Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA.
Am J Speech Lang Pathol. 2021 Jun 18;30(3S):1525-1541. doi: 10.1044/2020_AJSLP-20-00131. Epub 2021 Mar 8.
Purpose A subset of children with autism spectrum disorder (ASD) has speech sound disorders, including childhood apraxia of speech (CAS). To date, virtually all speech treatment studies consider ASD an exclusionary criterion, resulting in little scientific evidence for treatment of CAS for children who also have ASD. This study proposes and tests a novel approach, Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS), as a theoretically and clinically informed speech treatment option for this population. Method Using a multiple-baseline design within and across participants, three children with co-occurring ASD and CAS received 11-18 treatment sessions. Treatment targets were individually designed and matched with untreated control words. Probes were administered at the start of each session to assess speech production accuracy perceptually. Changes in production accuracy were examined through visual inspection and quantified with effect sizes. Results Findings were mixed, with one child showing significant gains for half of the treated targets at follow-up and two children showing no clear improvement. Conclusions Preliminary evidence suggests potentially positive treatment effects for ACT4CAS when implemented as intended, although treatment intensity and disorder severity likely influence treatment outcome. Replication and comparison of ACT4CAS to other speech treatments is needed. Supplemental Material https://doi.org/10.23641/asha.14110445.
目的 自闭症谱系障碍(ASD)的一部分儿童存在语音障碍,包括儿童言语运动障碍(CAS)。迄今为止,几乎所有的言语治疗研究都将 ASD 作为排除标准,导致对于同时患有 ASD 的 CAS 儿童的治疗方法缺乏科学证据。本研究提出并测试了一种新方法,即自闭症为中心的儿童言语运动障碍治疗(ACT4CAS),作为一种针对该人群的具有理论和临床意义的言语治疗选择。方法 使用参与者内和参与者间的多项基线设计,3 名同时患有 ASD 和 CAS 的儿童接受了 11-18 次治疗。治疗目标是根据个人情况设计并与未经治疗的对照组单词相匹配。在每次治疗开始时进行探针评估,以感知性评估语音产生准确性。通过视觉检查检查生产准确性的变化,并通过效果大小进行量化。结果 结果喜忧参半,一名儿童在随访时对一半治疗目标有显著改善,而两名儿童没有明显改善。结论 初步证据表明,ACT4CAS 按照预期实施时可能具有积极的治疗效果,尽管治疗强度和疾病严重程度可能会影响治疗结果。需要对 ACT4CAS 与其他言语治疗方法进行复制和比较。补充材料 https://doi.org/10.23641/asha.14110445.