Sound Production Treatment: Investigation of Blocked and Random Practice Effects

Acquired apraxia of speech (AOS) is a neurologic motor speech disorder that is characterized by slow rate of speech, difficulties in sound production, and disrupted prosody (McNeil, Robin, & Schmidt, 2009). AOS is typically accompanied by aphasia and occurs rarely in its “pure” form, without aphasia (Duffy, 2005). Duffy reported that 22% of stroke survivors, who were diagnosed with aphasia as their primary communication disorder, also had AOS (Duffy, 2007). The relative contributions of aphasia and AOS to overall communication disruption in persons with both disorders are not well understood. Although many persons with aphasia and AOS likely require treatment for both disorders, there has been limited research addressing treatments that have been designed to target these disorders simultaneously. None of the AOS treatments described in the AOS treatment guidelines included direct treatment for language (Wambaugh et al., 2006). Recently, Youmans, Youmans, and Hancock (2011) modified script training to include feedback for sound production accuracy and articulatory placement; positive findings were reported for three participants with AOS and aphasia. Response Elaboration Training (RET; Kearns, 1985) was modified for persons with aphasia and AOS (Wambaugh & Martinez, 2000; Wambaugh et al., 2012), but did not include specific treatment for apraxic speech production errors. In the current investigation, modified-RET (M-RET) was combined with an established AOS treatment, Sound Production Treatment (SPT, Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998) to improve language and speech production. The purpose of the current investigation was to examine the effects of this novel treatment with three speakers with aphasia and AOS