Apraxia of Speech: A Comparison of EPG Treatment & Sound Production Treatment
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Apraxia of Speech
- Sponsor
- VA Office of Research and Development
- Enrollment
- 6
- Locations
- 1
- Primary Endpoint
- Speech Production: Percent Change in Treated Items Immediately Post Treatment
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The purpose of the proposed research is to examine the effects of two treatment approaches on speech production involving speakers with chronic apraxia of speech (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.
Detailed Description
EPG has been used to treat apraxia of speech (AOS) as well as other speech production disorders (i.e., articulation disorders \& cleft palate). SPT is one of the most systematically studied treatment approaches for AOS. Both treatment approaches are considered clinical treatment approaches/standards of care for AOS. The pseudopalate used in conjunction with EPG treatment is an acceptable device for treating speech production disorders including AOS. The pseudopalate is custom-fit for each patient and is similar to a dental retainer and is considered minimally invasive. The purpose of this research is to systematically examine the effects of treatment on speech production using EPG treatment vs. an SPT approach. The planned investigation is intended to explicate the acquisition, maintenance, and generalization effects of each treatment approach. The specific experimental questions to be addressed are as follows: 1. Will treatment using an EPG approach or an SPT approach result in greater accuracy of articulation of trained speech sounds produced in words? 2. Will treatment using an EPG approach or an SPT approach result in greater accuracy of articulation of untrained exemplars of trained speech sounds produced in words (i.e., response generalization)? 3. Will treatment using an EPG approach or an SPT approach result in greater long term maintenance effects for trained speech sounds? 4. Do different treatment approaches result in distinct ratings of functional communication skills via the Aphasia Communication Outcome Measure (ACOM; Doyle et al., 2012) and an outcome measure of speech intelligibility using the Assessment of Intelligibility of Dysarthric Speech (AIDS; Yorkston \& Beukelman, 1981)?
Investigators
Eligibility Criteria
Inclusion Criteria
- •Veterans or non Veterans with apraxia of speech who reside in the Salt Lake City region (commutable),
- •6 months or more post stroke or other focal brain injury, no other neurological conditions
- •native English speakers, hearing adequate for experimental task (e.g., pass puretone screening at 35dB at 500, 1K, 2K Hz or adequate aided hearing)
- •non linguistic cognition within normal limits
Exclusion Criteria
- •less than 6 months post stroke
- •insufficient hearing, insufficient non linguistic cognitive skills
- •neurological conditions other than stroke
- •unable to attend treatment in the Salt Lake City vicinity
Outcomes
Primary Outcomes
Speech Production: Percent Change in Treated Items Immediately Post Treatment
Time Frame: Baseline vs. Immediately Post Treatment (7 week treatment period)
Change in accuracy of articulation of treated items measured by percent increase in accuracy above the highest baseline measurement; production of words designated for treatment was measured repeatedly in non-treatment probes prior to treatment, throughout all study phases and immediately post treatment with percent accuracy calculated for each probe (0% to 100% correct). The highest percentage accuracy achieved in baseline probes was subtracted from the percentage accuracy achieved at the conclusion of treatment to obtain change in accuracy value - this reflects change from maximum correct performance in baseline (baseline). e.g., if in baseline probes, performance ranged from 10% to 30% accuracy and at post treatment performance was 90% accuracy, the change value would be 60% (90% minus 30%). A greater value indicates greater change in articulation/production of words. Change could be positive (improved articulation) or negative (poorer articulation)
Secondary Outcomes
- Functional Communication Skills: T-Score(Baseline vs. 10 weeks after the completion of all treatment [measured at pre-treatment and post-treatment; conclusion of all treatment])
- Speech Intelligibility: Percentage(Baseline vs. 10 weeks post all treatment [measured at pre-treatment and post-treatment; conclusion of all treatment])
- Speech Production: Percent Change in Untreated Items (Related Items) Immediately Post Treatment(Baseline vs. Immediately Post Treatment (7 week treatment period))
- Speech Production: Percent Change for Treated Items After the Completion of Treatment(Baseline vs. 7 weeks post treatment [measured immediately after the completion of each treatment])