Apraxia of Speech: Comparison of EPG Treatment (Tx) and Sound Production Treatment (SPT) (EPG&SPT)

VA Office of Research and Development

Status: Completed

Conditions: Apraxia of Speech; Speech Disorders; Aphasia, Acquired

Treatments: Behavioral: SPT; Device: EPG Tx

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT02554513

C2068-P

Details and patient eligibility

About

The purpose of the proposed research is to examine the effects of two treatment approaches on speech production involving speakers with chronic apraxia of speech (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.

Full description

EPG has been used to treat apraxia of speech (AOS) as well as other speech production disorders (i.e., articulation disorders & cleft palate). SPT is one of the most systematically studied treatment approaches for AOS. Both treatment approaches are considered clinical treatment approaches/standards of care for AOS. The pseudopalate used in conjunction with EPG treatment is an acceptable device for treating speech production disorders including AOS. The pseudopalate is custom-fit for each patient and is similar to a dental retainer and is considered minimally invasive.

The purpose of this research is to systematically examine the effects of treatment on speech production using EPG treatment vs. an SPT approach. The planned investigation is intended to explicate the acquisition, maintenance, and generalization effects of each treatment approach. The specific experimental questions to be addressed are as follows:

1. Will treatment using an EPG approach or an SPT approach result in greater accuracy of articulation of trained speech sounds produced in words?
2. Will treatment using an EPG approach or an SPT approach result in greater accuracy of articulation of untrained exemplars of trained speech sounds produced in words (i.e., response generalization)?
3. Will treatment using an EPG approach or an SPT approach result in greater long term maintenance effects for trained speech sounds?
4. Do different treatment approaches result in distinct ratings of functional communication skills via the Aphasia Communication Outcome Measure (ACOM; Doyle et al., 2012) and an outcome measure of speech intelligibility using the Assessment of Intelligibility of Dysarthric Speech (AIDS; Yorkston & Beukelman, 1981)?

Enrollment: 6 patients

Sex: All

Ages: 21 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Veterans or non Veterans with apraxia of speech who reside in the Salt Lake City region (commutable),
• 6 months or more post stroke or other focal brain injury, no other neurological conditions
• native English speakers, hearing adequate for experimental task (e.g., pass puretone screening at 35dB at 500, 1K, 2K Hz or adequate aided hearing)
• non linguistic cognition within normal limits

Exclusion criteria

• less than 6 months post stroke
• insufficient hearing, insufficient non linguistic cognitive skills
• neurological conditions other than stroke
• unable to attend treatment in the Salt Lake City vicinity

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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6 participants in 2 patient groups

EPG Tx

Active Comparator group

Description:

An articulatory-kinematic treatment in conjunction with visual biofeedback specifically tongue to palate contact to improve speech production

Treatment:

Device: EPG Tx

Sound Production Treatment (SPT)

Active Comparator group

Description:

An articulatory-kinematic treatment that uses integral stimulation to improve speech production.

Treatment:

Behavioral: SPT