Understanding Childhood Apraxia of Speech & Efficacious Approaches to Clinical Management Julie Case, Ph.D., CCC-SLP
Speech-Language-Hearing Sciences - Hofstra University
In Progress
Research Program Our research program includes the following objectives: 1. Advance current understanding of the underlying motor deficits of Childhood Apraxia of Speech (CAS) as compared to other Speech Sound Disorders (SSD) and how speech motor impairment impacts speech performance within varied contexts. 2. Investigate effects of motor-based intervention, such as Dynamic Temporal and Tactile Cuing (DTTC; Strand, 2020), on speech production accuracy, speech motor control, and approaches to optimize treatment gains for children with CAS. 3. Explore the intersect between speech motor performance and language skills, including potential trade-off effects between speech and morphosyntactic domains.
Research Methods Multidimensional Analyses of Speech Production: Speech Production Accuracy: Narrow Phonetic Transcription Analyses
The Multi-Component Rating Scale (MCRS): A Novel Measure of Speech Accuracy in Childhood Apraxia of Speech (in collaboration with NYU & supported by the Hofstra Faculty Research and Development Grant)
= “bupPY”
Segmental Accuracy (0/1)
Word Structure (0/1)
Prosody (0/1)
Movement Transition (0/1)
Score: (0 + 1 + 0 + 1)/4
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0.25
Relationship between Speech Production Accuracy & Morphosyntax in Children with Speech Sound Disorders within Story Retell (in collaboration with Karolinska Institutet) Speech Accuracy and Errors
Objective: To examine the relationship between speech production and morphosyntactic abilities in children with CAS and other SSDs in the context of story retell.
Clinical Implications of Speech Motor Control Research Case, J., & Grigos, M. I. (2020). How the study of speech motor control can inform assessment and intervention in CAS. Perspectives of the ASHA Special Interest Groups, 5(4), 784-793.
Correspondence: julie.case@hofstra.edu
CAS SSD TD
1
8-weeks DTTC Treatment + No Coaching
Home Practice (4-weeks)
Research Question: How does DTTC treatment combined with caregiver training impact speech production accuracy and speech motor control in children with CAS? Hypotheses: It is hypothesized that DTTC combined with caregiver training will result in improved speech production and refined speech motor control which will generalize to untreated targets and be maintained post-treatment.
PPC
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Our Team
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A Framework for Motoric Complexity Case, J., & Grigos, M. I. (2020). A framework of motoric complexity: An investigation in children with typical and impaired speech production. Journal of Speech, Language, and Hearing Research, 63(10), 3326-3348.
8-weeks DTTC Treatment + Caregiver Coaching
Caregiver Education Module
Currently measuring Inter- and Intra- Rater Reliability
Acoustic Spatiotemporal Index (aSTI)
Multidimensional Analysis of Variability Case, J., & Grigos, M. I. (2021). The Effect of Practice on Variability in Childhood Apraxia of Speech: A Multidimensional Analysis. American Journal of Speech-Language Pathology, 30, 1477-1495.
Objective: To measure if caregiver training can optimize treatment outcomes over the course of an 8-week intervention period in children with CAS (2.5-7 years of age).
SLPs apply MCRS to 3 blocks of words (39 words each block) produced by 2-4 year old children with CAS via an online experimental platform (Gorilla)
Speech Motor Control: Acoustic Analyses of Duration & Variability
Recent Work
The Effect of Caregiver Training of Dynamic Temporal & Tactile Cuing (DTTC) Treatment Outcomes in Childhood Apraxia of Speech (in collaboration with New York University with support from the Once Upon a Time Foundation)
Current Study: 30 Speech Language Pathologists (SLPs) receive online training about the MCRS + guided practice using this measure
“apraxia” /ə.ˈpræk.ˌsi.ə/
Acoustic Waveform & Spectrogram
In Development
β = -0.38, SE = 0.15, z = -2.56, p = 0.01 0
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Proportion C-units with Errors
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A lower PPC significantly increased the likelihood of linguistic errors in a C-unit in a narrative retell task after controlling for age and expressive language scores.
An Innovative Model for Treatment Delivery and Clinician Training Objective: A case study to investigate the effect of DTTC intervention on speech production accuracy and speech motor control in a 5 year old Spanish-speaking child (located in Mexico) in the context of teletherapy delivered by a clinician with expertise in CAS (located in the US) and the child’s local clinician (located in Mexico) following a training protocol.
Assessment + Baseline Data Collection
4-weeks: DTTC TeleTreatment (expert clinician)
4-weeks: DTTC Tele-Treatment (transition to local clinician)
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Clinician Training Phase I: Foundations of CAS & Motor-Based Treatment
Clinician Training Phase II: Guided Observation
Clinician Training Phase III: (Dynamic Coaching)
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Research Assistants Kelly Sullivan (‘22) Lacie Berkowitz (‘23) Abigail Brown (‘23)
Gabriela Lovishuk (‘23) Lauren DiGregorio (‘23) Olivia Hinchcliffe (‘23)
Collaborators Maria Grigos, New York University Anna Eva Hallin, Karolinska Institutet Hailey Kopera, Iona University Emily Wang, New York University
Contact Us Lab Director: Julie Case Email: julie.case@hofstra.edu Website: www.casespeechlab.com
Hofstra Faculty Research Day 2021