Effects of integral stimulation therapy on speech - Portland State ...

Strand, 1999; Yorkston, Beukelman, Strand, & Bell; 1999). Perhaps the most important
premise <strong>of</strong> motor learning is that cognitive effort must be repeatedly stimulated through
practice and/or experience in order for one’s motor planning processes to be trained well
enough to allow for long term, generalized motor skill learning to occur. Ayres writes:
Planning requires thinking. If one has to think about actions, one is probably motor
planning. If one does not have to think about them, the actions have probably
become automatic and no longer require planning….If <strong>therapy</strong> is designed to
promote planning that requires thinking, then a variety <strong>of</strong> tasks that require thinking
should be available. Once learned well, a task may no longer be therapeutic. (Ayres,
1985, p. 24)
Determining which treatment methods for CAS are most appropriate is a difficult
task even for the most well informed speech-language pathologist. The vast majority <strong>of</strong>
research for treatment <strong>of</strong> apraxia has been conducted on adults with acquired apraxia <strong>of</strong>
speech. Treatment efficacy results have <strong>of</strong>ten been obtained by measuring performance
<strong>of</strong> speech tasks rather than the long term retention and generalization <strong>of</strong> speech skills to
novel speech contexts. Integral <strong>stimulation</strong> uses the principles <strong>of</strong> cognitive motor
learning, to maximize the generalization and transfer <strong>of</strong> speech skills to unfamiliar speech
contexts. Research in the fields <strong>of</strong> sports training, physical <strong>therapy</strong>, and movement
learning have provided a body <strong>of</strong> convincing evidence as to the effectiveness <strong>of</strong> motor
movement learning. This single-subject design examines the efficacy <strong>of</strong> <strong>integral</strong>
<strong>stimulation</strong> utilizing principles <strong>of</strong> cognitive motor learning on the speech intelligibility <strong>of</strong>
one child diagnosed with CAS.
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