Investigators from the Department of Communication Sciences and Disorders at the University of Utah report results from single-subject experimental research into outcome improvements in three persons with aphasia (PWA) who remotely received Combined Aphasia and Apraxia of Speech Treatment (CAAST). The goals of the research were to document outcome changes – in terms of acquisition, generalization, and maintenance effects – following the distance administration of the specified intervention, and to compare the effects against results found from analogous studies of the CAAST intervention delivered face-to-face.
Three adults with aphasia following stroke comprised the subjects of this research. They were 60 years old on average, with a mean time postonset of 74 months. Mean AQ was 57.1, with two presenting with moderate Broca’s aphasia and one with anomia. The therapeutic components of the CAAST intervention are derived from Response Elaboration Training techniques to target language issues, and Sound Production Treatment to promote speech improvement. Remote sessions were conducted over Webex or Zoom platforms, and employed single-subject experimental multiple probe designs, following five baseline sessions to characterize pretreatment performance. The treatment sessions lasted approximately an hour, and were scheduled three times a week for up to 7 weeks, after which maintenance probes were conducted at 2- and 6-week intervals. Outcome measures were — for language change — correct information units (CIU) produced by subjects, and – for articulation improvement – percent consonants correct (PCC).
The study results were positive. Visual inspection of graphs from the multiple-baseline single-subject experimental design show that – over the course of the intervention – subjects’ performances improved substantially on the outcome measure for language – CIUs — with gains being maintained posttreatment at intervals of two and six weeks. Analyses of the speech production outcome data likewise reveal that subjects’ scores on that outcome measure — “percent consonants correct” — also improved over the treatment period, which yielded higher word recognition scores for subjects’ utterances following intervention. Moreover, these outcome improvements were in keeping with results from prior in-person administration of CAAST, indicating effectiveness of the treatment protocol when delivered both face-to-face and via distance communication technologies such as Cisco Webex or ZOOM Medical.
For further reading: L. Kallhoff, P.T. Moua, D. Salomon, J. Wambaugh, 2023,
The outcomes of remote administration of combined aphasia and apraxia of speech treatment: a single-subject experimental design study. AJSLP, 32(5S): 2402–2417, https://doi.org/10.1044/2023_AJSLP-22-00297