Speech Therapy for Children With Rare Genetic Conditions and Childhood Apraxia of Speech

NCT07815249 | Recruiting

• 1 other identifier: 124323
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this trial is to learn if speech therapy can improve speech accuracy in children with rare genetic conditions and childhood apraxia of speech (CAS). This study will look at each child individually. Participants will complete 4-weeks of motor speech therapy (3 times per week) and will complete speech assessments before, during and after therapy to measure change. The motor speech therapy will be either Rapid Syllable Transition Treatment (ReST) or Dynamic Temporal and Tactile Cueing (DTTC). Assignment to ReST or DTTC will be based on the participant's age and speech ability. This trial will not compare ReST and DTTC.

Conditions

Childhood Apraxia of Speech; Genetic Condition

Keywords

Childhood apraxia of speech; Speech pathology; Speech therapy; Genetic; Genetic condition; Speech-language pathology; Motor speech

Outcome Measures

Primary Outcomes (1)

• Change in accuracy of trained speech targets following speech intervention where accuracy is measured by the percentage of words correct on an individualised probe word list

  This will be used to determine changes in accuracy of trained speech targets following speech intervention. Accuracy will be determined using an individualised probe word list (a higher percentage of correct words demonstrates higher accuracy).

  Baseline (3, 4 or 5 baselines depending on baseline allocation, complete twice weekly pre-treatment), Treatment week 1, Treatment week 2, Treatment week 3, Treatment week 4, 1-week post treatment, 4-weeks post treatment, 8-weeks post treatment.

Secondary Outcomes (7)

• Change in accuracy of untrained speech targets following speech intervention where accuracy is measured by the percentage of words correct on an individualised probe word list

  Baseline (3, 4 or 5 baselines depending on baseline allocation, complete twice weekly pre-treatment), Treatment week 1, Treatment week 2, Treatment week 3, Treatment week 4, 1-week post treatment, 4-weeks post treatment, 8-weeks post treatment.

• Change in the percentage of subjective (listener-based) single word speech intelligibility following speech intervention measured using the Preschool/Childhood Speech Intelligibility Measure (PSIM/CSIM)

  Baseline (3, 4 or 5 baselines depending on baseline allocation, complete twice weekly pre-treatment), Treatment week 1, Treatment week 2, Treatment week 3, Treatment week 4, 1-week post treatment, 4-weeks post treatment, 8-weeks post treatment.

• Change in subjective (listener-based) sentence level (connected speech) intelligibility following speech intervention measured using the Assessment of the Intelligibility of Dysarthric Speech (ASSIDS)

  Baseline (3, 4 or 5 baselines depending on baseline allocation, complete twice weekly pre-treatment), Treatment week 1, Treatment week 2, Treatment week 3, Treatment week 4, 1-week post treatment, 4-weeks post treatment, 8-weeks post treatment.

• Change in objective measures of speech timing following speech intervention measured using acoustic measures obtained from three short speech tasks (2-minute monologue, diadochokinetic rate (i.e., "pa-pa-pa") and sustained vowel.

  Baseline (3, 4 or 5 baselines depending on baseline allocation, complete twice weekly pre-treatment), Treatment week 1, Treatment week 2, Treatment week 3, Treatment week 4, 1-week post treatment, 4-weeks post treatment, 8-weeks post treatment.

• Change in objective measures of vocal control following speech intervention measured using acoustic measures obtained from three short speech tasks (2-minute monologue, diadochokinetic rate (i.e., "pa-pa-pa") and sustained vowel.

  Baseline (3, 4 or 5 baselines depending on baseline allocation, complete twice weekly pre-treatment), Treatment week 1, Treatment week 2, Treatment week 3, Treatment week 4, 1-week post treatment, 4-weeks post treatment, 8-weeks post treatment.

Study Arms (1)

Motor speech therapy

EXPERIMENTAL

DTTC or ReST

Behavioral: Rapid Syllable Transition Treatment; Behavioral: Dynamic Temporal and Tactile Cueing

Interventions

Rapid Syllable Transition Treatment BEHAVIORAL

ReST is a motor speech treatment targeting prosodic accuracy (correct stress patterns) and smooth transitions between sounds. It uses pseudo-words (also known as nonwords) to remove reliance on meaning and focus on pure motor planning and programming demands (i.e., the core deficit in CAS). Participants will complete 60 minutes of motor speech therapy (ReST), 3 times per week for 4 weeks, totalling 12 treatment sessions.

