Treatment for Acquired Apraxia of Speech - UMass Amherst

16 Pages·2009·0.12 MB·English

by  Grace Cotton

Treatment for Acquired
Apraxia of Speech
Kristine Stanton
Grace Cotton
What is Apraxia of Speech
(AOS)?
“a disturbed ability to produce
purposeful, learned movements despite
intact mobility, secondary to brain
damage”
(Knollman- Porter, 2008)
5 Primary Clinical Characteristics
of Apraxia of Speech (AOS)
1. Slow rate of speech
2. Sound distortions
3. Sound substitutions
4. Errors that are consistent in terms of type,
inconsistent in terms of location
5. Abnormal prosody
(Wambaugh et al., 2006b)
Factors that Impact Success of
Treatment
Family support
(cid:132)
Motivation/Self initiation
(cid:132)
Self awareness and insight
(cid:132)
Insight into the future
(cid:132)
Intensity of treatment
(cid:132)
Distributed practice
(cid:132)
Specificity of training
(cid:132) (Knollman- Porter, 2008)
Motor Learning Principle
(cid:132)
Frequency of clinician feedback
(Austermann Hula, et al.,
(cid:132)
2008)
Treatment for AOS
Articulatory kinematic
(cid:132)
Alternative and augmentative communication
(cid:132)
device (AAC)
Rate and/or Rhythm
(cid:132)
Intersystemic facilitation/reorganization
(cid:132)
(Wambaugh et al., 2006c)
Constraint-induced therapy
(cid:132)
(Knollman-Porter, 2008)
Articulatory Kinematic
Auditory, visual, written and tactile cues
(cid:132)
3 Approaches
(cid:132)
Modeling/repetition
(cid:132)
Integral stimulation
(cid:132)
PROMPT
(cid:132)
AAC Device
Low tech (cid:206)(cid:206) High tech
(cid:132)
Client or family may resist AAC
(cid:132)
“The AAC device is not just a machine…[it]
(cid:132)
becomes part of the person’s
personality…The grandkids—they thought
that the AAC device was Tom’s voice”
(Beukelman et al., 2007)
Rate and Rhythm
Methods used to pace speech:
(cid:132)
Metronome
(cid:132)
Hand tapping
(cid:132)
Computer display
(cid:132)
Pacing board
(cid:132)
Intersystemic
Facilitation/Reorganization
Uses manual limb gestures to re-access
(cid:132)
speech production
Limb gestures:
(cid:132)
Ameri-Ind
(meaningful gesture)
(cid:132)
Finger tapping
(non-meaningful gesture)
(cid:132)
Hand tapping
(non-meaningful gesture)
(cid:132)
Theory = using intact limb system may
(cid:132)
facilitate use of the impaired speech
system.
(Knollman-Porter, 2008)
Intersystemic
Facilitation/Reorganization
3 Steps:
(cid:132)
Picture naming
(cid:132)
Correct (cid:206) go to the next picture
(cid:132)
Incorrect (cid:206) go to step 2
(cid:132)
Contrast error to target articulation of word
(cid:132)
Correct (cid:206) go to the next picture
(cid:132)
Incorrect (cid:206) go to step 3
(cid:132)
Provide mirror for client to view his
(cid:132)
production
(Knollman-Porter, 2008)