Effects of Treatment for Sound Errors in Apraxia of Speech and Aphasia

Abstract

This investigation was designed to examine the acquisition, generalization, and maintenance effects of a treatment for sound errors in speakers with co-occurring apraxia of speech and aphasia. Three speakers with chronic apraxia of speech and aphasia were studied in the context of a multiple baseline design across speakers and behaviors. Treatment combined the use of minimal contrast pairs with traditional sound production training techniques such as integral stimulation and articulatory placement cueing and was applied sequentially to sounds that were determined to be consistently in error before training. Results revealed increased correct sound productions for all speakers in trained and untrained words. Response generalization effects across sounds and stimulus generalization effects varied, but appeared to be limited for most speakers. Although positive maintenance effects were evidenced, some loss of treatment gains was noted following cessation of treatment.

Sound Production Treatment: Synthesis and Quantification of Outcomes

“…As a unified treatment, SPT has received systematic examination since 1998 (Wambaugh & Cort, 1998;Wambaugh, Kalinyak-Fliszar, et al, 1998;. Although certain techniques utilized in SPT had been included in AOS treatment reports prior to 1998 (LaPointe, 1984;Rosenbek, Lemme, Ahern, Harris, & Wertz, 1973;Wertz, LaPointe, & Rosenbek, 1984), SPT's specific treatment components had not yet been combined into a fully operationalized and replicable form.…”

“…Although certain techniques utilized in SPT had been included in AOS treatment reports prior to 1998 (LaPointe, 1984;Rosenbek, Lemme, Ahern, Harris, & Wertz, 1973;Wertz, LaPointe, & Rosenbek, 1984), SPT's specific treatment components had not yet been combined into a fully operationalized and replicable form. As such, it was not until the initial SPT report (Wambaugh, Kalinyak-Fliszar, et al, 1998) that a protocol specifying the techniques was sufficiently developed to allow replication in the literature.…”

“…SPT has been demonstrated to increase sound production accuracy in treated and untreated words, phrases, or sentences for speakers with AOS with a range of AOS severities from mild (Wambaugh et al, in press) to severe (Wambaugh, Kalinyak-Fliszar, et al, 1998;Wambaugh & Mauszycki, 2010). SPT research has recently been directed toward the examination of the effects of practice schedule and treatment intensity, with participants showing improved sound production as a result of both blocked and random practice schedules (Wambaugh et al, 2014) and in both intensive and traditional (nonintensive) treatment applications (Wambaugh et al, 2013).…”

“…. than for any other treatment for AOS" (Duffy, 2013, p. 450) is sound production treatment (SPT; Wambaugh, 2004;Wambaugh & Cort, 1998;Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998;Wambaugh, Martinez, McNeil, & Rogers, 1999;Wambaugh & Mauszycki, 2010;Wambaugh & Nessler, 2004; Nessler, Cameron, & Mauszycki, 2013;Wambaugh, Nessler, Wright, & Mauszycki, 2014, in press;. SPT uses modeling repetition, minimal pair contrastive practice, orthographic cuing, integral stimulation, articulatory placement cuing, and repeated practice in a response-contingent hierarchy.…”

A speech motor learning approach to treating apraxia of speech: Rationale and effects of intervention with an adult with acquired apraxia of speech

“…The emphasis is on minimal contrast practice of the sounds that the apraxic speaker produces incorrectly during pre-testing. The sounds are treated sequentially or simultaneously in word stimuli.(Wambaugh, Kalinyak-Fliszar, West, & Doyle 1998;Wambaugh, Martinez, McNeil, & Rogers, 1999). The rationale is that treatment "may act to improve access to or specification of the generalized motor program (GMP;Schmidt, 1975) and/or associated parameters of targeted sounds" (Wambaugh & Nessler, 2004, p409).…”