Syllable- and Rhythm-Based Approaches in the Treatment of Apraxia of Speech

Abstract

This paper presents new treatment approaches for patients with apraxia of speech (AOS), which are based on current theoretical work relating to the pathomechanism of AOS. Particularly, we focus on the question of which speech units and structural properties are involved in the error mechanism of speakers with apraxia. Based on a psycholinguistic model of spoken language production (Levelt, Roelofs, & Meyer, 1999), we review data from single-word production experiments and from analyses of spontaneous speech demonstrating an impact on (a) the degree of “over-learnedness” of syllables (syllable frequency), (b) the internal structure of syllables (syllable complexity), and (c) supra-syllabic, metrical aspects of utterances (word stress) on error production in AOS. In the second section, we present two experimental learning studies and a treatment study that take these results into consideration. The first learning experiment suggests that syllables are more natural units than segments in the treatment of patients with severe AOS. Based on the results of the second learning study, we recommend a treatment approach which uses formally related training syllables in the reacquisition of complex target syllables. Finally, results of a treatment study using a metrical pacing technique led to the assumption that fluency and segmental accuracy could be enhanced by external rhythmic cues.