Acquired apraxia of speech: the effects of repeated practice and rate/rhythm control treatments on sound production accuracy

Journal ArticlePurpose: This investigation was designed to elucidate the effects of repeated practice treatment on sound production accuracy in individuals with apraxia of speech (AOS) and aphasia. A secondary purpose was to determine if the addition of rate/rhythm control to treatment provided further benefits beyond those achieved with repeated practice. Method: A single-subject design was employed with 10 speakers with chronic AOS and aphasia. Articulation accuracy served as the dependent measure. Participants received repeated practice treatment until a plateau in performance was observed or high levels of accuracy were achieved. If performance criterion was not reached, rate/rhythm control was added to the treatment to determine if additional gains would be made

Modified response elaboration training: a systematic extension with replications

pre-printBackground: Response Elaboration Training (RET; Kearns, 1985) has been found to consistently result in increased production of content in discourse with persons with aphasia. Positive treatment effects have been reported for persons representing a variety of aphasia types and severities. RET was modified for application with persons with acquired apraxia of speech and aphasia and positive outcomes were also associated with the modified treatment (Wambaugh & Martinez, 2000). Although RET has received systematic study, its stimulus generalization effects are not well understood. Aims: This investigation was designed to measure the stimulus generalization effects of modified RET (M-RET) in a variety of conditions as well as to further study the effects of M-RET applied to a personal recount condition. Methods & Procedures: Multiple baseline designs (across behaviors and participants) were utilized to examine treatment effects. Treatment was applied sequentially to picture sets and a personal recount condition with six persons with chronic aphasia. Production of correct information units (CIUs) was measured in the following conditions: 1) discourse production in response to sets of trained and untrained pictures, 2) home conversations, and 3) production of discourse in structured tasks. Formal measures of functional communication were also completed prior to and following treatment. Outcomes & Results: Increases in production of CIUs in response to pictures were observed for 11 of the 12 applications of M-RET to picture sets. Response generalization to untrained picture sets was associated with M-RET applied to pictures sets; increases were slight and were greater for untrained sets that were probed more frequently. Maintenance of gains was generally strong for the participants with non fluent aphasia, but was minimal for the participant with fluent aphasia. Gains were not evident for M-RET applied to personal recounts; only one participant evidenced changes possibly associated with treatment in the personal recount condition. Improvements in structured discourse samples and a functional communication measure were observed for the majority of the participants following treatment. Lack of compliance in completion of recordings of home conversations limited the utility of that measure

Semantic feature analysis: Application to confrontation naming of actions in aphasia

pre-printBackground: Despite advances in the development and testing of therapies for verb retrieval impairments in aphasia, generalization effects of treatment remain a challenge. Semantic Feature Analysis (SFA) is a word retrieval treatment that has been reported to result in generalized responding to untrained object names with persons with aphasia (Boyle, 2010). The theorized therapeutic mechanisms of SFA appeared to be appropriate for facilitating retrieval of trained and untrained action names. Aims: This investigation was designed to extend pilot research in which SFA was applied to verb retrieval (Wambaugh & Ferguson, 2007). The primary purpose of the current study was to examine the acquisition and response generalization effects of SFA applied to action naming with four persons with chronic aphasia. Additional purposes were to examine changes in production of content in discourse and to explore the correspondence of accuracy of naming during treatment to probe performance. Methods & Procedures: SFA was modified slightly to be appropriate for application to action naming as opposed to object naming; several feature categories were changed, but all other procedures were retained. Treatment was applied sequentially to two sets of action names in the context of multiple baseline designs across behaviors and participants. Accuracy of naming of trained and untrained actions in probes was measured repeatedly throughout all phases of the design. Production of correct information units (CIUs) in discourse was measured prior to and following treatment. The relationship of probe naming performance to naming performance during treatment sessions was examined using correlational analyses. Outcomes & Results: Increased accuracy of naming of trained action names was associated with treatment for three of the four participants. The remaining participant did not demonstrate improvement in naming on probes despite some gains during treatment. Generalization to Running Head: SFA - Action Naming 3 untrained action names did not occur for any of the participants. Increases in CIU production were observed for only one of the participants. For the participants with positive naming outcomes, probe performance correlated well with naming performance during treatment. For the participant who demonstrated some improvements in treatment, but did not show gains in naming on probes, weak correlations were obtained. Conclusions: SFA appears to have potential for promoting improved action naming in aphasia. However, more research is warranted to explore treatment modifications to promote generalization. Correlational analyses indicated that gains in naming during treatment may not always be reflected in probe performance and thus, require verification through probing in non-treatment conditions

Apraxia of speech: perceptual analysis of trisyllabic word productions across repeated sampling occasions

Journal ArticleEarly apraxia of speech (AOS) research has characterized errors as being variable, resulting in a number of different error types being produced on repeated productions of the same stimuli. Conversely, recent research has uncovered greater consistency in errors, but there are limited data examining sound errors over time (more than one occasion). Furthermore, the influence of conditions of stimulus presentation (blocked vs. random) on sound errors remains uncertain. The purpose of this investigation was to examine the effects of repeated sampling and conditions of stimulus presentation on speech sound errors for 11 speakers with AOS/aphasia

