title: Treatment intensity and childhood apraxia of speech.
abstract: BACKGROUND
  Intensive treatment has been repeatedly recommended for the treatment of speech deficits in childhood apraxia of speech (CAS). However, differences in treatment outcomes as a function of treatment intensity have not been systematically studied in this population.
  
  
  OBJECTIVE
  To investigate the effects of treatment intensity on outcome measures related to articulation, functional communication and speech intelligibility for children with CAS undergoing individual motor speech intervention.
  
  
  METHODS
  A total of 37 children (32-54 months of age) with CAS received 1×/week (lower intensity) or 2×/week (higher intensity) individual motor speech treatment for 10 weeks. Assessments were carried out before and after a 10-week treatment block to study the effects of variations in treatment intensity on the outcome measures.
  
  
  RESULTS
  The results indicated that only higher intensity treatment (2×/week) led to significantly better outcomes for articulation and functional communication compared with 1×/week (lower intensity) intervention. Further, neither lower nor higher intensity treatment yielded a significant change for speech intelligibility at the word or sentence level. In general, effect sizes for the higher intensity treatment groups were larger for most variables compared with the lower intensity treatment group.
  
  
  CONCLUSIONS
  Overall, the results of the current study may allow for modification of service delivery and facilitate the development of an evidence-based care pathway for children with CAS.
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.
authors.forename: Aravind K
authors.initials: AK
authors.lastname: Namasivayam
authors.affiliation: The Speech and Stuttering Institute, Toronto, ON, Canada.
authors.forename: Margit
authors.initials: M
authors.lastname: Pukonen
authors.affiliation: The Speech and Stuttering Institute, Toronto, ON, Canada.
authors.forename: Debra
authors.initials: D
authors.lastname: Goshulak
authors.affiliation: ErinoakKids Centre for Treatment and Development, Mississauga, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hard
authors.affiliation: Toronto Rehabilitation Institute, Toronto, ON, Canada.
authors.forename: Frank
authors.initials: F
authors.lastname: Rudzicz
authors.affiliation: Radboud University, Nijmegen, the Netherlands.
authors.forename: Toni
authors.initials: T
authors.lastname: Rietveld
authors.affiliation: University of Groningen, Groningen, the Netherlands.
authors.forename: Ben
authors.initials: B
authors.lastname: Maassen
authors.affiliation: The Speech and Stuttering Institute, Toronto, ON, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Kroll
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.
authors.forename: Pascal
authors.initials: P
authors.lastname: van Lieshout
mesh_terms: D001072:Apraxias / Q000175:diagnosis* / Q000628:therapy*; D002675:Child, Preschool; D004493:Education; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D008297:Male; D000067404:Social Communication Disorder / Q000175:diagnosis / Q000628:therapy; D013065:Speech Intelligibility; D013070:Speech Therapy / Q000379:methods*
keywords: childhood apraxia of speech; developmental motor speech disorders; functional outcomes; speech intelligibility; speech-sound disorder; treatment intensity