Vibrotactile stimulation for intersystemic reorganization in the treatment of apraxia of speech.

Intersystemic reorganization in the treatment of apraxia of speech involves pairing fragments of a speech motor program with internal cues generated by some other, more intact system. Gestural reorganization, pairing speech with limb gestures, somehow provides an organizational framework for the proper sequencing of motor speech movements. This paper briefly develops some hypotheses suggesting that afference resulting from limb movements rather than a central movement program is involved in gestural reorganization, and that vibrotactile stimulation may have advantages over visual or auditory modalities. The effectiveness of vibrotactile as compared to auditory stress cues was assessed in a multiple schedule design for 1 patient who had had a cerebrovascular accident. Results indicated that, in an imitative paradigm, vibrotactile plus auditory stress and rhythm cues were more effective than auditory cues alone improving an apraxic patient's imitative production of single words.