Motor-based Intervention for Childhood Apraxia of Speech

Overseen By Maria I Grigos, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: New York University

Disqualifiers: Neurological, Developmental, Genetic disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 43

Duration: 8 weeks

72 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Dynamic Temporal and Tactile Cuing (DTTC) for childhood apraxia of speech?

Research shows that motor-based interventions like DTTC can improve speech intelligibility in children with childhood apraxia of speech. Additionally, similar treatments have been linked to changes in brain structures related to speech, suggesting a potential neurobiological effect. ^{1 2 3 4 5}

Is Dynamic Temporal and Tactile Cueing (DTTC) safe for use in humans?

The research articles provided do not contain specific safety data for Dynamic Temporal and Tactile Cueing (DTTC) or related motor-based interventions for childhood apraxia of speech. ^{1 4 5 6 7}

How is the Dynamic Temporal and Tactile Cueing (DTTC) treatment different from other treatments for childhood apraxia of speech?

DTTC is unique because it focuses on motor-based intervention, using specific timing and touch cues to help children improve their speech. This approach is different from other treatments as it emphasizes practicing speech movements and adjusting them in real-time, which can lead to changes in brain pathways related to speech. ^{1 2 3 4 5}

What is the purpose of this trial?

This trial tests a special method called DTTC to help young children with speech difficulties improve their speaking skills. The method uses touch and timing cues to guide mouth movements, aiming to make their speech clearer. The study focuses on young children who have trouble coordinating their speech.

Research Team

Maria I Grigos, PhD

Principal Investigator

New York University

Eligibility Criteria

This trial is for children aged 2.5 to almost 8 years with Childhood Apraxia of Speech (CAS) who have never had DTTC treatment, can pass a hearing test, and show specific speech difficulties without other neurological or developmental disorders.

Inclusion Criteria

My child has been diagnosed with CAS, showing specific speech difficulties.

I am between 2.5 and 8 years old.

I have never received DTTC treatment.

Exclusion Criteria

My child has a speech fluency disorder, even though they have been diagnosed with CAS.

I have been treated with DTTC before.

I have hearing loss, even though I also have CAS.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-3 weeks

1 visit (in-person)

Pre-Treatment

Probe data collection before treatment begins

5 weeks

5 visits (in-person)

Treatment

Participants receive DTTC treatment four times per week for 8 weeks

8 weeks

32 visits (in-person)

Maintenance

Probe data collection to assess maintenance of treatment effects

5 weeks

5 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Dynamic Temporal and Tactile Cuing

Trial Overview The study tests the effectiveness of Dynamic Temporal and Tactile Cuing (DTTC), a motor-based speech therapy, on improving word production in kids with CAS. It looks at how well they learn treated words, if it helps with untreated words, and if improvements last after treatment ends.

Participant Groups

Group I: Immediate Treatment Experimental Treatment 1 Intervention

Participants in the Immediate Treatment Group will receive DTTC Treatment four times per week (45-minute sessions each) for 8 weeks. Total duration will be 180 minutes/week over 32 sessions. Treatment will begin between 1-3 weeks following the diagnostic evaluation.

Group II: Delayed Treatment Experimental Treatment 1 Intervention

The Delayed Treatment Group serves as a control during the period in which participants are waiting to begin treatment. A delayed treatment onset is employed to control for maturation effects. Participants in the Delayed Treatment Group will receive DTTC Treatment four times per week (45-minute sessions each) for 8 weeks. Total duration will be 180 minutes/week over 32 sessions. Treatment will begin after an 8-week delay following the diagnostic evaluation.

Who Is Running the Clinical Trial?

New York University

Lead Sponsor

Trials

249

Recruited

229,000+

Findings from Research

Children with childhood apraxia of speech (CAS) showed significant improvements in speech intelligibility after undergoing a motor-based intervention called dynamic temporal and tactile cueing (DTTC), with these improvements maintained for at least 6 weeks post-treatment.

The study involved 120 naive listeners who rated the speech of five children, revealing that while individual listeners were consistent in their ratings (intrarater reliability), there was considerable variability between different listeners (interrater reliability), suggesting that using naive listeners in assessments may require careful consideration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Naive Listener Ratings of Speech Intelligibility Over the Course of Motor-Based Intervention in Children With Childhood Apraxia of Speech. Wang, EW., Grigos, MI.[2023]

In a study involving 10 children with childhood apraxia of speech, both motor speech treatment (PROMPT) and language, nonspeech oral motor treatment led to improvements in speech, which were associated with changes in the brain's left ventral corticobulbar tract.

The PROMPT treatment specifically resulted in additional positive changes in the left dorsal corticobulbar tract, suggesting that this multimodal approach may have beneficial neurobiological effects on speech motor control.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series. Fiori, S., Pannek, K., Podda, I., et al.[2022]

In a study involving 16 children aged 5-6, those with childhood apraxia of speech (CAS) showed improved accuracy in producing practiced words, but did not generalize these gains to unpracticed words, indicating limited transfer of motor learning.

Children with typical development (TD) demonstrated broader improvements in speech motor control, showing changes in both practiced and unpracticed words, suggesting more effective generalization of motor learning principles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes in movement transitions across a practice period in childhood apraxia of speech. Grigos, MI., Case, J.[2019]

In a study involving 30 children, including 9 with childhood apraxia of speech (CAS), it was found that attenuating auditory feedback significantly impacted the speech production of children with CAS, indicating they rely more on auditory feedback compared to those with speech delay or typical development.

The results suggest that children with CAS may have a deficit in their ability to use feedforward mechanisms for speech, highlighting the importance of auditory feedback in their speech monitoring and production.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reliance on auditory feedback in children with childhood apraxia of speech. Iuzzini-Seigel, J., Hogan, TP., Guarino, AJ., et al.[2015]

Children with childhood apraxia of speech (CAS) showed improvements in consonant accuracy and consistency when learning new words, indicating a learning effect despite their speech production challenges.

The study found that children with CAS had longer jaw movement durations compared to typically developing (TD) peers, suggesting they may need more time to plan and execute speech movements, especially for complex words.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Articulatory Control in Childhood Apraxia of Speech in a Novel Word-Learning Task. Case, J., Grigos, MI.[2020]

The study found that augmented visual kinematic feedback (AVKF) significantly improved speech accuracy in two adults with acquired apraxia of speech (AOS), suggesting that this type of feedback can enhance motor learning for speech production.

Positive effects were observed in both the acquisition of speech motor targets and their generalization to untreated contexts, indicating that AVKF may help individuals with AOS produce more accurate speech over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of online augmented kinematic and perceptual feedback on treatment of speech movements in apraxia of speech. McNeil, MR., Katz, WF., Fossett, TR., et al.[2021]

Dynamic Temporal and Tactile Cueing (DTTC) is designed to enhance neural processing for better sensorimotor planning and programming in children, providing a structured approach for clinicians to improve motor speech skills.

The article outlines essential elements and clinical decisions for implementing DTTC, emphasizing the importance of motor learning principles to ensure effective treatment and measurement of fidelity in practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech. Strand, EA.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Naive Listener Ratings of Speech Intelligibility Over the Course of Motor-Based Intervention in Children With Childhood Apraxia of Speech. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Changes in movement transitions across a practice period in childhood apraxia of speech. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Reliance on auditory feedback in children with childhood apraxia of speech. [2015]

5. United States pubmed.ncbi.nlm.nih.gov

Articulatory Control in Childhood Apraxia of Speech in a Novel Word-Learning Task. [2020]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of online augmented kinematic and perceptual feedback on treatment of speech movements in apraxia of speech. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech. [2021]