Clinical Trial: Treatment Intensity - Apraxia of Speech

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Effect of Intensity of Treatment on Rehabilitation of Acquired Apraxia of Speech

Brief Summary: A growing neurorehabilitation literature suggests that intense treatment may be desired to maximize the effects of therapy following neurologic injury. This investigation is designed to facilitate the development of efficacious, clinically applicable treatment for acquired apraxia of speech by examining the effects of intensity of treatment (e.g., 9 hours per week vs. 3 hours per week, while holding total number of sessions constant) with a group of speakers who have chronic apraxia of speech and aphasia.

Detailed Summary: This research is designed to examine the effects of treatment intensity on outcomes associated with an established treatment for acquired apraxia of speech (AOS). Intensity in the form of dose frequency and total intervention duration will be evaluated with Sound Production Treatment (SPT). The investigators will examine the effects of intense dose frequency (nine, one-hour sessions per week) and traditional dose frequency (three, one hour sessions per week). Total number of treatment sessions will be held constant allowing for comparison of total intervention duration (27 sessions over 3 weeks versus 27 sessions over 9 weeks). A two-phase, group cross-over design will be used. Thirty-six participants with chronic aphasia and AOS will be quasi-randomly assigned to one of two treatment groups - intense first or traditional first (18 per group). One group will receive SPT applied with intense dose frequency (SPT-I) followed by SPT applied with traditional dose frequency (SPT-T). The other group will receive the treatments in the reverse order (SPT-T followed by SPT-I). A two week no treatment interval will separate the treatment phases. The outcomes of interest will address changes in trained speech behaviors, untrained speech behaviors, and speech intelligibility and patient-rated communicative functioning.
Sponsor: VA Office of Research and Development

Current Primary Outcome:

  • Accuracy of articulation of treated items measured as effect size - change from baseline to end of treatment phase [ Time Frame: Pre treatment, 2 weeks following the first treatment phase, 2 weeks following the second treatment phase ]
    Accuracy of articulation of sounds in words, phrases, sentences designated for treatment. Assessed in nontreatment probes with productions elicited through repetition.
  • Accuracy of articulation of untreated items (generalization) measured as effect size - change from baseline to end of treatment phase [ Time Frame: Pre treatment, 2 weeks following the first treatment phase, 2 weeks following the second treatment phase ]
    Accuracy of articulation of sounds in words, phrases, and/or sentences that are untreated (but, are similar to treated items). Assessed in nontreatment probes with productions elicited through repetition.


Original Primary Outcome: Same as current

Current Secondary Outcome: Speech Intelligibility - change scores comparing baseline to end of treatment phases [ Time Frame: Pre treatment & 2 weeks following the first treatment phase & 2 weeks following the second treatment phase ]

Measure of how well an unfamiliar listener can understand speech. The Assessment of Intelligibility of Dysarthric Speech will be employed. The participant will repeat words which will be audiorecorded. A trained, but unfamiliar listener will orthographically transcribe the words that are produced. The transcriptions will be compared to the list of target (intended words) to determine a percentage of words that are correctly understood.


Original Secondary Outcome: Same as current

Information By: VA Office of Research and Development

Dates:
Date Received: December 22, 2014
Date Started: May 1, 2015
Date Completion: December 2018
Last Updated: April 6, 2017
Last Verified: April 2017