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

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A number <strong>of</strong> sessions were missed toward the end <strong>of</strong> the study as CP was sick with colds. Further limitations in the form <strong>of</strong> data collection occurred when this clinician inadvertently skipped a speech probe phrase (resulting in less data to include) or when video equipment did not operate effectively. More comprehensive analysis (tracking selfcorrections, number <strong>of</strong> productions, feedback tracking) <strong>of</strong> CP’s treatment would have been possible if every treatment session had been recorded. In this case, each speech probe was recorded when the child was seated, but full sessions were not consistently recorded as <strong>therapy</strong> required much movement and <strong>of</strong>ten practice outside <strong>of</strong> the speech room (hallway activities). Perhaps the most significant limitation <strong>of</strong> this study is that it included a single child rather than multiple subjects. CAS is a relatively rare speech disorder that is <strong>of</strong>ten misdiagnosed and difficult to identify, but efficacy studies that include larger samples <strong>of</strong> children would allow speech language-pathologists and parents alike to seek treatment for children with CAS more assuredly. The suggestions <strong>of</strong> this study are that frequent and intense motor practice <strong>of</strong> speech sounds in a variety <strong>of</strong> contexts with multi-sensory supports can greatly improve the intelligibility <strong>of</strong> a child with motor speech impairment like CAS. In this study, CP’s speech showed significant improvement for all target sound sets which generalized to spontaneous speech contexts in 3 out <strong>of</strong> the 4 target sound sets. In addition to greater speech accuracy, CP demonstrated a dramatic increase in the number <strong>of</strong> utterances used during spontaneous speech (pre-treatment MLU <strong>of</strong> 1.3 vs. 4.5 MLU following treatment). Family members and teachers commented on CP’s ability to communicate his thoughts more clearly and with more complexity than he had before <strong>integral</strong> <strong>stimulation</strong> <strong>therapy</strong> 72
treatment had begun. In addition to improved speech intelligibility and utterance length, CP frequently demonstrated strategies critical to <strong>integral</strong> <strong>stimulation</strong> <strong>therapy</strong> principles (slowed rate <strong>of</strong> speech for difficult sounds, frequent self-corrections, requests for modeled sound, increased awareness <strong>of</strong> own accuracy). Children and families <strong>of</strong>ten invest a great amount <strong>of</strong> energy and resources in obtaining long-term speech treatment for CAS. The body <strong>of</strong> efficacy research is currently inadequate to definitively conclude best practices for CAS diagnosis and treatment. Large scale research for CAS can be challenging to conduct given its relatively low prevalence and undefined diagnostic markers. Given these significant challenges, systematic treatment programs can be developed to evaluate treatment efficacy for CAS. This study adds to a growing body <strong>of</strong> work that suggests that <strong>integral</strong> <strong>stimulation</strong> <strong>therapy</strong> has positive effects on the speech intelligibility <strong>of</strong> children affected by CAS. Large scale research in the area <strong>of</strong> treatment efficacy for CAS will enable families to seek <strong>therapy</strong> with more confidence and assist speech-language pathologists in providing treatment effectively. 73
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EFFECTS OF INTEGRAL STIMULATION THE
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stimulation <stron
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Table of Contents
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List of Figures Fi
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The committee recognized that ident
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melodic support to overcome sound s
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Literature Review The differential
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part affect the numbers diagnosed a
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discrepancy suggests the probabilit
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neuromuscular impairment (Caruso &
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execute smooth and accurate speech.
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Table 1. Rosenbek et al.’s Hierar
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methodologies have yielded less con
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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 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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