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

and motor strengths, attempting to expand those strengths to other areas <strong>of</strong> speech. The
use <strong>of</strong> simple syllable shapes for sound production success, slow rate, focused attention
during movement performance drills, and attention to intonation and prosody have all
been identified as important strategies for effective treatment for CAS (Pannbacker,
1988; Strand, 1995). Additionally, intervention that includes providing cues at various
levels <strong>of</strong> support that are then faded as competency increases, providing multiple
modalities <strong>of</strong> supportive cues such as visual models, auditory models, tactile/sensory
feedback strategies, and creating maximum opportunities for the practice <strong>of</strong> speech
sounds in combinations rather than in isolation, have all been indicators <strong>of</strong> successful
treatment strategies for CAS (Pannbacker, 1988; Strand, 1995).
Integral Stimulation
Rosenbeck et al. developed an articulation treatment method, <strong>integral</strong> <strong>stimulation</strong>,
for acquired apraxia <strong>of</strong> speech in adults that proved efficacious in remediation <strong>of</strong> many <strong>of</strong>
the articulatory and prosodic characteristics <strong>of</strong> AOS (1975). The findings <strong>of</strong> this method
were confirmed by Wambaugh et al., (1998) in a secondary study using the <strong>integral</strong>
<strong>stimulation</strong> approach to <strong>therapy</strong> for individuals with AOS. Table 1 outlines the eight-step
task continuum using applications <strong>of</strong> <strong>integral</strong> <strong>stimulation</strong> used with adults with motor
speech disorders (Rosenbek, et al, 1973).
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