Children with idiopathic apraxia experience difficulties planning the movements necessary for intelligible speech. There is increasing evidence that targeted early interventions, such as Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT), can be effective in treating these disorders. In this study, we investigate possible cortical thickness correlates of idiopathic apraxia of speech in childhood, and changes associated with participation in an 8-week block of PROMPT therapy. We found that children with idiopathic apraxia (n = 11), aged 3–6 years, had significantly thicker left supramarginal gyri than a group of typically-developing age-matched controls (n = 11), t(20) = 2.84, p ≤ 0.05. Over the course of therapy, the children with apraxia (n = 9) experienced significant thinning of the left posterior superior temporal gyrus (canonical Wernicke’s area), t(8) = 2.42, p ≤ 0.05. This is the first study to demonstrate experience-dependent structural plasticity in children receiving therapy for speech sound disorders.Electronic supplementary materialThe online version of this article (doi:10.1007/s10548-013-0308-8) contains supplementary material, which is available to authorized users.

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Overall, the results of the current study may allow for modification of service delivery and facilitate the development of an evidence-based care pathway for children with CAS.

Background Treatment outcome data for children with severe speech sound disorders with motor speech involvement (SSD‐MSI) are derived from Phase I clinical research studies. These studies have demonstrated positive improvements in speech production. Currently there is no research examining the optimal treatment dose frequency for this population. The results of this study, which is the first of its kind, will inform the delivery of effective services for this population. Aims To investigate optimal treatment dose frequency for the Motor Speech Treatment Protocol (MSTP) for children with SSD‐MSI. Methods & Procedures A total of 48 children (aged 43–47 months) with SSD‐MSI participated in the study. Participants received 45‐min MSTP intervention sessions either once per week (lower dose frequency) or twice per week (higher dose frequency) for a 10‐week period. Blinded outcome assessments were carried out at pre‐ and post‐intervention. Outcomes & Results Treatment‐related change was assessed at body structures, functions and activities participation level as per the World Health Organization's International Classification of Functioning framework: Children and Youth Version (ICF‐CY) framework WHO (2007). These measures are related to articulation, functional communication and speech intelligibility. One‐way analysis of variance (ANOVA) revealed that for all variables the baseline scores were not statistically different (p > 0.05) between the two dose‐frequency groups. Overall, there was a significant main effect of Time (pre–post) across all variables (p < 0.01). However, repeated‐measures ANOVA did not result in any statistical interactions (Time × Dose frequency) for any of the variables tested (p > 0.05). Only marginal clinical advantages (< 4% change in intelligibility) were noted with the 10 extra sessions. Conclusions & Implications Overall, the MSTP intervention approach in conjunction with home practice led to significant positive changes for all measures in children with SSD‐MSI. No statistical differences between high‐ and low‐dose‐frequency groups were observed for any of the variables. Clinical effects were examined using effect sizes, as well as changes in articulation, speech intelligibility and functional communication; these differed marginally between the two dose frequencies. This suggests limited benefits of 10 additional sessions per block. Thus, it is recommended that caregivers, speech–language therapists and policy‐makers perform a cost–benefit analysis before determining the dose frequency, when considering additional sessions per block.

This study evaluated changes in motor speech control and inter-gestural coordination for children with speech sound disorders (SSD) subsequent to Prompts for Restructuring Oral and Muscular Phonetic Targets (PROMPT) intervention. We measured the distribution patterns of voice onset time (VOT) for a voiceless stop (/p/) to examine the changes in inter-gestural coordination. Two standardized tests were used (Verbal Motor Production Assessment for Children (VMPAC), GFTA-2) to assess the changes in motor speech skills and articulation. Data showed positive changes in patterns of VOT with a lower pattern of variability. All children showed significantly higher scores for VMPAC, but only some children showed higher scores for GFTA-2. Results suggest that the proprioceptive feedback provided through PROMPT had a positive influence on speech motor control and inter-gestural coordination in voicing behavior. This set of VOT data for children with SSD adds to our understanding of the speech characteristics underlying speech motor control. Directions for future studies are discussed.