Outcomes of a novel single case study incorporating Rapid Syllable Transition treatment, AAC and blended intervention in children with cerebral palsy: a pilot study

Abstract

Purpose

Motor speech and augmentative and alternative communication (AAC) interventions are commonly used with children with cerebral palsy (CP) but there is limited literature comparing the effectiveness of these interventions. The purpose of this study was to investigate the effectiveness of intensive AAC, Rapid Syllable Transition Treatment (ReST), and blended intervention, a combination of motor-speech and AAC, on speech accuracy and sentence length and complexity.

Methods

A single case experimental design across participants with repeated measurements across phases (ABACADA design) was used. Four participants aged 8–14 years with CP who used a speech-generating device (SGD) received three 6-week intervention blocks that included ReST, AAC, and blended intervention. Measures were taken during intervention and baseline phases and at maintenance two and four weeks after the last intervention phase. Participants were randomized to starting with either ReST or AAC with the blended intervention delivered last.

Results

All participants improved their speech accuracy and sentence length and complexity in speech and with their SGD in all three interventions. The data demonstrated overall immediacy of the effect with all interventions and retention of gains across the whole sequence of phases. The order of AAC or ReST interventions or the severity of CP did not impact the intervention gains.

Conclusion

This study suggests that intensive AAC, a multi-modal approach, and ReST improve speech accuracy and sentence length and complexity in children with moderate CP, but all require further investigation.

Implications for rehabilitation

• In this paper intensive AAC intervention with a speech generating device (SGD), ReST treatment and multimodal blended intervention were effective in improving speech accuracy and sentence length and complexity in both verbal speech and on communication with the SGD.

• ReST treatment has not been used with children with CP before. This study established a proof of concept for its effectiveness in children with CP. Further research is warranted.

Keywords:

• Cerebral palsy
• apid Syllable Transition treatment (ReST)
• augmentative and alternative communication (AAC)
• speech generating device (SGD)
• multimodal blended intervention
• novel communication intervention
• single case experimental design

Acknowledgements

The authors acknowledge the four children and their families, as well as Cerebral Palsy Alliance and staff, and our intern, Helene Paulson.

Disclosure statement

The authors declare that the research was conducted in the absence of any financial relationships that could be construed as a potential conflict of interest.