Sound Production Treatment: Synthesis and Quantification of Outcomes

Bailey, Dallin and Eatchel, Kelly and Wambaugh, Julie (2014) Sound Production Treatment: Synthesis and Quantification of Outcomes. [Clinical Aphasiology Paper]

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Abstract

Treatment for acquired apraxia of speech (AOS) has taken numerous forms, with positive outcomes reported for most treatments. Following a critical evaluation and synthesis of the AOS treatment literature, AOS treatment guideline developers concluded that “taken as a whole, the AOS treatment literature indicates that individuals with AOS may be expected to make improvements in speech production as a result of treatment, even when AOS is chronic….and the strongest evidence for this conclusion exists for treatments designed to improve articulatory kinematic aspects of speech production” (Wambaugh, Duffy, McNeil, Robin, & Rogers, 2006; p.lxii ). This conclusion was based upon general criteria concerning the overall quantity and quality of the evidence-base. Strom (2008) subsequently confirmed the positive effects of articulatory-kinematic AOS treatment approaches using meta-analysis. The AOS guidelines developers grouped treatment studies by general focus (e.g., articulatory-kinematic, rate/rhythm, intersystemic reorganization, and alternative/augmentative); at the time of the guidelines report, no one treatment had a sufficient database to warrant individual consideration (Wambaugh et al., 2006). Over the past decade, additional AOS treatment evidence has accumulated with investigations moving toward comparisons of treatment approaches (Wambaugh, Mauszycki, & Ballard, 2013). Sound Production Treatment (SPT; Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998) is an articulatory-kinematic AOS treatment that has received relatively systematic study over the past 15 years. There are now sufficient reports of SPT to support its evaluation as a specific approach rather than as part of the general category of articulatory-kinematic approaches. A synthesis and quantification of the effects of SPT is needed to permit comparison to other treatments, to allow evaluation of different applications of SPT, and to facilitate examination of generalization effects of treatment. The purpose of the current investigation was to quantify the effects of SPT in terms of the magnitude of change (i.e., effect size) associated with treatment and follow-up phases of efficacy studies.

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