Poster # 95: METRONOME PACING IN CHILDREN WITH DEVELOPMENTAL APRAXIA OF SPEECH (DAOS) John Seikel, Jaime Lewis, Audrey Weston, Barbara Bain, Shari Goode, & Heather Rogers Idaho State University Department of Communication Sciences & Disorders, and Education of the Deaf Poster formatted by Jackie Stokes Method A quantitative, multiple single-subject design was employed. Participants consisted of 4 children (2 female, 2 male, 6 – 12 years) with varying degrees of DAOS Baseline level syllable production ability (mono-, bi-, tri-, 4 or 5 syllable words) was obtained over the course of three or four sessions and treatment began at their level of function. A control measure (sustained vowel duration) was acquired at pre- and post treatment phases Probes consisted of trained and untrained words (monosyllabic, bisyllabic, trisyllabic, four, and five syllable) administered without metronome, and presented by audio recording. Target words and generalization probes were selected based on subjects’ syllable length level. Each subject was trained to produce 100 words in rhythm with a metronome. Clinician instruction and demonstration were provided. The child was instructed to produce one syllable per beat, with one beat in between words. The metronome was set at 60 beats per minute (bpm). If the subject was unable to obtain 60 bpm (40% or better), the rate was reduced to the previous syllable level. Criterion for advancement to the next rate was 80% of the words produced with the beat Subject 1 Results Background Developmental Apraxia of speech (DAOS) has been defined by ASHA ( ) as “a disorder of the nervous system that affects the ability to sequence and say sounds, syllables, and words.” Implicit in this definition is a deficit in planning and programming the articulators for speech production, in absence of identifiable motor weakness. DAOS differs from acquired apraxia of speech (AAOS) in that DAOS is a developmental disorder (Strand, 1995; Shriberg, Aram, & Kwiatkowski, 1997). Many treatment approaches have been attempted with DAOS, including oral motor approaches, gestural and visual approaches. Wambaugh and Martinez (2000) found that the accuracy of consonant production in words in AAOS increased as a result of metronome pacing and handtapping. This study examined effects of metronome pacing on number of consecutive syllables and phoneme accuracy in children with DAOS, following Wambaugh and Martinez. Subject 2 Results Subject 1 obtained similar results for Apraxia Profile for both testing sessions. Generalization data revealed that four syllable words showed continual improvement (Figure 1). Bisyllable words improved for treatment data with the metronome set at 60 bpm. Bisyllable words at 90 bpm remained stable (Figure 2). Percent of consonants correct in generalization improved in treated bisyllable words and 4-syllable untreated words. Bisyllable whole-word accuracy in treated words improved Generalization to the untreated words did not occur (Figures 3 & 4). Subject 2 obtained similar pre- and post-treatment scores on Apraxia Profile with the exception of improvement on diadochokinesis and sentence imitation using prosody. Generalization data showed improvement on the treated trisyllable and 4-syllable words (Figure 5). Treatment data (Figure 6) showed improvement in trisyllable words at 60 bpm through 4-syllable words at 90 bpm. Percent consonants correct in generalization (Figure 7) improved at all word levels until session 9. Whole word accuracy generalization did not occur (Figure 8). Figure 2. Subject 1 Treatment Data 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Treatment Session Number Percent Correct Trisyllable Words at 60 bpm Bisyllable Words at 60 bpm Bisyllable Words at 90 bpm