Treating Childhood Apraxia of Speech: Role of Biofeedback & Practice Distribution

治疗儿童言语失用症：生物反馈的作用

• 批准号: 9377668
• 负责人: Jonathan Preston
• 金额: $ 44.61万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9377668
• 关键词: Academic Research Enhancement Awards; Adult; Articulation; Behavioral Research; Biofeedback; Case Study; Child; Client; Clinical; Development; Developmental apraxia; Disease; Environment; Ethics; Experimental Designs; Feedback; Fostering; Goals; Hour; Impairment; Individual; Intervention; Knowledge; Lead; Learning; Modeling; Modification; Monitor; Motor; Movement; Neurophysiology - biologic function; Outcome; Pattern; Performance; Process; Production; Protocols documentation; Randomized; Research; Research Design; Role; Sampling; Schedule; School-Age Population; Speech; Speech Disorders; Speech Sound; Speech Therapy; System; Testing; Therapeutic; Time; Tongue; Training; Treatment Protocols; Treatment outcome; Ultrasonography; Visual; base; blind; clinical decision-making; design; graduate student; improved; learning outcome; limb movement; motor learning; programs; scientific literacy; sequence learning; skill acquisition; skills; social; standard care; theories; traditional therapy; undergraduate student; visual feedback

Childhood apraxia of speech is a developmental speech sound disorder that may lead to persisting speech errors, often despite years of treatment. Such impairments may lead to social, academic, and vocational limitations. Thus, there is a need to explore alternate treatment approaches. This study will explore how to improve speech sound production in school-age children with CAS by modifying a standard speech therapy program. Two adaptations to speech therapy will be tested in a 2 x 2 randomized group design. In Aim 1, we will compare a standard treatment schedule of 2 one-hour sessions per week vs. a treatment sequence beginning with an intensive therapy schedule (10 hrs of treatment in one week), which will then transition to a more distributed practice schedule. This treatment modification is intended to minimize erred practice between training sessions in the early stages of learning, then foster generalization through increased time between practice sessions. In Aim 2, we will compare a standard treatment that includes only verbal feedback to the client during speech practice vs. a treatment sequence that initially includes real-time ultrasound visual feedback of the tongue during speech, which will be faded over the course of treatment. Ultrasound visual feedback is designed to train articulatory movements. It may enhance children’s understanding of the articulatory goals of speech movement patterns by comparing executed tongue movements with intended movements. Prior case reports and single subject experimental designs have shown that speech sound production may be enhanced by including ultrasound visual feedback, although no prior randomized group studies have been conducted. Beside these modifications, the other aspects of treatment will be held constant. Outcomes will be evaluated by tracking changes in percent consonants correct from a large speech sample, scored by individuals who are blind to treatment status. The four groups will be compared to determine the extent to which speech sound therapy can be enhanced through a treatment sequence that begins with intensive practice and/or with ultrasound visual feedback. Finally, as part of the R15 mechanism, undergraduate and graduate students will be involved in clinically oriented research. They will develop scientific literacy by being exposed to critical aspects of the scientific process including research design, operationalization of behavioral research protocols, blinding, reliability, fidelity monitoring, and ethical considerations in research.

儿童言语失用症是一种发育性言语声音障碍，可能导致 尽管经过多年的治疗，但持续的言语错误可能会导致社交、 因此，有必要探索替代治疗方法。 本研究将探讨如何通过以下方法改善患有 CAS 的学龄儿童的语音产生： 修改标准言语治疗程序将在 2 x 中进行测试。 2.随机分组设计。 在目标 1 中，我们将比较每周 2 次一小时疗程的标准治疗方案与每周 2 次一小时疗程的标准治疗方案。 治疗顺序从强化治疗计划开始（一周治疗 10 小时）， 然后将过渡到更加分散的练习计划。 在学习的早期阶段尽量减少培训课程之间的错误练习，然后培养 通过增加练习之间的时间来进行概括。 在目标 2 中，我们将比较仅包括向客户提供口头反馈的标准治疗方法 言语练习期间与最初包括实时超声视觉的治疗序列 言语时舌头的反馈会在超声治疗过程中逐渐消失。 视觉反馈旨在训练发音动作，它可以增强孩子对事物的理解。 通过比较执行的舌头运动与言语运动模式的发音目标 先前的病例报告和单受试者实验设计表明， 语音的产生可以通过包括超声视觉反馈来增强，尽管之前没有 已经进行了随机分组研究。 除了这些修改之外，治疗的其他方面将保持不变。 通过跟踪大型语音样本中辅音正确百分比的变化进行评估，评分为 对治疗状况不知情的个体将比较这四组以确定治疗的程度。 可以通过从强化开始的治疗顺序来增强言语声音治疗 练习和/或超声视觉反馈。 最后，作为R15机制的一部分，本科生和研究生将参与 他们将通过接触临床的关键方面来培养科学素养。 科学过程，包括研究设计、行为研究方案的实施、盲法、 研究中的可靠性、保真度监控和伦理考虑。

项目成果

A Randomized Controlled Trial of Treatment Distribution and Biofeedback Effects on Speech Production in School-Age Children With Apraxia of Speech.

• DOI: 10.1044/2023_jslhr-22-00622
• 发表时间: 2023-08
• 期刊: Journal of speech, language, and hearing research : JSLHR
• 作者: J. Preston;Nicole F Caballero;Megan C. Leece;Dongliang Wang;Benedette M Herbst;Nina R. Benway

A Pilot Randomized Control Trial of Motor-Based Treatments for Childhood Apraxia of Speech: Rapid Syllable Transition Treatment and Ultrasound Biofeedback.

• DOI: 10.1044/2022_ajslp-22-00144
• 发表时间: 2023-03-09
• 期刊: American journal of speech-language pathology
• 影响因子: 2.6