Sound production treatment: application with severe apraxia of speech

Journal ArticleAcquired apraxia of speech (AOS) has been shown to be responsive to behavioural intervention. Although numerous treatments for AOS have been developed, most have received limited study. Specifically, the AOS treatment evidence base is compromised by a lack of replication of treatment effects. Sound Production Treatment (SPT; Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998) has undergone more systematic examination than other AOS treatments and has been documented to result in predictable improvements in consonant production. However, SPT has not been studied with persons with severe AOS and perseverative speech behaviours. Aims: The purpose of this investigation was to examine the acquisition, response generalisation, and maintenance effects of SPT with a speaker with severe AOS, significant nonfluent aphasia, and verbal perseverations

Variability in Apraxia of Speech: A Perceptual, Acoustic, and Kinematic Analysis of Stop Consonants

This investigation was designed to examine articulatory variability over time in an individual with AOS and aphasia. Stimuli were randomly presented on three sampling occasions and stop consonant productions were examined via perceptual, acoustic and kinematic analyses. Findings revealed that predictability of errors across sampling time varied by sound. The same error frequently occurred for a sound within a sampling time, but infrequently on the same word. Acoustic and kinematic measurements also indicated different patterns of variability for sounds

Semantic Feature Analysis: Further Examination of Outcomes

Semantic Feature Analysis (SFA) has received considerable study over the past two decades as a word-retrieval treatment for aphasia (Boyle & Coelho, 1995; Lowell, Beeson, & Holland, 1995; Boyle, 2010; Wambaugh, Mauszycki, Cameron, Wright, & Nessler, 2013). SFA has been shown to have consistently positive acquisition effects (i.e., improvement of trained items), with generally positive but less predictable generalization effects (i.e., improvement in untrained items). SFA was originally designed as a cognitive treatment for children and adolescents sustaining traumatic brain injury (TBI) (Haarbauer-Krupa, Moser, Smith, Sullivan & Szekeres, 1985). The therapy was designed as an “organizing process for thinking and verbal expression” (p.303). Massaro and Tompkins (1994) operationalized SFA in a study with two participants with TBI. In keeping with the intentions of the original developers, Massaro and Tompkins measured SFA’s treatment effects in terms of increased production of semantically relevant content. In the treatment of aphasia, the focus of SFA relative to outcomes has been naming accuracy. That is, SFA has been used as a means of systematically stimulating semantic networks to facilitate naming. Additionally, SFA has been considered to potentially serve as a mediating strategy for self-cuing accurate naming and/or a compensatory strategy for circumventing word-retrieval difficulties. The current study was designed to elucidate the effects of SFA in aphasia treatment beyond naming accuracy. Given SFA was designed to improve verbal expression in general and may serve as a compensatory strategy, increased production of relevant content was of interest (after Tompkins & Massaro, 1994). In light of inconsistent generalization effects associated with SFA, the study was designed to explore its generalization effects relative to aspects of untreated items. Specifically, untreated items were controlled in terms of semantic relatedness, exposure in probing, and knowledge of phonological form

Apraxia of Speech: Perceptual Analysis of Trisyllabic Words Across Repeated Sampling Occasions

Apraxia of Speech: Perceptual Analysis of Trisyllabic Words Across Repeated Sampling Occasion

Apraxia of Speech: Perceptual Analysis of Mono-, Bi-, and Trisyllabic Words Across Repeated Sampling Occasions

The primary characteristics considered to define acquired apraxia of speech (AOS) have continued to evolve, but a few characteristics remain controversial among researchers and clinicians (McNeil, Robin, & Schmidt, 2009). Particularly, the consistency or variability of speech sound errors in AOS (Croot, 2002). For years, variability of speech sound errors has been considered a primary characteristic of AOS (Deal & Darley, 1972; Johns & Darley, 1970; Wertz, LaPointe, & Rosenbek, 1984). Apraxic errors were considered to be variable with regard to the location of the error within a word (Johns & Darley; LaPointe & Johns, 1975) and the nature of the error (Johns & Darley; LaPointe & Horner, 1976) across repeated productions of the same stimuli. Conversely, more recent research with “pure” apraxic speakers and speakers with AOS and accompanying aphasia has suggested that speech sound errors may not be variable (Mauszycki, Dromey, & Wambaugh, 2007; Mauszycki, Wambaugh, & Cameron, 2010a, 2010b; Mlcoch, Darley, & Noll, 1982; McNeil, Odell, Miller, & Hunter, 1995; Shuster & Wambaugh, 2003; Wambaugh, Nessler, Bennett & Mauszycki, 2004). However, there are limited data examining sound errors over time (i.e., beyond a single session). Furthermore, the influence of conditions of stimuli presentation on sound errors remains uncertain. The purpose of this investigation was to further examine variability of speech production in individuals with AOS and aphasia. Of specific interest were the effects of repeated sampling and conditions of stimulus presentation (i.e., random and blocked by sound) on the variability of error types identified using narrow phonetic transcription

Perceptually Salient Sound Distortions and Apraxia of Speech: A Performance Continuum

We sought to characterize articulatory distortions in apraxia of speech and aphasia with phonemic paraphasia and to evaluate the diagnostic validity of error frequency of distortion and distorted substitution in differentiating between these disorders