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COMPLETED

NCT03903120

PHASE1

ASSIST: Treatment for Childhood Apraxia of Speech

Sponsor: Temple University

View on ClinicalTrials.gov

Summary

Childhood apraxia of speech (CAS) is a pediatric motor speech disorder that impairs the planning of movements needed for intelligible speech. Children with CAS often show little or slow progress in standard speech therapy. This research is a Phase 1 study that tests initial efficacy and optimal parameters of a theoretically based integral stimulation treatment called ASSIST (Apraxia of Speech Systematic Integral Stimulation Treatment). In four small randomized group design studies across three recruitment cycles (N=20 per cycle), children receive 16 hours of individual ASSIST. The studies systematically investigate the effect of treatment (ASSIST vs. no ASSIST; Study 1), the effect of complexity (complex vs. simple utterances; Study 2), the effect of lexicality (word vs. nonword targets; Study 3), and the effect of treatment intensity (Massed vs. Distributed ASSIST; Study 4). Studies 1 and 4 also systematically examine the effect of treatment on functional outcome measures, including parent ratings of intelligibility and communicative participation, and objective intelligibility measures obtained from unfamiliar listeners.

Official title: ASSIST: Child Apraxia Speech Treatment

Key Details

Gender

All

Age Range

4 Years - 9 Years

Study Type

INTERVENTIONAL

Enrollment

Start Date

2019-04-18

Completion Date

2025-11-30

Last Updated

2026-05-22

Healthy Volunteers

Yes

Conditions

Childhood Apraxia of Speech

Interventions

BEHAVIORAL

ASSIST

Integral stimulation based treatment ("watch me, listen to me, say what I say") for CAS that is based on principles of motor learning and neuroplasticity and includes a systematic approach to adaptive practice. Treatment includes a focus on prosody, use of visual, tactile, auditory cues, slowing speech rate, and large amounts of practice.

Inclusion Criteria: 1. Age between 4;0 and 9;11 (years;months) at enrollment, based on parent report. 2. From homes where the primary language spoken is English, based on parent report. 3. Verbal output (50+ words) and communicative intent, as determined by the clinician and parent report. 4. Speech sound disorder, as determined by a score \<16th percentile on the Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation Assessment (Dodd et al., 2006) and/or the Goldman-Fristoe Test of Articulation (Goldman \& Fristoe, 2015). 5. CAS as a primary speech diagnosis, based on the following criteria: 1. An average rating \> 1 across three expert speech-language pathologists (SLPs), who will independently rate presence of CAS in children live or from video recordings of the assessment using a 3-point scale (0 = no CAS, 1 = possible CAS, 2 = CAS). These judgments will be based on perceptual speech features of CAS (inconsistent vowel and consonant errors, difficulties achieving and transitioning into articulatory configurations, abnormal prosody). 2. An Apraxia Score of 1 or 2 on a Maximum Performance protocol in which they sustain vowels and fricatives as long as possible and repeat syllables as fast as possible (Rvachew et al., 2005; Thoonen et al., 1999). 6. Normal hearing based on parent report or passing a standard pure-tone audiometry hearing screening at 500, 1000, 2000, and 4000 Hz (ASHA, 1997). 7. Typical nonverbal cognition as determined by a T-score within 1.5 standard deviation (SD) of the mean on nonverbal subtests of the Reynolds Intellectual Assessment Scales (Reynolds \& Kamphaus, 2003). Exclusion Criteria: 1. Diagnosis of disorder that significantly affects communication and/or social interactions (e.g., autism), as per referral diagnosis. 2. Uncorrected vision impairments that may interfere with ability to process visual cues used in treatment, as per parent report. 3. Significant impairments of oral structure (e.g., cleft palate) as judged by the SLP based on an oral mechanism exam (Robbins \& Klee, 1987). 4. A primary diagnosis of dysarthria, as judged by the SLP. 5. Unrelated health concerns that prevent children from participating, per parent report. 6. Inability to meet toileting needs independently or separate from parent for a full day (as needed for camp), based on parent report.

Locations (1)

Temple University

Philadelphia, Pennsylvania, United States