School of Communication Sciences and Disorders, University of Central Florida, Orlando.
Am J Speech Lang Pathol. 2020 Nov 12;29(4):2109-2130. doi: 10.1044/2020_AJSLP-19-00116. Epub 2020 Sep 30.
Purpose This study continued Phase I investigation of a modified Phonomotor Treatment (PMT) Program on motor planning in two individuals with apraxia of speech (AOS) and aphasia and, with support from prior work, refined Phase I methodology for treatment intensity and duration, a measure of communicative participation, and the use of effect size benchmarks specific to AOS. Method A single-case experimental design with multiple baselines across behaviors and participants was used to examine acquisition, generalization, and maintenance of treatment effects 8-10 weeks posttreatment. Treatment was distributed 3 days a week, and duration of treatment was specific to each participant (criterion based). Experimental stimuli consisted of target sounds or clusters embedded nonwords and real words, specific to each participants' deficit. Results Findings show improved repetition accuracy for targets in trained nonwords, generalization to targets in untrained nonwords and real words, and maintenance of treatment effects at 10 weeks posttreatment for one participant and more variable outcomes for the other participant. Conclusions Results indicate that a modified version of PMT can promote generalization and maintenance of treatment gains for trained speech targets via a multimodal approach emphasizing repeated exposure and practice. While these results are promising, the frequent co-occurrence of AOS and aphasia warrants a treatment that addresses both motor planning and linguistic deficits. Thus, the application of traditional PMT with participant-specific modifications for AOS embedded into the treatment program may be a more effective approach. Future work will continue to examine and maximize improvements in motor planning, while also treating anomia in aphasia.
目的 本研究继续进行了一项经改良的 Phonomotor 治疗（PMT）计划在两名运动性言语失用症（AOS）和失语症患者中进行运动规划的第一阶段研究，并在前期工作的支持下，对治疗强度和持续时间、交际参与的衡量标准以及特定于 AOS 的效应量基准进行了第一阶段方法的改进。 方法 采用跨行为和参与者的多个基线的单病例实验设计，以检查治疗效果的获得、泛化和维持情况，治疗时间为 8-10 周。治疗每周进行 3 天，治疗持续时间针对每个参与者（基于标准）。实验刺激包括目标音或集群嵌入在非词和实词中，具体针对每个参与者的缺陷。 结果 研究结果表明，在训练过的非词中，目标的重复准确性得到提高，在未训练过的非词和实词中也得到了泛化，并且一名参与者在治疗后 10 周时仍保持了治疗效果，而另一名参与者的结果则更为多变。 结论 结果表明，经改良的 PMT 可通过强调重复暴露和练习的多模态方法促进训练过的语音目标的泛化和治疗效果的维持。虽然这些结果很有希望，但 AOS 和失语症的频繁同时发生需要一种既针对运动规划又针对语言缺陷的治疗方法。因此，将针对 AOS 嵌入治疗计划的传统 PMT 与针对特定参与者的修改相结合的应用可能是一种更有效的方法。未来的工作将继续检查和最大限度地提高运动规划的改善，同时也治疗失语症的命名障碍。
