Context Scale (ICS). The goal of these questionnaires is to assess communication in the child’s daily interactions with family members, teachers, and peers by using a Likert scale to quantify various aspects of their communication skills. The questionnaires were completed twice before treatment was implemented and one more time at the conclusion of treatment. The results of the study suggest that broad changes in functional communication outcomes were observed but were not reliably attributable to treatment. However, there is evidence that in a deeper analysis, IS treatment may result in measurable improvements within specific WHO ICF domains. The pattern of changes was not clearly predictable from changes in speech accuracy, indicating that functional improvements cannot be assumed from accuracy measures and instead must be measured separately. The results indicate that further research is needed in determining these domain-specific functional outcome measures for CAS treatment.