RecruitingNot ApplicableNCT04642053

A Randomized Control Trial of Motor-based Intervention for CAS

A Randomized Control Trial of Motor-based Intervention for Childhood Apraxia of Speech

Sponsor

New York University

Enrollment

72 participants

Start Date

Sep 14, 2021

Study Type

INTERVENTIONAL

Conditions

Childhood Apraxia of Speech

Summary

Childhood apraxia of speech (CAS) is a complex, multivariate speech motor disorder characterized by difficulty planning and programming movements of the speech articulators (ASHA, 2007; Ayres, 1985; Campbell et al., 2007; Davis et al., 1998; Forrest, 2003; Shriberg et al., 1997). Despite the profound impact that CAS can have on a child's ability to communicate, little data are available to direct treatment in this challenging population. Historically, children with CAS have been treated with articulation and phonologically based approaches with limited effectiveness in improving speech, as shown by very slow treatment progress and poor generalization of skills to new contexts. With the emerging data regarding speech motor deficits in CAS, there is a critical need to test treatments that directly refine speech movements using methods that quantify speech motor control. This research is a Randomized Control Trial designed to examine the outcomes of a non-traditional, motor-based approach, Dynamic Temporal and Tactile Cuing (DTTC), to improve speech production in children with CAS. The overall objectives of this research are (i) to test the efficacy of DTTC in young children with CAS (N=72) by examining the impact of DTTC on treated words, generalization to untreated words and post-treatment maintenance, and (ii) to examine how individual patterns of speech motor variability impact response to DTTC.

Eligibility

Min Age: 29 MonthsMax Age: 95 Months

Plain Language Summary

Simplified for easier understanding

This study is testing a speech therapy intervention called Dynamic Temporal and Tactile Cueing (DTTC) in young children with childhood apraxia of speech (CAS). CAS is a motor speech disorder — not caused by muscle weakness, but by the brain's difficulty planning and coordinating the movements needed to produce speech sounds accurately and consistently. Children with CAS often struggle to be understood and typically require intensive, specialized speech therapy. Children aged approximately 2.5 to 7 years old who have been diagnosed with CAS will be randomly assigned to receive either DTTC therapy or a comparison motor-based intervention. Researchers will assess how speech accuracy and intelligibility change over the course of treatment. The goal is to establish which intervention approach works best for children with CAS and at what intensity. You may be eligible if: - Your child is between 2.5 and 7 years and 11 months old - Your child has a confirmed diagnosis of childhood apraxia of speech (CAS) - Your child has normal oral-peripheral structure (mouth, tongue, etc.) - Your child passes a hearing screening - Your child has not previously received DTTC therapy You may NOT be eligible if: - Your child has a neurological disorder (e.g., cerebral palsy), developmental disorder (e.g., autism), or genetic disorder (e.g., Down syndrome) - Your child has features of dysarthria (muscle-based speech weakness), a fluency disorder, or hearing loss Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

BEHAVIORALDynamic Temporal and Tactile Cuing

Dynamic Temporal and Tactile Cuing is based on principles of integral stimulation where the client watches, listens to and imitates the clinician (Strand, 2020). Treatment will begin by training the child to imitate and simultaneously produce syllables/words with the clinician. Sessions will focus on establishing accurate movement transitions in treated words. The child will be asked to imitate the clinician's production of the target. If the child's imitation is inaccurate, they will be instructed to simultaneously produce the target with the clinician. Simultaneous productions will continue to provide practice opportunity with maximal cuing. As the child gains greater accuracy, simultaneous productions will be faded and direct imitation will be attempted again. Over the course of treatment, the movement gesture will be shaped with the goal being accurate production with normal rate and naturalness.