Does Speech Sounds on Cue provide an evidence based treatment for Apraxia of Speech?
The short answer is yes it does – and it is also user friendly, allowing people with Apraxia of Speech and Aphasia to practice independently and frequently on their devices.
Speech Sounds on Cue was developed by Australian Speech Pathologist Carol Bishop who wanted to extend the work she was doing in the clinic so her clients could practice independently at home.
The treatment is an articulatory-kinematic therapeutic approach. It uses a combination of repeated, motoric practice; modeling-repetition; integral stimulation; and articulatory cueing which are all common to articulatory-kinematic treatments. (see Rosenbeck et al.,1973)
Apraxia of speech (AOS) is a disorder of expressive speech attributed to an impairment at the motor planning and programming phases of speech production. The articulatory-kinematic approach is an approach to treatment of AOS based on the principles of motor learning, which focus on the spatial and temporal aspects of movement. (Duffy, 2013)
A recent Systematic Review concluded that the existing evidence base for AOS treatment indicates that individuals with AOS can benefit from treatment even when AOS is considered chronic (Wambaugh et al., 2006b). This report by the AOS Treatment Guidelines Committee found a substantial body of evidence supporting the use of articulatory-kinematic treatments for AOS. The committee recommended that “articulatory kinematic approaches be utilized with individuals with moderate-to-severe AOS who demonstrate disrupted communication due to disturbances in the spatial and temporal aspects of speech production” (Wambaugh et al., 2006b p.lxii).
The first version of Speech Sounds on Cue was developed in 1999 by Australian Speech Pathologist Carol Bishop. Carol was a pioneer in developing computer software to assist her clients to practice their speech independently outside the clinic. The initial program released in 1999 was a Widows program called Dyspraxia Drills on Disc. It was based on the work of Australian Speech Pathologist Betty Hill (Hill, 1978) combined with Roenbek’s Integral Stimulation technique, (Rosenbeck et al.,1973)
Because Apraxia of Speech often co-occurs with Aphasia, ( Duffy, 2013), Carol included extra cues to assist people who also have Aphasia (Photos for confrontation naming and carrier phrase and written word cues)
The program was further developed in 2004 and 2011 as the Windows program Speech Sounds on Cue to include the principals of Motor Learning (see Maas et al.,2008).
Because people with AOS and/or Aphasia can practice any time on their touchscreen computer, iPhone or iPad, it allows frequent practice of drills. It allows distributed practice in short bursts over the day and week which is not possible by just working on speech in the clinic. The app allows people to move through the phases starting with acquision of the speech sounds with simple repetitive blocked practice to acquire the sound (when “Basic Practice” is selected). Once the motor speech skill is acquired, the person can select “Random Practice” exercises and work on 2 or 3 sounds at a time to enhance learning or work on Rhyming words for more variation, or can start to name the pictures with the sound turned of or say the whole sentences as well as the target words.
There are free lite versions of both the Australian and US voice versions available on the app store to enable people with Apraxia or Aphasia to see if it assists them to improve.
Ballard, K. J., Wambaugh, J. L., Duffy, J. R., Layfield, C., Maas, E., Mauszycki, S., & McNeil, M. R. (2015). Treatment for acquired apraxia of speech: A systematic review of intervention research between 2004 and 2012. American Journal of Speech-Language Pathology, 24, 316-327.
Duffy, J. (2013).Apraxia of Speech. In J. Duffy (Ed.), Motor speech disorders: Substrates, differential diagnosis and management (3rd ed). St. Louis: Elsevier Mosby.
Hill, B. (1978).Verbal dyspraxia in clinical practice. Carlton, Vic. Pitman Medical Australia.
Maas, E., Robin, D. A., Austermann Hula, S. N., Freedman, S. E., Wulf, G., & Ballard, K. J. (2008).Principles of motor learning in treatment of motor speech disorders. American Journal of Speech Language Pathology, 17, 277-298.
Rosenbek, J. C., Lemme, M. L., Ahern, M. B., Harris, E. H., & Wertz, R. T. (1973). A treatment for apraxia of speech in adults. Journal of Speech and Hearing Disorders, 38, 462–472.
Wambaugh, J. L., Duffy, J. R., McNeil, M. R., Robin, D. A., & Rogers, M. (2006a). Treatment guidelines for acquired apraxia of speech: A synthesis and evaluation of the evidence. Journal of Medical Speech-Language Pathology, 14(2), xv–xxxiii.
Wambaugh, J. L., Duffy, J. R., McNeil, M. R., Robin, D. A., & Rogers, M. (2006b). Treatment guidelines for acquired apraxia of speech: Treatment descriptions and recommendations. Journal of Medical Speech-Language Pathology, 14(2), xxxv–ixvii.