Treatments of Acquired Apraxia of Speech

获得性言语失用症的治疗

• 批准号: 8262127
• 负责人: Julie L. Wambaugh
• 金额: --
• 依托单位: VA SALT LAKE CITY HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8262127
• 关键词: Academy; Acute; Address; African American; Aftercare; Aphasia; Area; Attention; Behavior; Behavior Therapy; Biofeedback; Brain region; Calendar; Chronic; Communication; Communication impairment; Data; Data Analyses; Development; Diagnosis; Dropout; Effectiveness; Ensure; Etiology; Evidence based treatment; Experimental Designs; Feedback; Frequencies; Gestures; Graph; Guidelines; Individual; Instruction; Investigation; Joints; Laboratories; Language; Limb structure; Literature; Maintenance; Measures; Minor; Modeling; Motor; Neurologic; Participant; Pathologist; Patients; Performance; Phase; Population; Prevalence; Production; Protocols documentation; Reporting; Research; Research Personnel; Response Generalization; Robin bird; Sampling; Science; Severities; Specific qualifier value; Speech; Speech Disorders; Speech Intelligibility; Speech Sound; Speech Therapy; Stimulus; Stroke; System; Techniques; Testing; TimeLine; Training; Treatment outcome; Veterans; Visit; Visual; abstracting; base; clinical application; design; evidence base; follow-up; health administration; improved; indexing; kinematics; mortality; motor learning; programs; sex; sound; treatment duration; treatment effect

DESCRIPTION (provided by applicant): Project Abstract Acquired apraxia of speech (AOS) is a neurologic speech disorder that is characterized by slowed rate of speech, difficulties in sound production, and disrupted prosody. There are limited data concerning its prevalence, but Duffy (2005) reported that AOS was the primary communication disorder in 7.6% of 6101cases of neurologic motor speech disorders. As a secondary diagnosis (e.g., accompanying aphasia) AOS occurs even more frequently. The AOS treatment evidence base is meager in terms of both quantity and quality of AOS treatment investigations. However, sufficient data exist to support the statement that behavioral treatments for AOS may be expected to result in improvements in speech production even when AOS is chronic (Wambaugh et al., 2006). The purpose of the proposed research is to examine the effects of a treatment for AOS with speakers with chronic, moderate-severe to mild-moderate AOS. The impact of the motor learning variables of random practice and blocked practice will be investigated with application of Sound Production Treatment (SPT). The planned investigation is designed to explicate the acquisition, maintenance and generalization effects of SPT administered using the two types of practice. A combination of group and single-subject experimental designs will be utilized. Twenty-four participants with AOS will be assigned to one of two treatment groups (12 per group). One group will receive SPT-Blocked followed by SPT- Random. The other group will receive the treatments in the reverse order (SPT-Random followed by SPT-Blocked). Each participant will receive treatment administered in the context of a single-subject, multiple baseline design across behaviors. The primary dependent variable will be articulation of speech sounds. A baseline phase will be conducted with each participant, followed by application of either SPT-Blocked or SPT-Random. A two week period of no treatment will follow the first phase of treatment. During this period, extended baselining of the untrained behaviors will occur to ensure stability of responding prior to the second phase of treatment. At the end of the two week period, probing will occur to measure short term maintenance of trained behaviors. After the two week period, the second treatment will be applied to the remaining set of behaviors. Follow-up testing of all behaviors will occur at 2, 6, and 10 weeks after the cessation of all treatment. Performance across groups will be compared in terms of rate of acquisition of trained behaviors (i.e., articulation of targeted speech sounds) and effect sizes. Performance within groups and within individuals will also be evaluated. In addition, unfamiliar listeners (certified speech/language pathologists) will perform ratings of speech naturalness and intelligibility using pre- and post-treatment speech samples.

描述（由申请人提供）： 项目抽象获得的语音失用（AOS）是一种神经系统言语障碍，其特征是语音速度放缓，声音产生困难和韵律破坏。关于其患病率的数据有限，但Duffy（2005）报道说，AOS是神经系统运动语音疾病的6101酶中7.6％的主要通信障碍。作为次要诊断（例如，伴随的失语症），AOS的发生频率更高。 AOS治疗证据基础在AOS治疗研究的数量和质量方面都很微不足道。但是，存在足够的数据来支持这样的陈述，即即使AOS是慢性的，AOS的行为治疗也可能会改善语音产生（Wambaugh等，2006）。拟议的研究的目的是检查具有慢性，中度重度至中度AOS的扬声器对AO的治疗的影响。随机实践的运动学习变量和障碍练习的影响将通过使用声音生产处理（SPT）进行研究。计划的调查旨在阐明使用两种类型的实践给管理的SPT的获取，维护和泛化效应。将利用组和单个受试者实验设计的组合。具有AOS的24名参与者将分配给两个治疗组之一（每组12个）。一组将接收SPT阻滞，然后接收SPT-RANCTAR。另一组将以相反的顺序接收治疗（SPT随机，然后进行SPT阻滞）。每个参与者将在跨行为的单个主体，多个基线设计的背景下接受治疗。主要的因变量将是语音的表达。每个参与者将进行基线相，然后应用SPT阻止或SPT随机。第一个治疗的第一阶段将进行两个星期的未治疗。在此期间，将发生未经训练的行为的扩展基础，以确保在第二阶段的治疗前做出反应的稳定性。在两周期结束时，将进行探测以衡量训练有素的行为的短期维持。两周后，第二次治疗将应用于其余的行为集。所有治疗停止后的2、6和10周，所有行为的随访测试将进行。将根据训练有素的行为的获取率（即有针对性的语音表达的表达）和效果大小的绩效进行比较。组内和个人内部的表现也将得到评估。此外，陌生的听众（经过认证的语音/语言病理学家）将使用前和后处理后的语音样本对语音自然和清晰度进行评级。