A Novel Treatment for Aphasia and Apraxia of Speech : Measurement of Outcomes

NCT01979159 | Completed Results

• 1 other identifier: O1356-P
• Study Type: interventional
• Target: 4
• Locations: 1 country
• Sites: 1

Brief Summary

In order to determine if speech-language therapy has positive effect, reliable measurement tools are required to document outcomes. Currently, there is very limited information concerning the measurement of changes in speech production as a result of treatment for acquired apraxia of speech and aphasia. This study will obtain information concerning the reliability of several speech production measures over time. Thirty persons with chronic aphasia and apraxia of speech will be asked to provide speech samples in response to commonly used assessment tools on three sampling occasions so that the stability of measurements may be examined. After establishment of appropriate outcome measures, a small, pilot treatment study will be conducted with four participants. The participants will receive a new treatment for aphasia and acquired apraxia of speech and outcomes will be measured relative to speech and language production.

Conditions

Apraxia of Speech; Aphasia

Keywords

aphasia; apraxia of speech; outcomes

Outcome Measures

Primary Outcomes (2)

• Change in Language Content Production for Treated Stimuli: Effect Sizes (Magnitude of Change From Baseline to Follow-up)

  Correct Information Units (CIUs) is a measure of the amount of relevant content produced in connected language tallied according to operationalized criteria. CIU is not a test or scale - it is a measure that is applied to language samples - in this case, description of treated pictures. Participants described experimental pictures, responses were transcribed and CIUs counted. CIUs can range from 0 to an unlimited maximum. Effect sizes (ESs) were calculated as an indication of the magnitude of change in number of CIUs produced (pre treatment to post treatment. ESs can range from negative (poorer performance post-treatment) to positive values (better performance post-treatment), with larger positive values reflecting greater gains. Benchmarks are as follows: \>11.14 = large, 11.13 - 6.56 = medium, 6.55 - 3.88 = small, \<3.88 = negligible. Small to large ESs indicate production of measurably more CIUs in picture descriptions post-treatment. Larger the ES, the greater the change.

  Following completion of treatment at 6 weeks post

• Change in Production of Language Content for Untreated Sets - Generalization Measured in Effect Sizes

  Correct Information Units (CIUs) is a measure of the amount of relevant content produced in connected language tallied according to operationalized criteria. CIU is not a test or scale - it is a measure that is applied to language samples - in this case, description of untreated pictures. Participants described experimental pictures, responses were transcribed and CIUs counted. CIUs can range from 0 to an unlimited maximum. Effect sizes (ESs) were calculated as an indication of the magnitude of change in number of CIUs produced (pre treatment to post treatment. ESs can range from negative (poorer performance post-treatment) to positive values (better performance post-treatment), with larger positive values reflecting greater gains. Benchmarks are as follows: \>9.53 = large, 9.52 - 5.52 = medium, 6.55 - 3.29 = small, \<3.29 = negligible. Small to large ESs indicate production of measurably more CIUs in picture descriptions post-treatment. Larger the ES, the greater the change.

  baseline (prior to treatment) through follow-up at 6 weeks post treatment

Secondary Outcomes (1)

• Changes in Speech Intelligibility on the Assessment of Intelligibility of Dysarthric Speech

  pre and post treatment - prior to the start of treatment and at 6 weeks following the completion of treatment

Study Arms (1)

Combined Aphasia-ApraxiaTreatment

EXPERIMENTAL

Administration of Combined Aphasia and Apraxia of Speech Treatment )(CAAST) to 4 persons with aphasia and apraxia of speech in the context of single-subject designs

Behavioral: Combined Aphasia and Apraxia of Speech Treatment (CAAST)

Interventions

Combined Aphasia and Apraxia of Speech Treatment (CAAST) BEHAVIORAL

Therapy is delivered in a face-to-face format. The therapist uses picture stimuli, verbal modeling, feedback, reinforcement, forward-chaining to increase verbal production. For speech errors that occur, the therapist uses modeling, feedback, reinforcement, simultaneous production, articulatory instruction, and repeated practice to improve articulation.

