Speech Therapy Interventions for Acquired Apraxia of Speech: An Updated Systematic Review

Abstract

Purpose: This systematic review aims to summarize and evaluate the available literature on speech and language therapy interventions for acquired apraxia of speech since 2012. Method: A systematic search in six electronic databases was performed from 2013 to 2020. The following primary outcomes were summarized: (a) improvement in targeted behaviors, (b) generalization, and (c) maintenance of outcomes. Moreover, studies were evaluated for the level of evidence and the clinical phase. Results: Of the 3,070 records identified, 27 studies were included in this review. The majority of the studies ( n = 22) used articulatory kinematic approaches followed by intersystemic facilitation/reorganization treatments ( n = 4) and other approaches ( n = 1). According to the classes defined in Clinical Practice Guideline Process Manual (Gronseth et al., 2017), one was Class II, 10 were Class III, 10 were Class III-b (fulfill Class III criteria except for independence of assessors' criterion), and five were Class IV. In terms of clinical phase, one study classified as Phase III, 10 as Phase II, and 15 as Phase I. Conclusions: Among the interventions for apraxia of speech, articulatory kinematic treatments have become prominent over the last 8 years. Focusing on self-administrated therapies, use of technology for therapy administration and development of treatments that focus on apraxia of speech and aphasia simultaneously were identified as new advancements in the apraxia of speech literature. The methodological quality, clinical phase, and level of evidence of the studies have improved within the past 8 years. Large-scale randomized controlled trials for articulatory kinematic approaches and future studies on other treatment approaches are warranted. Supplemental Material: https://doi.org/10.23641/asha.22223785

Behavioral Treatment for Speech and Language in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech: A Systematic Review

“…Despite a robust literature base documenting the benefits of speech-language interventions for aphasia (Brady et al, 2016;Breitenstein et al, 2017;Shrubsole et al, 2016) and apraxia of speech (Ballard et al, 2015;Munasinghe et al, 2023;Wambaugh et al, 2006) caused by stroke, treatment for speech or language disorders in PPA and PPAOS is less widely implemented and evaluated. There are low referral rates (Taylor et al, 2009;Volkmer et al, 2020b) and continued clinical skepticism among referring and treating clinicians regarding the potential benefit of intervention for progressive disorders, especially regarding communicative impact beyond the clinic (i.e., social validity; Cupit et al, 2010).…”