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

methodologies have yielded less convincing treatment results. Auditory and rule-based
phonology treatment approaches have not yielded documented efficacious results when
investigated by researchers in the field <strong>of</strong> speech-language pathology (Darley et al., 1975;
Pannbacker, 1988; Powell, 1996). In fact, Rosenbeck and Wertz (1972) write “classical
reliance upon auditory discrimination training is probably inappropriate” (p.32).
Although the level (or levels) at which motor planning/programming impairment
occurs is unclear, Caruso and Strand (1999) recommend targeting a number <strong>of</strong> the
parameters that we know to be involved in the development <strong>of</strong> motor skill. Targeting
multiple parameters can aid in the self-regulation <strong>of</strong> correct articulator placement and
movement sequencing <strong>of</strong> oral structures during drilled and spontaneous speech
productions. Further, practiced sounds in a variety <strong>of</strong> contexts (sound, syllable, word,
phrase, and conversation) allows for greater generalization <strong>of</strong> learned motor skills.
Cognitive Motor Learning
In treating motor speech disorders clinicians must not only attempt to provide
their clients with efficacious treatment methods, they must also ensure that the conditions
under which treatment occurs will ensure that long-term learning <strong>of</strong> skills persists.
Cognitive motor learning theories address the conditions under which acquired motor
skills may best be learned and preserved. Given the general consensus on the motor
impairment component <strong>of</strong> CAS and AOS and preliminary studies indicating <strong>integral</strong>
<strong>stimulation</strong> as an efficacious treatment approach, researchers and clinicians have looked
to models <strong>of</strong> motor rehabilitation outside the field <strong>of</strong> speech-language pathology to
inform their beliefs about the effectiveness <strong>of</strong> their treatment applications. The theories <strong>of</strong>
cognitive motor learning have been shown to be efficacious in the teaching <strong>of</strong> sequential
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