Hanley Leah, Ballard Kirrie J, Dickson Alicia, Purcell Alison
Faculty of Medicine & Health, University of Sydney, New South Wales, Australia.
Private Practice, Sydney, New South Wales, Australia.
Am J Speech Lang Pathol. 2023 Jan 11;32(1):169-189. doi: 10.1044/2022_AJSLP-22-00007. Epub 2022 Dec 7.
This is a pilot study to apply an articulatory kinematic speech intervention that uses the principles of motor learning (PML) to improve speech and resonance outcomes for children with cleft palate. It is hypothesized that (a) treatment that applies select PML during practice will improve production of treated phonemes, representing both active and inconsistent passive errors, at word level in children with cleft palate; (b) effects of practice on phonemes with active or inconsistent passive errors will generalize to untreated exemplars of treated phonemes; and (c) learning will be retained for at least 1-month posttreatment.
A multiple-baseline design across participants combined with a crossover single-case experimental model was used. Participants attended two 8-week blocks of twice-weekly face-to-face speech therapy (40-50 min/treatment) to treat active and inconsistent passive cleft speech errors using articulatory kinematic speech intervention that applied PML. The participants were four children with cleft-type speech errors. The primary dependent variable measured was percentage of words correct across treatment items, generalization items, and control items. Perceptual accuracy of target words was scored. Effect sizes were calculated to quantify the magnitude of treatment effect.
For three children with active and inconsistent passive cleft speech errors and one child with active cleft speech errors and developmental phonological speech errors, this approach resulted in improvements to their treated items and generalization to their untreated items. Inconsistent passive cleft speech errors were particularly responsive to the treatment in the three children who presented with these errors.
This Phase I study has shown that articulatory kinematic speech intervention that applies the PML is effective in improving the speech outcomes for children with cleft palate and that there is validity in pursuing further research into this approach.
这是一项试点研究,旨在应用一种基于运动学习原理(PML)的发音运动学言语干预方法,以改善腭裂儿童的言语和共鸣效果。研究假设如下:(a)在练习过程中应用特定PML的治疗方法,将改善腭裂儿童在单词层面上经治疗音素的发音,包括主动错误和不一致的被动错误;(b)练习对有主动或不一致被动错误音素的影响将推广到经治疗音素的未治疗示例;(c)学习效果将在治疗后至少保留1个月。
采用参与者间多基线设计与交叉单病例实验模型相结合的方法。参与者参加了两个为期8周、每周两次的面对面言语治疗(每次治疗40 - 50分钟),使用应用PML的发音运动学言语干预来治疗主动和不一致的被动腭裂言语错误。参与者为4名患有腭裂型言语错误的儿童。测量的主要因变量是治疗项目、泛化项目和对照项目中正确单词的百分比。对目标单词的感知准确性进行评分。计算效应量以量化治疗效果的大小。
对于3名有主动和不一致被动腭裂言语错误的儿童以及1名有主动腭裂言语错误和发育性语音错误的儿童,这种方法使他们的治疗项目得到改善,并推广到未治疗项目。在出现这些错误的3名儿童中,不一致的被动腭裂言语错误对治疗特别敏感。
这项I期研究表明,应用PML的发音运动学言语干预对改善腭裂儿童的言语效果有效,并且进一步研究这种方法具有合理性。