Motor speech therapy

Dynamic Temporal and Tactile Cueing BEHAVIORAL

DTTC is a motor speech treatment. It is designed to support children with CAS who require intensive modelling, cueing, and motor practice. The treatment focuses on syllables rather than isolated sounds and progresses through a hierarchy of simultaneous production (i.e., with the clinician), immediate (copying), delayed, and spontaneous productions based on performance. Cueing is highly flexible and dynamic to ensure accurate speech movement patterns before practice intensity increases. Participants will complete 60 minutes of motor speech therapy (DTTC), 3 times per week for 4 weeks, totalling 12 treatment sessions.

Motor speech therapy

Eligibility Criteria

• Age: 3 Years - 16 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children aged between 3 and 16 years, with a confirmed genetic condition and a diagnosis of childhood apraxia of speech; English as the primary language at home; able to participate in speech therapy 3 times per week for 4 weeks

You may not qualify if:

• Diagnosis of an acquired brain or movement condition likely to affect speech; currently receiving motor speech therapy in the community; diagnosis of a behavioural condition likely to impact engagement (i.e., unable to participate for 45 minutes, unable to focus attention at the speech therapist's face for a few minutes at a time, unable to say any sounds and/or use gesture, unable to try to copy speech therapist; intolerant to touch (if touch cues are needed for DTTC)

Sponsors & Collaborators

• Murdoch Childrens Research Institute: lead

Study Sites (1)

Murdoch Children's Research Institute

Melbourne, Victoria, 3052, Australia

RECRUITING

Related Publications (20)

• Morgan AT, Amor DJ, St John MD, Scheffer IE, Hildebrand MS. Genetic architecture of childhood speech disorder: a review. Mol Psychiatry. 2024 May;29(5):1281-1292. doi: 10.1038/s41380-024-02409-8. Epub 2024 Feb 16.

  PMID: 38366112 BACKGROUND

• Maas E, Robin DA, Austermann Hula SN, Freedman SE, Wulf G, Ballard KJ, Schmidt RA. Principles of motor learning in treatment of motor speech disorders. Am J Speech Lang Pathol. 2008 Aug;17(3):277-98. doi: 10.1044/1058-0360(2008/025).

  PMID: 18663111 BACKGROUND

• Maas E, Gildersleeve-Neumann C, Jakielski KJ, Stoeckel R. Motor-based intervention protocols in treatment of childhood apraxia of speech (CAS). Curr Dev Disord Rep. 2014 Sep;1(3):197-206. doi: 10.1007/s40474-014-0016-4.

  PMID: 25313348 BACKGROUND

• Scarcella I, Michelazzo L, McCabe P. A Pilot Single-Case Experimental Design Study of Rapid Syllable Transition Treatment for Italian Children With Childhood Apraxia of Speech. Am J Speech Lang Pathol. 2021 Jun 18;30(3S):1496-1510. doi: 10.1044/2021_AJSLP-20-00133. Epub 2021 Apr 8.

  PMID: 33830791 BACKGROUND

• Grigos MI, Case J, Lu Y, Lyu Z. Dynamic Temporal and Tactile Cueing in Young Children With Childhood Apraxia of Speech: A Multiple Single-Case Design. J Speech Lang Hear Res. 2024 Apr 8;67(4):1042-1071. doi: 10.1044/2024_JSLHR-23-00415. Epub 2024 Mar 21.

  PMID: 38512002 BACKGROUND

• Thomas DC, McCabe P, Ballard KJ. Rapid Syllable Transitions (ReST) treatment for Childhood Apraxia of Speech: the effect of lower dose-frequency. J Commun Disord. 2014 Sep-Oct;51:29-42. doi: 10.1016/j.jcomdis.2014.06.004. Epub 2014 Jul 6.

  PMID: 25052390 BACKGROUND

• Thomas DC, McCabe P, Ballard KJ, Lincoln M. Telehealth delivery of Rapid Syllable Transitions (ReST) treatment for childhood apraxia of speech. Int J Lang Commun Disord. 2016 Nov;51(6):654-671. doi: 10.1111/1460-6984.12238. Epub 2016 May 10.

  PMID: 27161038 BACKGROUND

• Strand EA. Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech. Am J Speech Lang Pathol. 2020 Feb 7;29(1):30-48. doi: 10.1044/2019_AJSLP-19-0005. Epub 2019 Dec 17.

  PMID: 31846588 BACKGROUND

• Kratochwill TR, Levin JR. Enhancing the scientific credibility of single-case intervention research: randomization to the rescue. Psychol Methods. 2010 Jun;15(2):124-44. doi: 10.1037/a0017736.

  PMID: 20515235 BACKGROUND

• Krasny-Pacini A, Evans J. Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide. Ann Phys Rehabil Med. 2018 May;61(3):164-179. doi: 10.1016/j.rehab.2017.12.002. Epub 2017 Dec 15.

