An exciting new collaboration between McGill University and the MAB-Mackay Rehabilitation Centre is seeking to develop better therapies for Childhood Apraxia of Speech (CAS).As an added benefit of this project, McGill Speech-Language Pathology students are learning to treat this difficult neuromotor speech disorder and providing important clinical services to the CAS population.
CAS is characterized by a difficulty in executing motor programs, which leads to poor control of voluntary speech. Speech is effortful and usually unintelligible. Children with CAS have quite variable profiles and there are currently no established treatment methods found to work for everyone. Even experienced speech-language pathologists find CAS very difficult to treat. It is a real challenge for the McGill students to treat children with CAS but they are proud to help develop new knowledge in this area where it is so lacking.
Treating Apraxia of Speech in Children (TASC) is a research project funded by the Childhood Apraxia of Speech Association of North America (CASANA). It is coordinated by McGill University researchers from the department of Communication Sciences and Disorders, under the direction of Dr. Susan Rvachew. The student speech-language pathologists are supervised by Tanya Matthews, Megan Braun, and Sophie Vaillancourt. The project is being carried out at the MAB-Mackay Rehabilitation Centre in Montreal.
The goal of the project is to investigate the effectiveness of speech therapies that are based on principles of motor learning. Motor learning determines how we are able to acquire motor skills such as riding a bike, playing the piano, and in this case, even speaking. Different types of practice and feedback can affect the way a new motor program is learned. Different combinations of practice and feedback conditions may be more-or-less effective with different children depending upon the underlying characteristics of their speech problem. In this study, the children sometimes receive a treatment that teaches them to listen carefully to speech to better perceive the target words and detect errors in their own speech; other times the children receive a treatment that teaches them to use visual cues to help them articulate and sequence speech sounds correctly in words.
Over the course of 24 weeks between January and July 2013, a total of 11 children with CAS received speech therapy for free at the Mackay Rehabilitation Centre. Within the TASC framework, each child received three therapy sessions a week for six weeks. Each therapy session was about one hour long, for a total of 18 hours of treatment. Meanwhile, McGill researchers collected data on the children’s progress for their particular speech goals under different treatment conditions.
The benefits of this project are multifold. For one, it provides specialized treatment to a population for which services are often lacking or inadequate. “Many parents were grateful for the service and the chance just to get their child into therapy,” says Tanya Matthews, TASC project coordinator. “They were also thankful that the information we collect here can be used later to help their child in their private therapy by really tailoring the therapy to their needs.” In terms of the children’s response to therapy, positive reports from parents have already come in. One mother says that her child started using L-blends at home, thus showing generalization of speech goals from the therapy context to real-world contexts.
On the research side of things, another major benefit of the project is the potential to find which treatment methods are the most effective with the CAS population. “This study will help speech-language pathologists match treatment approaches to the individual characteristics of their clients, including severe cases of childhood apraxia of speech,” says Matthews. This is of huge importance to the field of speech-language pathology and could lead to more clinicians being able to effectively treat the condition.
Finally, the TASC project has provided educational opportunities for McGill speech-pathology students, who ran the majority of the therapy sessions as part of their clinical practica. “It’s very good experience to be able to work with this population,” says Amanda Ovadia, student clinician. “Childhood apraxia of speech is not always something students get a lot of exposure to.”
Over the next few months the TASC group data will be analyzed in order to determine the treatment methods that were most effective with the patients. Additionally, each family will be informed of their child’s individual progress, information that will be most useful when the child returns to their private or school therapists. All in all, by combining clinical education, therapy and research, the TASC project is paving the way to a clearer understanding of childhood apraxia of speech and better treatment methods to serve those in need.
