Acquired apraxia of speech (AOS) in isolation following a stroke is a rare occurrence; it is often accompanied by aphasia and/or dysarthria. Distinguishing characteristics of AOS are sound substitutions and sound distortions, an increase in these distortions with an increased rate and/or increased complexity, articulatory inaccuracy related to place and manner, and a disproportionate number of words per minute relative to maximum sustained vowel duration [1,2]. Most AOS treatment protocols are characterized as articulatory-kinematic approaches based on the theoretical framework that AOS is a phonatory-motor disorder. This distinction is relevant given the diversity of outcome measures reported across treatment studies. Outcome measures reported in the literature vary from binary systems to multidimensional rating scales. Each system comes with its own advantage and disadvantage Purpose: The purpose of this study was to investigate potential benefits of using a qualitative and quantitative outcome measure of articulation accuracy and suprasegmental characteristics in isolation for speech motor learning in acquired apraxia of speech (AOS). Methods: Baseline, retention, and maintenance measures from an oral reading task of 2 speakers with chronic AOS and aphasia were rated using an 11-point multidimensional rating scale accounting for articulation and immediacy and a hybrid scale measuring number of correctly produced words, presence of distortions in correctly produced words, and immediacy of the production. Participants received motor learning guided treatment two days a week for eighteen sessions. Results: The multidimensional rating scale and the hybrid scale comparably represented speech motor changes related to articulation accuracy and immediacy of the production across the duration of the intervention. The hybrid scale provided a sensitive measure for individual differences in immediacy and presence of distortions not represented in the multidimensional rating scale. Conclusions: The results of this pilot study provide evidence to support the benefit of using a qualitative and quantitative outcome measure for speech motor changes in acquired AOS. The individual differences identified through the hybrid scale have clinical and research implications.
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