Treatment of sound errors in aphasia and apraxia of speech: Effects of phonological complexity

Abstract

BACKGROUND: Recent research suggests that the complexity of treatment stimuli influences the effectiveness of treatment. However, no studies have examined the role of complexity on sound production treatment in adult individuals with sound production impairments. AIMS: This study examines effects of syllable complexity on treatment outcome in two patients with acquired sound production problems. Complexity is defined in terms of syllable structure: clusters are more complex than singletons. Using a single-subject multiple-baseline design, we address the question: Is treatment of complex syllables more effective than treatment of simple syllables? METHODS #ENTITYSTARTX00026; PROCEDURES: Two patients with aphasia and apraxia of speech were trained to produce complex or simple syllables (using modelling). Improvement was measured by percent correct on a word and nonword repetition test. OUTCOMES #ENTITYSTARTX00026; RESULTS: We found that both treatment on simple syllables and treatment on complex syllables led to improved production of simple syllables, while treatment of complex syllables also led to improvement on some complex syllables for one of the two patients. CONCLUSIONS: These results suggests that training complex items is more effective than training simple items, at least for some patients. Possible reasons for lack of stronger effects are discussed, as well as directions for future research.

Complexity in Language Learning and Treatment

“…In addition, the complexity account is buttressed by evidence from other sources. Complexity training effects have been found in individuals with acquired apraxia of speech, with sound acquisition and generalization patterns similar to those shown by Gierut in children with phonological delays (Maas, Barlow, Robin, & Shapiro, 2002). Children with specific language impairment show acquisition and generalization of whmovement structure in a manner much like that noted by Thompson and Shapiro for adults with aphasia (Ebbles & van der Lely, 2002;Levy & Friedmann, in press).…”

Treating agrammatic aphasia within a linguistic framework: Treatment of Underlying Forms

“…Furthermore, training marked structures (e.g., defined in terms of sonority or cluster formation) results in greater system-wide changes than training unmarked structures (see, for example, Gierut, 1998;Gierut & Champion, 2001; see also Archibald, 1998;Barlow, 2001, for evidence from L2 phonological acquisition). We have also observed such complexity training effects with adult individuals with apraxia of speech (Maas, Barlow, Robin, & Shapiro, 2002) and those with fluent aphasia and naming deficits . Finally, evidence for the complexity hypothesis also comes from domains outside language (e.g., in maths learning, Yao, 1989;and in motor learning, Schmidt & Lee, 1999).…”

Do principles of motor learning enhance retention and transfer of speech skills? A systematic review

“…Currently, evidence from the limb motor learning literature is inconsistent; there are studies to support both the use of training simple targets and those that support the training of more complex targets. Only one study has investigated the effects of target complexity on speech motor learning in individuals with motor speech disorders while controlling for complexity condition (Maas, Barlow, Robin, & Shapiro, 2002;Schneider & Frens, 2005). Downloaded by [University of California, San Diego] at 08:54 08 June 2015…”