Apraxia of Speech: A comparison of EPG Treatment & Sound Production Treatment

Va Salt Lake City Healthcare System, Salt Lake City UT

Investigators

Abstract

? DESCRIPTION (provided by applicant): Acquired apraxia of speech (AOS) is a treatable neurogenic sensorimotor speech disorder that is characterized by a slow rate of speech, difficulties in speech sound production, and prosodic abnormalities. The severity of AOS can vary from minor speech sound distortions to an inability to produce any meaningful speech. In 2005, Duffy found AOS was the primary diagnosis for 7.6% of 6101 cases of neurologic motor speech disorders. However, more recent data revealed AOS was the primary diagnosis for 12.2% of individuals with communication disorders, but AOS tends to occur more frequently as a secondary communication disorder in conjunction with aphasia (Duffy, 2007). There are sufficient data to support the statement that behavioral treatments for AOS result in improvements in speech production even when AOS is chronic (Wambaugh et al., 2006; Ballard et al., in press). Although, there are a number of different interventions for AOS that have been associated with positive treatment effects, there are no studies that have directly compared treatment approaches. The purpose of the proposed research is to examine the effects of two treatment approaches on speech production involving speakers with chronic AOS and aphasia. The planned investigation is designed to examine the acquisition, maintenance and generalization effects of each treatment. One approach, electropalatography (EPG) uses visual biofeedback in conjunction with articulatory-kinematic treatment and the other approach, sound production treatment (SPT) is one of the most systematically studied articulatory-kinematic treatments for AOS. A combination of group and single-subject experimental designs will be utilized. Ten participants with chronic AOS and aphasia will be assigned to one of two treatment groups (5 per group). One group will receive EPG treatment followed by SPT and the other group will receive the treatments in the reverse order (SPT followed by EPG treatment). Each participant will receive treatment administered in the context of a single-subject, multiple baseline design across behaviors. A baseline phase will be conducted with each participant, followed by application of either EPG treatment or SPT. A two week period of no treatment will follow the first treatment. During this period, extended baselining of the untrained behaviors will occur to ensure stability of responding prior to the second treatment. After the two week period, the second treatment will be applied to the remaining set of behaviors. Follow-up testing of all behaviors will occur at 2, 6, and 10 weeks after the cessation of all treatment. The outcomes of interest will address changes in trained behaviors, untrained behaviors (i.e., generalization effects), maintenance of trained and untrained behaviors, speech intelligibility, and patient-rated communicative functioning.