Effects of Treatment Intensity on Outcomes in Acquired Apraxia of Speech.

Purpose: 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. Method: 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. Results: 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. Conclusion: 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. Supplemental Materials: https://doi.org/10.23641/asha.5734053.

Fluency adaptation in speakers with Parkinson disease: a motor learning perspective.

PURPOSE: Fluency adaptation is characterised by a reduction in stuttering-like behaviours over successive readings of the same speech material and is an effect that is typically observed in developmental stuttering. Prominent theories suggest that short-term motor learning associated with practice explain, in part, fluency adaptation. The current investigation examined the fluency adaptation effect in a group of speakers with Parkinson disease (PD) who exhibited stuttering-like disfluencies. METHOD: Individuals with PD (n = 21) and neurologically healthy controls (n = 19) read a passage five times. Per cent syllables stuttered was measured and calculated for each reading passage. RESULT: Participants in the PD group exhibited significantly more stuttering-like disfluencies than control speakers. Twelve individuals in the PD group exhibited at least three per cent syllable stuttered on at least one reading. Statistical trends revealed that the subgroup of individuals with PD who stuttered exhibited a significant reduction in stuttering moments over the five successive readings. CONCLUSION: A significant fluency adaptation effect was observed for the group of speakers with PD who exhibited stuttering-like disfluencies. Results of the current study are discussed within the framework of the motor learning hypothesis of fluency adaptation.

Quantification and Systematic Characterization of Stuttering-Like Disfluencies in Acquired Apraxia of Speech.

PURPOSE: The purpose of this article is to quantify and describe stuttering-like disfluencies in speakers with acquired apraxia of speech (AOS), utilizing the Lidcombe Behavioural Data Language (LBDL). Additional purposes include measuring test-retest reliability and examining the effect of speech sample type on disfluency rates. METHOD: Two types of speech samples were elicited from 20 persons with AOS and aphasia: repetition of mono- and multisyllabic words from a protocol for assessing AOS (Duffy, 2013), and connected speech tasks (Nicholas & Brookshire, 1993). Sampling was repeated at 1 and 4 weeks following initial sampling. Stuttering-like disfluencies were coded using the LBDL, which is a taxonomy that focuses on motoric aspects of stuttering. RESULTS: Disfluency rates ranged from 0% to 13.1% for the connected speech task and from 0% to 17% for the word repetition task. There was no significant effect of speech sampling time on disfluency rate in the connected speech task, but there was a significant effect of time for the word repetition task. There was no significant effect of speech sample type. CONCLUSIONS: Speakers demonstrated both major types of stuttering-like disfluencies as categorized by the LBDL (fixed postures and repeated movements). Connected speech samples yielded more reliable tallies over repeated measurements. Suggestions are made for modifying the LBDL for use in AOS in order to further add to systematic descriptions of motoric disfluencies in this disorder.

Effects of Blocked and Random Practice Schedule on Outcomes of Sound Production Treatment for Acquired Apraxia of Speech: Results of a Group Investigation.

Purpose: 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; Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998) for speakers with chronic acquired apraxia of speech and aphasia. Method: 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. Results: All participants demonstrated improved articulation of treated items with both practice schedules. Effect sizes were calculated to estimate magnitude of change for treated and untreated items by treatment condition. No significant differences were found for SPT-R and SPT-B relative to effect size. Percent change over the highest baseline performance was also calculated to provide a clinically relevant indication of improvement. Change scores associated with SPT-R were significantly higher than those for SPT-B for treated items but not untreated items. Conclusion: SPT can result in improved articulation regardless of schedule of practice. However, SPT-R may result in greater gains for treated items. Supplemental Materials: https://doi.org/10.23641/asha.5116831.

Sound production treatment for acquired apraxia of speech: Effects of blocked and random practice on multisyllabic word production.

PURPOSE: This study was designed to examine the effects of practice schedule, blocked vs random, on outcomes of a behavioural treatment for acquired apraxia of speech (AOS), Sound Production Treatment (SPT). METHOD: SPT was administered to four speakers with chronic AOS and aphasia in the context of multiple baseline designs across behaviours and participants. Treatment was applied to multiple sound errors within three-to-five syllable words. All participants received both practice schedules: SPT-Random (SPT-R) and SPT-Blocked (SPT-B). RESULT: Improvements in accuracy of word production for trained items were found for both treatment conditions for all participants. One participant demonstrated better maintenance effects associated with SPT-R. Response generalisation to untreated words varied across participants, but was generally modest and unstable. Stimulus generalisation to production of words in sentence completion was positive for three of the participants. Stimulus generalisation to production of phrases was positive for two of the participants. CONCLUSION: Findings provide additional efficacy data regarding SPT's effects on articulation of treated items and extend knowledge of the treatment's effects when applied to multiple targets within multisyllabic words.

Semantic Feature Analysis: Further Examination of Outcomes.

PURPOSE: The purpose of this investigation was to systematically examine outcomes associated with Semantic feature analysis, which is an established treatment for word-retrieval deficits in aphasia. Attributes of the experimental design and stimuli were manipulated to evaluate generalized naming of semantically related and unrelated items. In addition, the study was designed to examine changes in production of semantic information. METHOD: Semantic feature analysis was applied in the context of multiple-baseline designs with 5 persons with chronic aphasia. Experimental items were controlled for semantic category membership, number of naming attempts, and provision of item names. Acquisition, generalization, and maintenance effects were measured in probes of naming performance. Production of semantic information was also measured in response to experimental items and in discourse tasks. RESULTS: Treatment was associated with systematic increases in naming of trained items for 4 of the 5 participants. Positive generalization to untrained exemplars of trained categories was found for repeatedly exposed items but not for limited-exposure items. Slight increases in production of semantic content were observed. CONCLUSION: Repeated attempts to name untreated items appeared to play a role in generalization. Provision of the names of untrained items may have enhanced generalized responding for 2 participants.