Efficacy of Integral Stimulation

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Published on October 21, 2008

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Efficacy of Integral Stimulation Intervention in Three Siblings with CAS : Efficacy of Integral Stimulation Intervention in Three Siblings with CAS Kathy J. Jakielski, Ph.D., CCC-SLP, Cathy E. Webb, B.A., & Mandi Gilbraith Augustana College, Rock Island, IL 2006 ASHA Convention, Miami, FL Acknowledgements Participants and their Family Augustana Research Foundation Augustana College Alumni Association Integral Stimulation Intervention based on principles of cognitive motor learning with focus on cognitive-motor programming for speech emphasizes multiple input modes, particularly auditory and visual technique to vary temporal presence of cues, fading cues as individual takes increasing responsibility for assembly, retrieval, and execution of speech motor plan studies by Rosenbek et al. (1973) and Strand and Debertine (2000) demonstrated the efficacy of using integral stimulation intervention in treatment of individuals with apraxia of speech Research Questions Several research questions were investigated in the present study. The answers to two questions are detailed in this presentation. Following a period of intervention using integral stimulation methods: What changes in articulatory skills were demonstrated by three participants with CAS from the beginning to the end of the study? What were the patterns of articulatory change exhibited by the three participants over the course of the study? Method Participants “C1” – male; 7;7-8;3; moderate CAS, receptive and expressive language disorder, mild nonverbal intelligence deficit “C2” – female; 9;0-9;8; moderate CAS, receptive and expressive language disorder, mild nonverbal intelligence deficit “C3” – female;15;6-16;1; moderate CAS, receptive and expressive language disorder, mild nonverbal intelligence deficit Intervention A1-B1-A2-B2 design A1 initial pre-intervention baseline measures B1 end of first 8-week intervention phase A2 baseline following 19-week withdraw phase B2 end of second 8-week intervention phase 2 45-minute sessions weekly 6-8 experimental and 5 control functional sentences for each child scaled-scoring system 2 – correctly articulated or articulated with phonetic modifications 1 – articulated with 1-2 errors 0 – articulated with more than 2 errors Data Analysis Question 1: analyzed A1 and B2 data; # of productions that received each score were summed and percentages calculated for all experimental and control stimuli Question 2: analyzed data at A1, B1, A2, and B2 Cueing Hierarchy maximum cueing; simultaneous production; mimed production; immediate repetition; successive repetition; question response Results Question 1: Levels of Accuracy at Beginning and End of Study Question 2: Overall Pattern of Results over Course of Study Discussion all 3 children largely were unable to produce experimental and control sentences at beginning of the study all 3 children produced 93-100% of experimental sentences with at least partial accuracy by end of the study all 3 children demonstrated mastery of 39-73% of the experimental sentences by end of the study 16-24% mastery of control sentences from beginning to end of the study attributable to carryover of progress on experimental sentences to control sentences that were phonetically similar all 3 children demonstrated improvement by B1, with C3 producing her best speech after first intervention phase all 3 children demonstrated some regression over withdraw phase; amount of regression varied by child the oldest child demonstrated the most speech improvement and the youngest child demonstrated the least References Rosenbek, J.C., Lemme, M.L., Ahern, M.B., Harris, E.H., & Wertz, R.T. (1973). A treatment for apraxia of speech in adults. Journal of Speech and Hearing Disorders, 38, 462-472. Schmidt, R.A., & Wrisberg, C.A. (2004). Motor learning and performance: A problem-based learning approach (3rd ed.). Champaign, IL: Human Kinetics. Strand, E.A., & Debertine, P. (2000). The efficacy of integral stimulation intervention with developmental apraxia of speech. Journal of Medical Speech-Language Pathology, 8, 295-300.

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