A Randomized Controlled Trial for Children With Childhood Apraxia of Speech Comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme–Third Edition Purpose This randomized controlled trial compared the experimental Rapid Syllable Transition (ReST) treatment to the Nuffield Dyspraxia Programme–Third Edition (NDP3; Williams & Stephens, 2004), used widely in clinical practice in Australia and the United Kingdom. Both programs aim to improve speech motor planning/programming for children with apraxia of speech (CAS), ... Research Article
Research Article  |   June 01, 2015
A Randomized Controlled Trial for Children With Childhood Apraxia of Speech Comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme–Third Edition
 
Author Affiliations & Notes
  • Elizabeth Murray
    The University of Sydney, Australia
  • Patricia McCabe
    The University of Sydney, Australia
  • Kirrie J. Ballard
    The University of Sydney, Australia
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Elizabeth Murray: elizabeth.murray@sydney.edu.au
  • Editor: Jody Kreiman
    Editor: Jody Kreiman×
  • Associate Editor: Ben A. M. Maassen
    Associate Editor: Ben A. M. Maassen×
Article Information
Speech, Voice & Prosodic Disorders / Apraxia of Speech & Childhood Apraxia of Speech / Research Issues, Methods & Evidence-Based Practice / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   June 01, 2015
A Randomized Controlled Trial for Children With Childhood Apraxia of Speech Comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme–Third Edition
Journal of Speech, Language, and Hearing Research, June 2015, Vol. 58, 669-686. doi:10.1044/2015_JSLHR-S-13-0179
History: Received July 11, 2013 , Revised May 29, 2014 , Accepted February 13, 2015
 
Journal of Speech, Language, and Hearing Research, June 2015, Vol. 58, 669-686. doi:10.1044/2015_JSLHR-S-13-0179
History: Received July 11, 2013; Revised May 29, 2014; Accepted February 13, 2015
Web of Science® Times Cited: 9

Purpose This randomized controlled trial compared the experimental Rapid Syllable Transition (ReST) treatment to the Nuffield Dyspraxia Programme–Third Edition (NDP3; Williams & Stephens, 2004), used widely in clinical practice in Australia and the United Kingdom. Both programs aim to improve speech motor planning/programming for children with apraxia of speech (CAS), but they differ in types of stimuli used, level of stimulus complexity at initiation of treatment, and the principles of motor learning that they apply.

Method Treatment was delivered to 26 children with mild to severe CAS aged 4–12 years through trained and supervised speech-language pathology students in 1-hr sessions, 4 days a week for 3 weeks at a university clinic. Articulation and prosodic accuracy were assessed at pretreatment, 1 week, 1 month, and 4 months posttreatment using blinded independent assessors to compare treatment, maintenance, and generalization effects.

Results The ReST and NDP3 treatments demonstrated large treatment effects. ReST maintained treatment gains from 1-week to 4-months posttreatment more effectively than the NDP3. Significant generalization to untreated stimuli was observed for both ReST and NDP3.

Conclusions ReST and NDP3 have strong evidence of treatment and generalization gains in children with CAS when delivered intensively. Overall, ReST has greater external evidence from multiple sources but both treatments have support for clinical use.

Acknowledgments
We acknowledge our funding sources: the Douglas and Lola Douglas Scholarship on Child and Adolescent Health; Nadia Verrall Memorial 2010 and Postgraduate Student Scholarship 2011 through Speech Pathology Australia, James Kentley Memorial Scholarship, Postgraduate Research Support Schemes and Faculty of Health Sciences funding to Elizabeth Murray, the University of Sydney International Development Program Fund to Patricia McCabe and Kirrie J. Ballard, and the Australian Research Council Future Fellowship (FT120100255) to Kirrie J. Ballard. Parts of this study were presented at the 2012 Annual Speech Pathology Australia Conference. The authors also sincerely thank the families and children who participated. We thank the authors of the NDP3, Pamela Williams and Hilary Stephens, and Professor Donald A. Robin, who conceived the ReST program. We thank the treating and assessing clinicians, interns, and research assistants: Morin Beausoleil, Kate Broome, Sarah Coventry, Olivia Crowe, Claire Formby, Jennifer Fortin Zornow, Alyssa Gearin, Sally Hanna, Samantha Hardy, Loren Holmes, Amie Jakimyszyn, Melody Lam, Flora Lau, Angela Laundes, Claire Layfield, Catherine Mason, Sarah Masso, Anne McKenzie, Lauren Osborne, Aimee-Kate Parkes, Gemma Patterson, Alyssa Piper, Jemma Prag, Phoebe Sim, Donna Thomas, Lauri Vinokur, and Caitlin Winkelman. Many thanks to Shaun Langtry for IT support, and Robert Heard and Natalie Munro for statistical advice.
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