ACT4CAS (Beiting & Maas, 2021)

Purpose: A subset of children with autism spectrum disorder (ASD) has speech sound disorders, including childhood apraxia of speech (CAS). To date, virtually all speech treatment studies consider ASD an exclusionary criterion, resulting in little scientific evidence for treatment of CAS for children who also have ASD. This study proposes and tests a novel approach, Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS), as a theoretically and clinically informed speech treatment option for this population.Method: Using a multiple-baseline design within and across participants, three children with co-occurring ASD and CAS received 11–18 treatment sessions. Treatment targets were individually designed and matched with untreated control words. Probes were administered at the start of each session to assess speech production accuracy perceptually. Changes in production accuracy were examined through visual inspection and quantified with effect sizes. Results: Findings were mixed, with one child showing significant gains for half of the treated targets at follow-up and two children showing no clear improvement.Conclusions: Preliminary evidence suggests potentially positive treatment effects for ACT4CAS when implemented as intended, although treatment intensity and disorder severity likely influence treatment outcome. Replication and comparison of ACT4CAS to other speech treatments is needed.Supplemental Material S1. Target selection. Beiting, M., & Maas, E. (2021). Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS): A single-case experimental design study. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2020_AJSLP-20-00131Publisher Note: This article is part of the Special Issue: Select Papers From the 2020 Conference on Motor Speech.

目的：自闭症谱系障碍（ASD）儿童中，一部分存在语音障碍，包括儿童构音障碍（CAS）。迄今为止，几乎所有语音治疗研究都将自闭症作为排除标准，导致针对同时患有自闭症和CAS的儿童进行CAS治疗的科学证据极为有限。本研究旨在提出并检验一种新颖的方法，即以自闭症为中心的儿童构音障碍治疗（ACT4CAS），作为针对该群体的理论及临床指导的语音治疗选择。方法：采用多基线设计，对三位同时患有自闭症和CAS的儿童进行了11-18次治疗 session。治疗目标根据个体情况设计，并与未经治疗的控制词汇相匹配。在每次治疗的开始阶段进行探查，以感知评估语音生产的准确性。通过视觉检查和效应量量化了生产准确性的变化。结果：研究结果不尽一致，一位儿童在随访时显示出治疗目标中一半的显著进步，而其他两位儿童则未出现明显的改善。结论：初步证据表明，当ACT4CAS按照预期实施时，可能产生积极的治疗效果，尽管治疗强度和疾病严重程度可能影响治疗效果。需要复制和比较ACT4CAS与其他语音治疗的效果。补充材料S1. 目标选择。Beiting, M. & Maas, E. (2021). 儿童构音障碍的自闭症中心治疗（ACT4CAS）：一项单案例实验设计研究。美国言语-语言病理学杂志。在线预发表。https://doi.org/10.1044/2020_AJSLP-20-00131出版者注：本文是特别专题“2020年运动语音会议精选论文”的一部分。