  PMID: 29253607 BACKGROUND

• Vogel AP, Stoll LH, Oettinger A, Rommel N, Kraus EM, Timmann D, Scott D, Atay C, Storey E, Schols L, Synofzik M. Speech treatment improves dysarthria in multisystemic ataxia: a rater-blinded, controlled pilot-study in ARSACS. J Neurol. 2019 May;266(5):1260-1266. doi: 10.1007/s00415-019-09258-4. Epub 2019 Mar 6.

  PMID: 30840144 BACKGROUND

• Pennington L, Lombardo E, Steen N, Miller N. Acoustic changes in the speech of children with cerebral palsy following an intensive program of dysarthria therapy. Int J Lang Commun Disord. 2018 Jan;53(1):182-195. doi: 10.1111/1460-6984.12336. Epub 2017 Jul 17.

  PMID: 28714530 BACKGROUND

• Yorkston KM, Beukelman DR. Communication efficiency of dysarthric speakers as measured by sentence intelligibility and speaking rate. J Speech Hear Disord. 1981 Aug;46(3):296-301. doi: 10.1044/jshd.4603.296.

  PMID: 7278175 BACKGROUND

• Maas E, Gildersleeve-Neumann C, Jakielski K, Kovacs N, Stoeckel R, Vradelis H, Welsh M. Bang for Your Buck: A Single-Case Experimental Design Study of Practice Amount and Distribution in Treatment for Childhood Apraxia of Speech. J Speech Lang Hear Res. 2019 Sep 20;62(9):3160-3182. doi: 10.1044/2019_JSLHR-S-18-0212. Epub 2019 Aug 19.

  PMID: 31425660 BACKGROUND

• Gomez M, Purcell A, Jakielski K, McCabe P. A single case experimental design study using an operationalised version of the Kaufman Speech to Language Protocol for children with childhood apraxia of speech. Int J Speech Lang Pathol. 2024 Apr;26(2):194-211. doi: 10.1080/17549507.2023.2211750. Epub 2023 Oct 19.

  PMID: 37855390 BACKGROUND

• McKechnie J, Ahmed B, Gutierrez-Osuna R, Murray E, McCabe P, Ballard KJ. The influence of type of feedback during tablet-based delivery of intensive treatment for childhood apraxia of speech. J Commun Disord. 2020 Sep-Oct;87:106026. doi: 10.1016/j.jcomdis.2020.106026. Epub 2020 Jul 8.

  PMID: 32693310 BACKGROUND

• McCabe P, Preston JL, Evans P, Heard R. A Pilot Randomized Control Trial of Motor-Based Treatments for Childhood Apraxia of Speech: Rapid Syllable Transition Treatment and Ultrasound Biofeedback. Am J Speech Lang Pathol. 2023 Mar 9;32(2):629-644. doi: 10.1044/2022_AJSLP-22-00144. Epub 2023 Feb 27.

  PMID: 36848673 BACKGROUND

• Morgan AT, Murray E, Liegeois FJ. Interventions for childhood apraxia of speech. Cochrane Database Syst Rev. 2018 May 30;5(5):CD006278. doi: 10.1002/14651858.CD006278.pub3.

  PMID: 29845607 BACKGROUND

• Murray E, McCabe P, Ballard KJ. A systematic review of treatment outcomes for children with childhood apraxia of speech. Am J Speech Lang Pathol. 2014 Aug;23(3):486-504. doi: 10.1044/2014_AJSLP-13-0035.

  PMID: 24686844 BACKGROUND

• Murray E, McCabe P, Ballard KJ. A Randomized Controlled Trial for Children With Childhood Apraxia of Speech Comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme-Third Edition. J Speech Lang Hear Res. 2015 Jun;58(3):669-86. doi: 10.1044/2015_JSLHR-S-13-0179.

  PMID: 25807891 BACKGROUND

MeSH Terms

Conditions

Apraxias; Genetic Diseases, Inborn; Communication Disorders

Condition Hierarchy (Ancestors)

Psychomotor Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Miya D St John, PhD

  Murdoch Childrens Research Institute

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Miya D St John, PhD

CONTACT

+610399366586; miya.stjohn@mcri.edu.au

Maddy K Hill, MSpPath

CONTACT

+610399366586; maddy.hill@mcri.edu.au

Study Design

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

Model Details: Multiple baseline single case experimental design

Study Record Dates

• First Submitted: September 6, 2026
• First Posted: September 11, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2028
• Last Updated: September 11, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

AU (1)