Treatments of Acquired Apraxia of Speech

描述（由申请人提供）： 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）报道，在6101例神经性运动性言语障碍中，AOS是7.6%的原发性交流障碍。作为次要诊断（例如，伴随失语症）AOS发生的频率更高。就AOS治疗调查的数量和质量而言，AOS治疗的证据基础都很薄弱。然而，存在足够的数据来支持这样的陈述，即即使当AOS是慢性的时，AOS的行为治疗也可以预期导致言语产生的改善（Wambaugh等人，2006年）。拟议的研究的目的是检查AOS治疗的影响与扬声器与慢性，中度-重度到轻度-中度AOS。随机练习和封闭练习的运动学习变量的影响将与声音产生治疗（SPT）的应用进行研究。计划的调查旨在阐明收购，维护和推广的SPT管理使用两种类型的做法的效果。将采用分组和单个受试者实验设计的组合。24例AOS受试者将被分配至两个治疗组之一（每组12例）。一组将接受SPT-阻断，随后接受SPT-随机。另一组将以相反的顺序接受治疗（SPT-随机，然后是SPT-阻断）。每名受试者将接受在单受试者、多基线设计的背景下进行的治疗。主要因变量将是语音的清晰度。将对每名受试者进行基线阶段，然后应用SPT-阻断或SPT-随机。第一阶段治疗后将有两周的无治疗期。在此期间，将对未经训练的行为进行延长基线，以确保在第二阶段治疗之前反应的稳定性。在两周结束时，将进行探测，以测量训练行为的短期维持。两周后，第二次治疗将应用于剩余的一组行为。所有行为的随访测试将在所有治疗停止后2、6和10周进行。将根据训练行为的获得率（即，目标语音的清晰度）和效果大小。还将评估小组内和个人内的表现。此外，不熟悉的听众（认证的语音/语言病理学家）将使用治疗前和治疗后的语音样本对语音自然度和可懂度进行评级。

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.