Using Webcam Interactive Technology to Implement Treatment for Severe Apraxia: A Case Example

By Lasker, Joanne P.; Stierwalt, A. G. Julie et al. | Journal of Medical Speech - Language Pathology, December 2010 | Go to article overview

Using Webcam Interactive Technology to Implement Treatment for Severe Apraxia: A Case Example


Lasker, Joanne P., Stierwalt, A. G. Julie, Spence, Mary, Cavin-Root, Courtney, Journal of Medical Speech - Language Pathology


Outcomes from a prior study with a client with apraxia (Lasker, Stierwalt, Hageman. & LaPointe, 2008) demonstrated the effectiveness of a treatment protocol chat combined the Motor Learning Guided approach (Hageman, Simon, Backer, & Burda, 2002) and daily home practice with a speech generating device (SGD). In this study a similar treatment protocol was implemented with a 28-year-old who presented with severe apraxia of speech and aphasia. The client participated in four treatment sessions a week--two via Skype and two face-to-face sessions. The combined approach of MLG and SGD practice resulted in acceptable productions on trained items. In addition, treatment conducted via Skype and face-to-face sessions resulted in similar outcomes in terms of intelligibility, immediacy, and naturalness ratings. Improvements were noted in the client's overall verbal output in testing and conversations. Results demonstrated both the effectiveness of the MLG/SGD treatment approach and the feasibility of conducting this protocol using webcam interactive technology.

Keywords: apraxia; motor learning; Skype; AAC

Researchers have begun to consider how principles of motor learning might best be incorporated into treatment for motor speech disorders (Schmidt & Bjork, 1992). Based on these principles, Hageman et al. (2002) developed a motor learning guided (MLG) approach to treat a client with acquired apraxia of speech. The MLG approach controlled feedback (type and frequency), incorporated a pause time (so that clients could evaluate their productions), and implemented a fixed practice schedule. In their initial report, the MLG approach was compared to Melodic Intonation Therapy (MIT) (Albert, Sparks, & Helm, 1973), a more traditional approach to treating apraxia of speech. Hageman et al. (2002) reported greater speech gains in their client during the MLG treatment when performance was compared to speech gains using the MIT treatment.

Lasker et al. (2008) combined the MLG approach with a speech generating device (SGD) for home practice. Their study demonstrated that the approach was effective at improving speech production in a client with profound apraxia of speech who was several years post-stroke. This was consistent with other clinical studies that demonstrate an improvement in spoken language output after practice with a SGD (McCall, Shelton, Weinrich, & Cox, 2000).

Another treatment innovation, the use of interactive webcam technology (i.e., Skype), has recently been studied. Hill et al. (2006) explored the feasibility and effectiveness of assessing acquired neurogenic motor speech disorders via an Internet-based telerehabilitation application. To date, however, there has been limited research in using Skype technology to deliver treatments for apraxia of speech.

The purpose of the present study was to determine whether the use of the MLG approach delivered via Skype in combination with practice on an SGD improved spoken productions in a client with severe apraxia of speech.

METHOD

Participant

LG was a 28-year-old electrician who had a left CVA two and a half years prior to this intervention. LG presented with right arm weakness but lived independently, had a cell phone (used primarily for texting) and a desktop computer, and managed many activities of daily living independently Following his stroke, LG participated in a period of inpatient rehabilitation but was discharged when he became ambulatory. When evaluated at our clinic 6 months post-stroke, LG was not receiving treatment due to limited funding options. He demonstrated a moderate to severe nonfluent aphasia and profound apraxia of speech without accompanying limb or oral apraxia. His verbal output was limited to the words "no" and "yeah." He was able to communicate successfully using writing, gestures, and a variety of partner-supported conversation techniques (Garrett & Lasker, 2005). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Using Webcam Interactive Technology to Implement Treatment for Severe Apraxia: A Case Example
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.