title: Self-Administered Computer Therapy for Apraxia of Speech: Two-Period Randomized Control Trial With Crossover.
abstract: OBJECTIVE
  There is currently little evidence on effective interventions for poststroke apraxia of speech. We report outcomes of a trial of self-administered computer therapy for apraxia of speech.
  
  
  METHODS
  Effects of speech intervention on naming and repetition of treated and untreated words were compared with those of a visuospatial sham program. The study used a parallel-group, 2-period, crossover design, with participants receiving 2 interventions. Fifty participants with chronic and stable apraxia of speech were randomly allocated to 1 of 2 order conditions: speech-first condition versus sham-first condition. Period 1 design was equivalent to a randomized controlled trial. We report results for this period and profile the effect of the period 2 crossover.
  
  
  RESULTS
  Period 1 results revealed significant improvement in naming and repetition only in the speech-first group. The sham-first group displayed improvement in speech production after speech intervention in period 2. Significant improvement of treated words was found in both naming and repetition, with little generalization to structurally similar and dissimilar untreated words. Speech gains were largely maintained after withdrawal of intervention. There was a significant relationship between treatment dose and response. However, average self-administered dose was modest for both groups. Future software design would benefit from incorporation of social and gaming components to boost motivation.
  
  
  CONCLUSIONS
  Single-word production can be improved in chronic apraxia of speech with behavioral intervention. Self-administered computerized therapy is a promising method for delivering high-intensity speech/language rehabilitation.
  
  
  BACKGROUND
  URL: http://orcid.org/0000-0002-1278-0601. Unique identifier: ISRCTN88245643.
authors.affiliation: From the Division of Psychology and Language Sciences, University College London, London, United Kingdom (R.V.); Department of Human Communication Sciences, University of Sheffield, Sheffield, United Kingdom (P.E.C., L.D., L.I., S.P.W.); and Division of Language and Communication Science, City University London, London, United Kingdom (A.R.). rosemary.varley@ucl.ac.uk.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Varley
authors.affiliation: From the Division of Psychology and Language Sciences, University College London, London, United Kingdom (R.V.); Department of Human Communication Sciences, University of Sheffield, Sheffield, United Kingdom (P.E.C., L.D., L.I., S.P.W.); and Division of Language and Communication Science, City University London, London, United Kingdom (A.R.).
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Cowell
authors.affiliation: From the Division of Psychology and Language Sciences, University College London, London, United Kingdom (R.V.); Department of Human Communication Sciences, University of Sheffield, Sheffield, United Kingdom (P.E.C., L.D., L.I., S.P.W.); and Division of Language and Communication Science, City University London, London, United Kingdom (A.R.).
authors.forename: Lucy
authors.initials: L
authors.lastname: Dyson
authors.affiliation: From the Division of Psychology and Language Sciences, University College London, London, United Kingdom (R.V.); Department of Human Communication Sciences, University of Sheffield, Sheffield, United Kingdom (P.E.C., L.D., L.I., S.P.W.); and Division of Language and Communication Science, City University London, London, United Kingdom (A.R.).
authors.forename: Lesley
authors.initials: L
authors.lastname: Inglis
authors.affiliation: From the Division of Psychology and Language Sciences, University College London, London, United Kingdom (R.V.); Department of Human Communication Sciences, University of Sheffield, Sheffield, United Kingdom (P.E.C., L.D., L.I., S.P.W.); and Division of Language and Communication Science, City University London, London, United Kingdom (A.R.).
authors.forename: Abigail
authors.initials: A
authors.lastname: Roper
authors.affiliation: From the Division of Psychology and Language Sciences, University College London, London, United Kingdom (R.V.); Department of Human Communication Sciences, University of Sheffield, Sheffield, United Kingdom (P.E.C., L.D., L.I., S.P.W.); and Division of Language and Communication Science, City University London, London, United Kingdom (A.R.).
authors.forename: Sandra P
authors.initials: SP
authors.lastname: Whiteside
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001072:Apraxias / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000379:methods*; D013060:Speech; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000379:methods*
keywords: aphasia; apraxias; computers; cross-over studies; speech; therapeutics