Combined aphasia and apraxia of speech treatment (CAAST): Systematic replications in the development of a novel treatment

<p><i>Purpose</i>: The purpose of this investigation was to examine the effects of a modified version of a newly developed therapy for aphasia and acquired apraxia of speech (AOS), Combined Aphasia and Apraxia of Speech Treatment (CAAST).</p> <p><i>Method</i>: Four speakers with chronic AOS and aphasia received CAAST in the context of multiple baseline designs. Dependent variables included language measures (i.e. production of correct information units (CIUs)) and speech production measures (i.e. speech intelligibility and percent correct consonants (PCC) in sentence repetition).</p> <p><i>Result</i>: Three of the participants demonstrated improved CIU production with treated picture sets and two also demonstrated generalization to untreated sets. All participants achieved substantially increased CIU production in an untrained discourse context. Speech intelligibility increased for three of the participants and increases in PCC were observed for all of the participants at two weeks post-treatment. However, PCC improvements were maintained for only two of the speakers at six weeks post-treatment.</p> <p><i>Conclusion</i>: The revised CAAST protocol was associated with improved changes in speech and generalization across contexts in comparison to the previous iteration of CAAST. However, focus on sentence production in generalization practice may have been detrimental to CIU production for one participant.</p

Treatment intensity in acquired apraxia of speech (Wambaugh et al., 2018)

<div><b>Purpose:</b> This investigation was designed to examine the effects of treatment intensity (i.e., dose frequency) on the outcomes of Sound Production Treatment (SPT) for acquired apraxia of speech.</div><div><b>Method:</b> Five men with chronic apraxia of speech and aphasia received both intense SPT (3 hr per day/3 days per week) and nonintense/traditional SPT (SPT-T; 1 hr per day/3 days per week) in the context of single-case experimental designs. Each treatment was applied separately to a designated set of experimental words with 1 treatment applied at a time. Twenty-seven treatment sessions were conducted with each phase of treatment. Accuracy of articulation of target sounds within treated and untreated experimental words was measured during the course of the investigation.</div><div><b>Results:</b> All participants demonstrated improved articulation with both treatment intensities. Better maintenance of gains for treated items was found with SPT-T for 2 participants as measured at an 8-week posttreatment retention probe. Superior maintenance of increased accuracy of production of untreated items was also observed with SPT-T for all participants.</div><div><b>Conclusion:</b> A less intense (distributed) application of SPT facilitated better maintenance of improved articulatory accuracy for untreated items, and in some cases treated items, than intense SPT.</div><div><br></div><div><b>Supplemental Material S1.</b> Examples of participants’ discourse: pretreatment samples (Nicholas & Brookshire, 1993). </div><div><br></div><div><b>Supplemental Material S2.</b> Probe and treatment stimuli. </div><div><br></div><div><b>Supplemental Material S3.</b> Sound Production Treatment (SPT) treatment log (minimal pair). </div><div><br></div><div>Wambaugh, J. L., Wright, S., Boss, E., Mauszycki, S. C., DeLong, C., Hula, W., & Doyle, P. J. (2018). Effects of treatment intensity on outcomes in acquired apraxia of speech.<i> American Journal of Speech-Language Pathology, 27</i>(1S), 306–322. </div

Detailed information regarding participant grouping, probe and treatment stimuli, severity criteria, and accuracy of production of target sounds (Wambaugh et al., 2017)

<div>The purpose of this investigation was to compare the effects of schedule of practice (i.e., blocked vs. random) on outcomes of Sound Production Treatment (SPT) for speakers with chronic acquired apraxia of speech and aphasia. </div><div><br></div><div>A combination of group and single-case experimental designs was used. Twenty participants each received SPT administered with randomized stimuli presentation (SPT-R) and SPT applied with blocked stimuli presentation (SPT-B). Treatment effects were examined with respect to accuracy of articulation as measured in treated and untreated experimental words produced during probes.</div><div><br></div><div>For more information on the methodology and results, please see the original article. </div><div><br></div><div><b>Supplemental Material S1.</b> Participant identifiers used in previous studies.</div><div><b><br></b></div><div><b>Supplemental Material S2.</b> Participant matching by group.</div><div><br></div><div><b>Supplemental Material S3.</b> Probe and treatment stimuli for all participants.</div><div><br></div><div><b>Supplemental Material S4. </b>Criteria used to determine severity descriptors.</div><div><b><br></b></div><div><b>Supplemental Material S5. </b>Accuracy of production of target sounds in experiment words for</div><div>various participants.</div><div><br></div><div>Wambaugh, J. L., Nessler, C., Wright, S., Mauszycki, S. C., DeLong, C., Berggren, K., & Bailey, D. J. (2017). Effects of blocked and random practice schedule on outcomes of sound production treatment for acquired apraxia of speech: Results of a group investigation. <i>Journal of Speech, Language, and Hearing Research, 60</i>(6S), 1739–1751. </div