Authors: Savage MC, Stead AL, Hoffman PR
Title: Treating Apraxia of Speech as a Result of Postencephalitic Parkinsonism Using Discourse
Source: Journal of Medical Speech Language Pathology 2012 20(2): 35-42
Year: 2012
Research Design: Single Case Design

Background: The purpose of this single-subject study was to investigate if phonologic placement treatment seated in spontaneous discourse would improve phonetic accuracy and increase intelligibility in an individual with postencephalitic parkinsonism resulting in apraxia of speech. Methods: The participant was a 60-year-old male with postencephalitic parkinsonism, oral and speech apraxia, and dysarthria. A single-subject ABAB design using pre-and posttesting and repeated measurement of phonemes during baseline and treatment was used. Phonological and visual supports were embedded within conversational discourse related to current events. Data were analyzed using visual inspection and effect sizes. Results: Results showed a treatment effect for all targeted phonemes as well as posttest measures of overall intelligibility. Assessment of Intelligibility of Dysarthric Speech scores rose from 0% to 24% intelligible at the single word level. Large effect sizes were found for all target phonemes, /b/ (d = 2.89), /m/ (d = 4.76), (d = 1.18) and /n/ (d = 1.94). Conclusions: A phonologically based treatment embedded in discourse was effective in facilitating basic verbal communication in a previously nonverbal individual.

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