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Comparison of SPT and MPT for apraxia of speech (King et al., 2023)

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posted on 2023-09-01, 14:34 authored by Charlotte King, Julie Wambaugh, Edwin Maas

Purpose: The purpose of this investigation was to compare the effects of two specific treatment protocols for acquired apraxia of speech (AOS): Sound production Treatment (SPT) and Metrical Pacing Therapy (MPT), and to examine changes in communicative participation.

Method: Four speakers with chronic AOS and aphasia were each administered SPT and MPT in a replicated crossover design (ABACA/ACABA) with nonconcurrent multiple baselines across participants and behaviors. Treatment outcomes were compared with respect to whole word correctness (WWC) for treated and untreated multisyllabic word targets. Speech intelligibility was assessed using the Chapel Hill Multilingual Intelligibility Test, and communicative participation was measured using the Communicative Participation Item Bank at baseline, washout, and follow-up phases.

Results: Three of the four participants experienced statistically significant improvements in WWC with SPT, and three of the four participants with MPT. Based on a priori criteria, three participants demonstrated relatively greater benefit from SPT and one participant demonstrated relatively greater benefit from MPT. There were measurable improvements in intelligibility following SPT for three of the four participants. Only one participant in this investigation reported a significant change in communicative participation, and only following MPT.

Conclusions: This study demonstrated that individuals in the chronic stages of AOS can benefit from both SPT and MPT, corroborating prior research on articulatory kinematic and rate and/or rhythm control treatment approaches. It contributes a comparison of two protocols for AOS with respect to whole word targets, intelligibility, and individual self-report of communicative participation changes. More participants showed a relative advantage of SPT over MPT. One individual reported communicative participation improvement after MPT.

Supplemental Material S1. Speech features: Apraxia of Speech Rating Scale 3.0.

Supplemental Material S2. Selection criteria for investigation.

Supplemental Material S3. Target, response generalization, and stimulus generalization items for each participant.

Supplemental Material S4. Whole word correctness scoring system.

Supplemental Material S5. Sound Production Treatment protocol.

Supplemental Material S6. Video of pacing templates.

Supplemental Material S7. Considerations for interrater reliability: Training materials.

Supplemental Material S8. Metrical Pacing Therapy protocol.

Supplemental Material S9. Procedural fidelity for SPT (Sound Production Treatment) and Metrical Pacing Therapy (MPT).

King, C., et al. (2023). A Comparison of Sound Production Treatment and Metrical Pacing Therapy for Apraxia of Speech: A Single-Case Experimental Design. American Journal of Speech-Language Pathology, 32(5S), 2493–2511.

Publisher Note: This article is part of the Select Papers From the 51st Clinical Aphasiology Conference.


The principal investigator received a research grant from the University Office of Research and Sponsored Projects to assist in conducting this study.