Using motor learning guided theory and augmentative and alternative communication to improve speech production in profound apraxia: a case example.
A 49-year-old man with profound apraxia of speech and moderate nonfluent aphasia participated in a two-pronged treatment that combined the motor learning guided (MLG) approach for apraxia ofspeech and augmentative and alternative communication (AAC). When he began the treatment protocol, JW was 4 years postonset from a series of three left cerebrovascular accidents. Researchers implemented a hierarchical motor learning guided approach that manipulated aspects of practice and feedback to help the client acquire and retain targeted words and phrases. In addition, researchers assisted in JW acquiring a speech generating device (SGD) with which he practiced treatment targets at home daily. After three cycles of the combined treatment protocol, JW made gains in acquiring and using treatment targets, as well as in producing untreated stimuli. The combination of treatment approaches-MLG and home practice with an SGD-resulted in changes in speech production in a client with profound apraxia who experienced limited success with more traditional apraxia treatment approaches.