Apraxia of Speech: A comparison of EPG Treatment & Sound Production Treatment

 描述(由申请人提供)： 获得性言语失用(AOS)是一种可治疗的神经源性感觉运动性言语障碍，以语速减慢、发音困难和韵律异常为特征。AOS的严重程度可以从轻微的语音失真到无法产生任何有意义的语音。2005年，达菲发现，在6101例神经运动性语言障碍患者中，7.6%的患者主要诊断为AOS。然而，最近的数据显示，AOS是12.2%的沟通障碍患者的主要诊断，但AOS倾向于更频繁地发生为继发性沟通障碍与失语症(Duffy，2007)。有足够的数据支持这样的说法，即即使在AOS是慢性的情况下，AOS的行为治疗也会导致言语产生的改善(Wambaugh等人，2006年；Ballard等人，在印刷中)。虽然，有许多不同的干预措施与积极的治疗效果有关，但还没有研究直接比较治疗方法。这项研究的目的是考察两种治疗方法对慢性AOS和失语症患者言语产生的影响。计划中的调查旨在检查每种治疗方法的获取、维护和推广效果。一种方法是使用视觉生物反馈结合关节运动疗法，另一种方法是声音产生疗法(SPT)，它是对AOS进行系统研究的关节运动疗法之一。将采用分组和单一受试者相结合的实验设计。10名患有慢性自闭症和失语症的参与者将被分配到两个治疗组中的一个(每组5人)。一组将接受EPG治疗，然后是SPT，另一组将以相反的顺序接受治疗(SPT和EPG治疗)。每个参与者都将接受在单一受试者、多个行为基线设计的背景下进行的治疗。将对每个参与者进行基线阶段，然后应用EPG治疗或SPT。在第一次治疗之后，将有两周的时间不治疗。在此期间，将延长未训练行为的基线，以确保在第二次治疗之前反应的稳定性。两周后，第二次治疗将应用于剩余的一组行为。所有行为的跟踪测试将在所有治疗停止后2、6和10周进行。感兴趣的结果将涉及经训练的行为、未经训练的行为(即泛化效应)、经训练和未经训练的行为的维持、语音可理解性以及患者评定的交流功能的变化。

 DESCRIPTION (provided by applicant): Acquired apraxia of speech (AOS) is a treatable neurogenic sensorimotor speech disorder that is characterized by a slow rate of speech, difficulties in speech sound production, and prosodic abnormalities. The severity of AOS can vary from minor speech sound distortions to an inability to produce any meaningful speech. In 2005, Duffy found AOS was the primary diagnosis for 7.6% of 6101 cases of neurologic motor speech disorders. However, more recent data revealed AOS was the primary diagnosis for 12.2% of individuals with communication disorders, but AOS tends to occur more frequently as a secondary communication disorder in conjunction with aphasia (Duffy, 2007). There are sufficient data to support the statement that behavioral treatments for AOS result in improvements in speech production even when AOS is chronic (Wambaugh et al., 2006; Ballard et al., in press). Although, there are a number of different interventions for AOS that have been associated with positive treatment effects, there are no studies that have directly compared treatment approaches. The purpose of the proposed research is to examine the effects of two treatment approaches on speech production involving speakers with chronic AOS and aphasia. The planned investigation is designed to examine the acquisition, maintenance and generalization effects of each treatment. One approach, electropalatography (EPG) uses visual biofeedback in conjunction with articulatory-kinematic treatment and the other approach, sound production treatment (SPT) is one of the most systematically studied articulatory-kinematic treatments for AOS. A combination of group and single-subject experimental designs will be utilized. Ten participants with chronic AOS and aphasia will be assigned to one of two treatment groups (5 per group). One group will receive EPG treatment followed by SPT and the other group will receive the treatments in the reverse order (SPT followed by EPG treatment). Each participant will receive treatment administered in the context of a single-subject, multiple baseline design across behaviors. A baseline phase will be conducted with each participant, followed by application of either EPG treatment or SPT. A two week period of no treatment will follow the first treatment. During this period, extended baselining of the untrained behaviors will occur to ensure stability of responding prior to the second treatment. 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. The outcomes of interest will address changes in trained behaviors, untrained behaviors (i.e., generalization effects), maintenance of trained and untrained behaviors, speech intelligibility, and patient-rated communicative functioning.