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

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discrepancy suggests the probability <strong>of</strong> some degree <strong>of</strong> genetic involvement. The isolation <strong>of</strong> a section <strong>of</strong> chromosome 7 <strong>of</strong> the FOXP2 gene linked to one London family’s common occurrence (50% <strong>of</strong> sampled members) <strong>of</strong> or<strong>of</strong>acial apraxia and apraxia <strong>of</strong> speech is further evidence <strong>of</strong> neurological involvement (Lai et al., 2000; Lai, Fisher, Hurst, Vargha-Khadem & Monaco, 2005). Further studies in the United States, Europe and Australia tested individuals with CAS for FOXP2 mutation and identified several as having mutations or deletions. Despite some clear indications for neurological impairment, the specific neurological processes remain ambiguous. Researchers such as Crary (1993), Hall, et al., (1993), and Caruso and Strand (1999) argue that impairments occur at one or more levels <strong>of</strong> motor processing. Others posit that linguistic as well as motoric impairment is at play affecting underlying representation <strong>of</strong> phonemes and/or syntax (Aram & Nation, 1982; Ekelman & Aram, 1983) as found in Crary (1993). Whether studies finding deficits in syntactic comprehension (Ekelman & Aram, 1983) reflect a core impairment feature <strong>of</strong> CAS or whether they are deficits secondary to the motor processing disorder is unclear. Theories <strong>of</strong> non-linear phonology and biologically-based models <strong>of</strong> phonology suggest the deficit is a result <strong>of</strong> multiple components. Velleman and Strand (1994) reason that CAS is a disorder <strong>of</strong> hierarchical organization within both speech and language processes. Most clinicians recognize that various linguistic and motor processes are interactive and thus impairment in one process will, in time, most likely influence the other. Clinicians depend largely on their theoretical perspectives <strong>of</strong> language development and efficacy research to guide their decision-making for treatment. In the 10
absence <strong>of</strong> empirical evidence <strong>of</strong> the origins <strong>of</strong> suspected CAS, and the processes that are implicated, clinicians may find themselves unsure <strong>of</strong> their etiologic beliefs in relation to CAS. Definition and Diagnostic Markers CAS is <strong>of</strong>ten broadly described as a motor-planning disorder typically occurring without the presence <strong>of</strong> motor weakness. Others describe CAS more specifically as “an inability to perform accurate and coordinated oral movements during speech in the absence <strong>of</strong> oral movement deficits in non-speech volitional motor tasks (no paresis)”, (Crary, 1993, p 110). The importance <strong>of</strong> consistent and defined diagnostic markers for CAS was illustrated by Forrest (2003) in a study <strong>of</strong> practicing speech-language pathologists. Forrest examined 50 characteristics identified by 75 SLPs as diagnostic criteria used in determining a diagnosis <strong>of</strong> CAS. The SLPs were found to have little interdiagnostic consistency as to which diagnostic characteristics were used. Diagnostic inconsistencies not only diminish a clinician’s ability to examine the efficacy <strong>of</strong> their own intervention methods, but compromise researchers’ abilities to examine larger scaled treatment efficacy, prevalence, and etiological links to CAS. Remediation/ Treatment Methods for CAS Determining which treatment methods for CAS are most appropriate is a difficult task for even the most well-informed speech-language pathologist. To date, surprisingly few studies evaluating treatment approaches for CAS have been conducted. The most appropriate treatment methods are thought to be those that address aspects <strong>of</strong> the generally agreed upon definitions <strong>of</strong> the disorder, suggesting impairment in the planning, the initiation, and the coordination <strong>of</strong> sequencing <strong>of</strong> speech sounds in the absence <strong>of</strong> 11
Page 1 and 2: EFFECTS OF INTEGRAL STIMULATION THE
Page 3 and 4: stimulation <stron
Page 5 and 6: Table of Contents
Page 7: List of Figures Fi
Page 10 and 11: The committee recognized that ident
Page 12 and 13: melodic support to overcome sound s
Page 14 and 15: Literature Review The differential
Page 16 and 17: part affect the numbers diagnosed a
Page 20 and 21: neuromuscular impairment (Caruso &
Page 22 and 23: execute smooth and accurate speech.
Page 24 and 25: Table 1. Rosenbek et al.’s Hierar
Page 26 and 27: methodologies have yielded less con
Page 28 and 29: associated with the practice or exp
Page 30 and 31: very nature of spe
Page 32 and 33: Integral Stimulation and Childhood
Page 34 and 35: stimulation <stron
Page 36 and 37: period of no treat
Page 38 and 39: diagnosis of moder
Page 40 and 41: Table 3. Summary of</strong
Page 42 and 43: Table 4. Summary of</strong
Page 44 and 45: Word Shapes Simple word shapes such
Page 46 and 47: Hearing Hearing evaluations were co
Page 48 and 49: target sounds would allow CP a mana
Page 50 and 51: adjective, and a noun or verb (see
Page 52 and 53: welcomed from CP’s parents who we
Page 54 and 55: simultaneously with the child, prov
Page 56 and 57: to restart the mental processes nee
Page 58 and 59: Analysis of speech
Page 60 and 61: Results This study examined the eff
Page 62 and 63: Post-Treatment Results for /s/ Clus
Page 64 and 65: Data Results for Labiodentals Frica
Page 66 and 67: Data Results for Affricates: /ȴ/ &
Page 68 and 69:
Data Results for Interdental Fricat
Page 70 and 71:
Figure 4. Percent correct for /θ/
Page 72 and 73:
Discussion This discussion examines
Page 74 and 75:
practice his motor speech skills in
Page 76 and 77:
Indicators that motor learning had
Page 78 and 79:
Conclusion The results of</
Page 80 and 81:
A number of sessio
Page 82 and 83:
References American Speech-Language
Page 84 and 85:
Delaney, A.L., & Kent, R.D. (2004,
Page 86 and 87:
Powell, T. W. (1996). Stimulability
Page 88 and 89:
Strand, E. A. (1995). Treatment <st
Page 90 and 91:
for regular treatment are determine
Page 92:
Appendix C -Data Tracking Form TX T
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