Treatments of Acquired Apraxia of Speech

获得性言语失用症的治疗

• 批准号: 8838134
• 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/8838134
• 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）： 项目摘要 获得性言语失用症 (AOS) 是一种神经性言语障碍，其特征是语速减慢、发声困难和韵律紊乱。关于其患病率的数据有限，但 Duffy (2005) 报告称，在 6101 例神经运动言语障碍病例中，7.6% 的 AOS 是主要的沟通障碍。作为辅助诊断（例如，伴随失语症），AOS 的发生频率甚至更高。 AOS 治疗证据基础在 AOS 治疗调查的数量和质量方面都很贫乏。然而，有足够的数据支持这样的说法：即使 AOS 是慢性的，AOS 的行为治疗也有望改善言语产生（Wambaugh 等，2006）。拟议研究的目的是检查对患有慢性、中重度至轻中度 AOS 的说话者进行 AOS 治疗的效果。将通过声音产生治疗（SPT）的应用来研究随机练习和块练习的运动学习变量的影响。计划中的调查旨在阐明使用两种类型的实践进行的 SPT 的习得、维持和泛化效果。将采用小组和单受试者实验设计的组合。 24 名患有 AOS 的参与者将被分配到两个治疗组之一（每组 12 人）。一组将接受 SPT-Blocked，然后接受 SPT-Random。另一组将以相反的顺序接受治疗（SPT-随机，然后是 SPT-阻止）。每个参与者都将接受在单受试者、跨行为的多基线设计的背景下进行的治疗。主要因变量是语音的发音。每个参与者都会进行基线阶段，然后应用 SPT-Blocked 或 SPT-Random。第一阶段治疗后将有两周的不治疗期。在此期间，将对未经训练的行为进行延长基线，以确保第二阶段治疗之前反应的稳定性。两周结束时，将进行探测以衡量受训行为的短期维持情况。两周后，第二次治疗将应用于其余的行为。所有行为的后续测试将在停止所有治疗后 2、6 和 10 周进行。将根据训练行为的获得率（即目标语音的发音）和效果大小来比较各组的表现。还将评估团体内和个人内的表现。此外，不熟悉的听众（经过认证的言语/语言病理学家）将使用治疗前和治疗后的语音样本对言语自然度和清晰度进行评级。