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

execute smooth and accurate speech. Few studies have evaluated the efficacy <strong>of</strong> Melodic
Intonation Therapy with CAS. Studies by Helfrich-Miller, (1994) and Krauss and
Galloway (1982) reported that subjects with CAS demonstrated increased speech
intelligibility and fewer articulation errors following treatment with MIT. It is unclear if
MIT was the only source <strong>of</strong> improved speech or whether other treatment methods
employed over the course <strong>of</strong> the study had contributed to the subjects’ gains.
A third treatment category for the management <strong>of</strong> CAS employs gestural
strategies with the intent <strong>of</strong> aiding the reorganization <strong>of</strong> speech output. Methods include
Adapted Cueing (ACT) (Klick, 1985), Jordan’s Gestures (Hall et al., 1993) and Signed
Target Phoneme (STP) <strong>therapy</strong> (Shelton & Graves, 1985). Gestural methods seek to
demonstrate “patterns <strong>of</strong> articulatory movement and manner <strong>of</strong> production” (Klick, 1985,
p. 256). Several studies report students with CAS exhibited increases in utterance lengths,
conversational turns, and communicative functions with their communicative partners
using augmentative and alternative communication materials and strategies in the form <strong>of</strong>
gestures, communication books, and speech generative devices (Bashir, Graham-Jones, &
Bostwick, 1984; Culp, 1989; Cumley & Swanson, 1999). It has been suggested that
treatment strategies that require a learner to discriminate between symbols and gestures
not physically representative <strong>of</strong> the actual speech sound movement can present a
cognitive processing load that may decrease the accuracy <strong>of</strong> speech movements (Strand,
1992).
Perhaps the most important consideration for clinicians choosing treatment
approaches is to create a plan that serves the individual needs and specific
symptomatology <strong>of</strong> the child. Successful approaches target a child’s various cognitive
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