Also known as: CAAST

Combined Aphasia-ApraxiaTreatment

Eligibility Criteria

• Age: 21 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Veterans or non Veterans with aphasia and apraxia of speech who reside in the Salt Lake City region (commutable),
• months or more post stroke or other focal brain injury, no other neurological conditions,
• native English speakers, hearing adequate for experimental task (e.g., pass puretone screening at 35dB at 500, 1K, 2K Hz),
• non linguistic cognition within normal limits

You may not qualify if:

• less than 12 months post stroke,
• insufficient hearing, insufficient non linguistic cognitive skills,
• neurological conditions other than stroke,
• more than one stroke or brain injury
• unable to attend treatment in the Salt Lake City vicinity

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Salt Lake City Health Care System, Salt Lake City, UT

Salt Lake City, Utah, 84148, United States

Location

Related Publications (6)

• Wambaugh JL, Wright S, Mauszycki SC, Nessler C, Bailey D. Combined aphasia and apraxia of speech treatment (CAAST): Systematic replications in the development of a novel treatment. Int J Speech Lang Pathol. 2018 Apr;20(2):247-261. doi: 10.1080/17549507.2016.1267262. Epub 2017 Jan 13.

  PMID: 28084854 RESULT

• Wambaugh JL, Wright S, Nessler C, Mauszycki SC. Combined Aphasia and Apraxia of Speech Treatment (CAAST): effects of a novel therapy. J Speech Lang Hear Res. 2014 Dec;57(6):2191-207. doi: 10.1044/2014_JSLHR-L-14-0004.

  PMID: 25075917 RESULT

• Bailey DJ, Blomgren M, DeLong C, Berggren K, Wambaugh JL. Quantification and Systematic Characterization of Stuttering-Like Disfluencies in Acquired Apraxia of Speech. Am J Speech Lang Pathol. 2017 Jun 22;26(2S):641-648. doi: 10.1044/2017_AJSLP-16-0108.

  PMID: 28654945 RESULT

• Haley KL, Smith M, Wambaugh JL. Sound Distortion Errors in Aphasia With Apraxia of Speech. Am J Speech Lang Pathol. 2019 Feb 21;28(1):121-135. doi: 10.1044/2018_AJSLP-17-0186.

  PMID: 31072155 DERIVED

• Bunker LD, Nessler C, Wambaugh JL. Effect Size Benchmarks for Response Elaboration Training: A Meta-Analysis. Am J Speech Lang Pathol. 2019 Mar 11;28(1S):247-258. doi: 10.1044/2018_AJSLP-17-0152.

  PMID: 30054623 DERIVED

• Bunker LD, Wright S, Wambaugh JL. Language Changes Following Combined Aphasia and Apraxia of Speech Treatment. Am J Speech Lang Pathol. 2018 Mar 1;27(1S):323-335. doi: 10.1044/2018_AJSLP-16-0193.

  PMID: 29497747 DERIVED

MeSH Terms

Conditions

Apraxias; Aphasia

Condition Hierarchy (Ancestors)

Psychomotor Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Speech Disorders; Language Disorders; Communication Disorders

Results Point of Contact

• Title: Dr. Julie Wambaugh
• Organization: VA Salt Lake City Health Care System

julie.wambaugh@va.gov

801-582-1565

Study Officials

• Julie L Wambaugh, PhD

  VA Salt Lake City Health Care System, Salt Lake City, UT

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: Single-case experimental design; multiple baseline design across behaviors and participants

Study Record Dates

• First Submitted: October 23, 2013
• First Posted: November 8, 2013
• Study Start: October 21, 2013
• Primary Completion: December 30, 2016
• Study Completion: December 22, 2017
• Last Updated: June 19, 2019
• Results First Posted: June 19, 2019

Record last verified: 2019-03

Locations

US (1)