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"Watch me, listen, do as I do."
Samantha Gay Julia Miller Elanie van Schalkwyk Elani Matthee
The Eight-Step
(Integral Stimulation) Continuum
for treating Apraxia of Speech
Retrieved from
https://www.youtube.com/watch?v=W22lucjT6go
The eight step continuum is based on the fundamental principal, integral stimulation.
The 8-step continuum emphasizes the following principals:
(Duffy, 2013)
Treatment can fall into 4 different categories:
1. Articulatory-kinematic treatment:
2. Rate/Rhythm control treatment:
3. Reorganization treatment.
4. AAC approaches.
The Eight-Steps (Integral Stimulation) Continuum for Treating Apraxia of Speech
What is integral stimulation?
Where the clinician asks the patient "Watch as I say the word" and then demonstrates the word. It can be helpful to also show a photo and a printed word.
1
The target stimulus is produced by the clinician.
2
The same as step one, BUT….
Therefore, the patient only has a visual cue as the auditory cue is faded.
3
Integral stimulation followed by imitation.
4
Integral stimulation with several successive productions.
Example:
Therapist: "Sam"
*The patient must say ‘Sam’ three times with no simultaneous or visual cues from the clinician*
Patient: "Sam, Sam, Sam"
5
Written stimuli is presented without any visual or auditory cues followed by patients production
6
Written stimuli with delayed response.
7
A response is elicited with an appropriate question.
Example: Let the patient answer the question.
Clinician: “Would you like anything?”
Instead of imitating the clinician the patient is expected to respond with the appropriate response.
Patient: “I would like a cup of tea”
*It is important to use appropriate and functional utterances that relate to the patients everyday life*
8
The therapist is to elicit an appropriate response from the patient in a roleplay situation.
This refers to the generalization of what has been targeted in therapy to everyday situations. It is important to note that this is not directly targeted in therapy (Rosenbek et al, 1973.)
!
Die model kan gemodifiseer word om in verskillende omgewings en met verskillende populasies gebruik te word:
(Strand & Debertine, 2000)
Retrieved from
https://www.youtube.com/watch?v=tAGnfss5oBA
Retrieved from
https://www.youtube.com/watch?list=PLXTouG6eNRKzh0nmCSOq4Y6HXwclcmIeE&v=9JgH2_nXneY
American Speech Language Hearing Association. 2005. Apraxia in Adults.
Retrieved from http://www.asha.org/public/speech/disorders/apraxia_adults.htm.
.
Baker, J., & Nyquist, B. (2008). Integral Stimulation Treatment for Children with
Childhood Apraxia of Speech (CAS). Retrieved from http://people.umass.edu/ mva/pdf/ComDis%20624%20Student%20Pres_08/ Baker_Nyquist_Integral_Stimulation_08.pdf]
.
Code, C, Petheram, B 2011. Delivering for aphasia. International Journal of
Speech-Language Pathology, 13(1), Pp. 3--10.
.
Duffy, J. R. (2013). Motor Speech Disorders: Substrates, Differential Diagnosis,
and Management (3rd edition). Philidelphia: Elsevier Mosby.
.
Freed, D. B. (2011). Motor Speech Disorders: Diagnosis and Treatment (2nd
edition). New York: Delmar Cengage Learning.
Moses, J. [jmoses09]. (2012, April 24). Apraxia Therapy- Eight Step Continuum
[Video file]. Retrieved from https://www.youtube.com/watch?v=tAGnfss5oBA
.
Rosenbek, J. C., Lemme, M. L., Harris, E. H., & Wertz, R. T. (1973). A Treatment for
Apraxia of Speech in Adults. Journal of Speech and Hearing Disorders, 38,
462-472.
.
SpeechTherapyOnline. (2015, February 12). APRAXIA treatment in
MoreSpeech.com [Video file]. Retrieved from https://www.youtube.com/watch?list=PLXTouG6eNRKzh0nmCSOq4Y6HXwclcmIeE&v=9JgH2_nXneY
.
Strand, E. A., & Debertine, P. (2000). The efficacy of integral stimulation i
intervention with developmental apraxia of speech. Journal of Medical Speech-Language Pathology, 8, 295–300.
.
Tenbe100. (2014, June 30). Integral Stimulation [Video file]. Retrieved from
https://www.youtube.com/watch?v=W22lucjT6go