The efficacy of integral stimulation intervention with developmental apraxia of speech

Treatment efficacy data are presented for a five year old female whose speech was characterized by the use of vowels (many of which were distorted) and the consonants /p/, /b/, /t/, /d/, /f/, and /v/. These consonants were not used in all coarticulatory contexts. She had normal receptive language, no cognitive deficits, and excellent pragmatic skills. Comprehensibility was estimated at roughly 10%. A structural-functional examination and connected speech sample revealed no dysarthria. The motor speech examination indicated that her severe phonologic impairment was due at least in part to difficulty with motor planning. A treatment approach based on integral stimulation was implemented. Baseline and probe data were collected. This paper presents a rationale for the treatment approach, a brief description of treatment implementation, and a summary of the very early data showing her improvement in speech production for the first set of stimuli. An integral stimulation approach incorporating a number of basic principles of motor learning resulted in speech improvement.