12 Nov Weekly Treatment for Childhood Apraxia of Speech With Rapid Syllable Transition Treatment: A Single-Case Experimental Design Study
Summary by Donna Thomas PhD
In many countries around the world, children with childhood apraxia of speech (CAS) receive one session per week of speech therapy. It is important to know whether this is effective and if it produces widespread improvements in children’s speech. This study investigated the effectiveness of one session per week of Rapid Syllable Transition Treatment (ReST) for five children with CAS aged 4- 8 years. During ReST treatment, children learn to improve their production of speech sounds and prosody (smoothly connecting the syllables, emphasising the right syllable). ReST treatment uses non-words such as ‘kedeefa’ and ‘bledorki’. Previous research has shown that ReST treatment on non-words leads to improvements in the ability to say real words.
ReST treatment was provided in 50-minute sessions, once per week, across 12 weeks in a university clinic. In this study, we collected information about the children’s accuracy with non-words in their treatment session. This allowed us to determine whether the children were responding to the cues they were given in the sessions. More importantly, we also collected information about their ability to say real and non-words outside of treatment sessions, and we monitored to see if there was any change between baseline (before treatment started), during therapy sessions across the 12-weeks of the treatment, and follow-up (after the treatment block ended). This allowed us to determine whether the children were retaining their improvements and transferring those improvements to real words.
All five children improved their production of non-words in the treatment sessions. This showed that they were responding to the ReST cues they received in the sessions. Even though all the children got better at saying non-words in their therapy sessions, only three children retained those improvements outside of the therapy sessions. For two children, the gains made in the treatment sessions were not retained. The real test of the effectiveness of any treatment is the children’s improvement with their production of untreated real words. In this study, only one of the five children improved with their production of untreated real words.
ReST treatment, when it is provided once per week, is not recommended. Only one child out of five showed improvement in real words following the treatment block. ReST therapy should be completed 2-4 times per week, as studies demonstrated most children improve with their production of real words following treatment.
This study also showed us that children’s improvements with treatment words in treatment sessions are not a reliable indicator of the effectiveness of the treatment. Effectiveness needs to be measured outside of treatment sessions (when the child is not being given cues about how to improve their speech), on untreated as well as treated items.
A copy of this study is available by emailing Donna Thomas (donna.thomas@sydney.edu.au).
Thomas, D., Murray, E., Williamson, E., & McCabe, P. (2024). Weekly Treatment for Childhood Apraxia of Speech With Rapid Syllable Transition Treatment: A Single-Case Experimental Design Study. Journal of Speech, Language, and Hearing Research, 67 (9S). 3392-3413. https://doi.org/10.1044/2023_JSLHR-22-00665
Summary by Donna Thomas PhD
In many countries around the world, children with childhood apraxia of speech (CAS) receive one session per week of speech therapy. It is important to know whether this is effective and if it produces widespread improvements in children’s speech. This study investigated the effectiveness of one session per week of Rapid Syllable Transition Treatment (ReST) for five children with CAS aged 4- 8 years. During ReST treatment, children learn to improve their production of speech sounds and prosody (smoothly connecting the syllables, emphasising the right syllable). ReST treatment uses non-words such as ‘kedeefa’ and ‘bledorki’. Previous research has shown that ReST treatment on non-words leads to improvements in the ability to say real words.
ReST treatment was provided in 50-minute sessions, once per week, across 12 weeks in a university clinic. In this study, we collected information about the children’s accuracy with non-words in their treatment session. This allowed us to determine whether the children were responding to the cues they were given in the sessions. More importantly, we also collected information about their ability to say real and non-words outside of treatment sessions, and we monitored to see if there was any change between baseline (before treatment started), during therapy sessions across the 12-weeks of the treatment, and follow-up (after the treatment block ended). This allowed us to determine whether the children were retaining their improvements and transferring those improvements to real words.
All five children improved their production of non-words in the treatment sessions. This showed that they were responding to the ReST cues they received in the sessions. Even though all the children got better at saying non-words in their therapy sessions, only three children retained those improvements outside of the therapy sessions. For two children, the gains made in the treatment sessions were not retained. The real test of the effectiveness of any treatment is the children’s improvement with their production of untreated real words. In this study, only one of the five children improved with their production of untreated real words.
ReST treatment, when it is provided once per week, is not recommended. Only one child out of five showed improvement in real words following the treatment block. ReST therapy should be completed 2-4 times per week, as studies demonstrated most children improve with their production of real words following treatment.
This study also showed us that children’s improvements with treatment words in treatment sessions are not a reliable indicator of the effectiveness of the treatment. Effectiveness needs to be measured outside of treatment sessions (when the child is not being given cues about how to improve their speech), on untreated as well as treated items.
A copy of this study is available by emailing Donna Thomas (donna.thomas@sydney.edu.au).
Thomas, D., Murray, E., Williamson, E., & McCabe, P. (2024). Weekly Treatment for Childhood Apraxia of Speech With Rapid Syllable Transition Treatment: A Single-Case Experimental Design Study. Journal of Speech, Language, and Hearing Research, 67 (9S). 3392-3413. https://doi.org/10.1044/2023_JSLHR-22-00665
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