Treatment Intensity - Apraxia of Speech

NCT02332915 | Completed Results

• 1 other identifier: C1782-R
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 2

Brief Summary

A growing neurorehabilitation literature suggests that intense treatment may be desired to maximize the effects of therapy following neurologic injury. This investigation is designed to facilitate the development of efficacious, clinically applicable treatment for acquired apraxia of speech by examining the effects of intensity of treatment (e.g., 9 hours per week vs. 3 hours per week, while holding total number of sessions constant) with a group of speakers who have chronic apraxia of speech and aphasia.

Conditions

Aphasia; CVA; Apraxia of Speech

Keywords

apraxia; aphasia; rehabilitation; efficacy; intensity

Outcome Measures

Primary Outcomes (2)

• Accuracy of Articulation of TREATED ITEMS Measured as Effect Size - Change From Baseline to End of Treatment Phase

  Accuracy of articulation of sounds in words, phrases, sentences designated for treatment. Assessed in nontreatment probes with productions elicited through repetition. Change in accuracy of articulation of trained items was measured from baseline to 2 weeks post treatment using effect size calculations as the indicator of magnitude of change. Percent accuracy was calculated for each probe (maximum = 100%, minimum = 0% correct). Effect size calculations involved calculating the difference between post- and pre-treatment probe accuracy percentages with corrections made for variability (standard deviations in performance). The larger the effect size, the greater the change in performance from pre-treatment. Positive effect sizes = increases in accuracy \& negative effect sizes = decreases in accuracy.

  Pre treatment, 2 weeks following the first treatment phase, 2 weeks following the second treatment phase

• Accuracy of Articulation of Untreated Items (Generalization) Measured as Effect Size - Change From Baseline to End of Treatment Phase

  Change in accuracy of articulation of untrained items as measured by effect sizes reflecting magnitude of change. Production of words designated to not receive treatment (i.e., generalization items) was measured repeatedly in non treatment probes prior to treatment, throughout all study phases, and at 2 weeks post treatment with percent accuracy calculated for each probe (0% to 100% correct). Effect size calculations involved calculating the difference between post- and pre-treatment probe accuracy percentages with corrections made for variability (standard deviations in performance). The larger the effect size, the greater the change in performance from pre-treatment.

  Pre treatment, 2 weeks following the first treatment phase, 2 weeks following the second treatment phase

Secondary Outcomes (1)

• Speech Intelligibility - Percent Intelligible Words Comparing Baseline to End of Treatment Phases

  Pre treatment & 2 weeks following each treatment phase

Study Arms (2)

SPT - Intense First

EXPERIMENTAL

Participants will receive intense application in the first phase of treatment, followed by the non intense application of treatment.

Behavioral: Sound Production Treatment (SPT)

SPT - Traditional First

EXPERIMENTAL

Participants will receive non intense, "traditional" application of treatment in the first phase of treatment, followed by the intense application of treatment.

Behavioral: Sound Production Treatment (SPT)

Interventions

Sound Production Treatment (SPT) BEHAVIORAL

SPT is a behavioral treatment for acquired apraxia of speech. It involves verbal modeling of target words by the clinician, simultaneous productions, articulatory placement instructions, and repeated practice. Treatment is administered in the context of an hierarchy.

SPT - Intense First; SPT - Traditional First

Eligibility Criteria

• Age: 21 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Veterans and non Veterans
• Males or females
• Stroke survivor who is at least 4 months post-stroke
• Speaker of English since childhood
• Ability to pass a pure-tone hearing screening (aided or unaided)
• currently non-hospitalized
• Age 21 to 90 years

You may not qualify if:

• neurological condition other than stroke
• currently clinically depressed
• history of speech/language problems prior to stroke
• untreated psychopathology

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (2)

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, 15240, United States

Location

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

Salt Lake City, Utah, 84148, United States

Location

Related Publications (2)

• Wambaugh JL, Wright S, Boss E, Mauszycki SC, DeLong C, Hula W, Doyle PJ. Effects of Treatment Intensity on Outcomes in Acquired Apraxia of Speech. Am J Speech Lang Pathol. 2018 Mar 1;27(1S):306-322. doi: 10.1044/2017_AJSLP-16-0188.

  PMID: 29497746 RESULT

• Wambaugh JL, Wright S, Nessler C, Mauszycki SC, Bunker L, Boss E, Zhang Y, Hula WD, Doyle PJ. Further Study of the Effects of Treatment Intensity on Outcomes of Sound Production Treatment for Acquired Apraxia of Speech: Does Dose Frequency Matter? Am J Speech Lang Pathol. 2020 Feb 7;29(1):263-285. doi: 10.1044/2019_AJSLP-19-00005. Epub 2020 Feb 3.

  PMID: 32011909 RESULT

MeSH Terms

Conditions

Aphasia; Apraxias

Condition Hierarchy (Ancestors)

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

Results Point of Contact

• Title: Julie Wambaugh
• Organization: University of Utah

julie.wambaugh@health.utah.edu

8015846164

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: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 22, 2014
• First Posted: January 7, 2015
• Study Start: May 1, 2015
• Primary Completion: October 10, 2019
• Study Completion: October 10, 2019
• Last Updated: July 12, 2022
• Results First Posted: November 17, 2020

Record last verified: 2022-03

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: Individual data for 17 participants has been shared in publications. The data for the remaining 7 participants will be shared in a final publication - approximately by January 2022.
• Access Criteria: Individual data are available in publications.

Locations

US (2)