SLPOtherClinical linguistics & phonetics2018

Changes in movement transitions across a practice period in childhood apraxia of speech.

Maria I Grigos, Julie Case

PMID 29281317

WHAT IT FOUND

Practice improved overall word accuracy in children with apraxia but did not generalize to unpracticed words.

Kinematic data showed children refined jaw movement variability in practiced real words, suggesting motor learning occurs at a level too subtle for standard transcription to detect.

Key findings

01Consonant and vowel accuracy for practiced words significantly improved from baseline to post-practice and were maintained three days later.

02Practice gains did not transfer to non-practiced control words, with no significant changes in accuracy for those tokens.

03Jaw movement variability decreased significantly from immediate post-practice to the three-day follow-up for the practiced real word, indicating refined motor control.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample size was very small (n=8 per group), limiting the generalizability of the findings. Participants had age-appropriate language and cognition, excluding children with CAS who have co-occurring language impairments, which are common. Kinematic analysis was restricted to accurate productions, meaning the study could not examine movement patterns during error production. The study focused only on the consonant-to-vowel transition, ignoring other critical transitions like vowel-to-consonant or syllable-to-syllable.

The easy way to misread this

Do not interpret the lack of generalization to non-practiced words as a failure of the treatment approach. The study used a single 20-minute practice session, which is far less intensive than clinical therapy. The authors note this duration was likely insufficient to elicit carryover, so this result does not mean practice fails to generalize in real-world treatment.

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