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ACQ
Volume 12, Number 1 2010
ACQ
uiring knowledge in speech, language and hearing
of the movement). KP is information about the nature
or quality of the movement. It includes biofeedback and
external feedback provided by an instructor (clinician). The
article draws on extensive literature regarding the nature of
feedback frequency, intensity, and timing.
Having disected this complex theory, the article finally
draws together the above concepts and discusses the
clinical implications when applying it to the people we treat
on a daily basis. It provides a case example and shows how
intervention may be constructed to improve motor speech
outcomes for people with AOS. While I believe there is still
much to learn about the motor speech system and how to
help repair it once it is broken, this article goes a long way
to bridge the divide between principles of learning, practice,
feedback, and attention with motor speech production.
Included below is the “shortlist” of key articles that form
a comprehensive reading list to help unlock the mysteries
behind AOS. I hope you enjoy!
References
Ballard, K.J., Maas, E., & Robin, D. A. (2007) Treating control
of voicing in apraxia of speech with variable practice.
Aphasiology
,
21
(12),1195-1217.
Guadagnoli M.A. & Lee, T.D. (2004). Challenge point: A
framework for conceptualizing the effects of various practice
conditions in motor learning.
Journal of Motor Behavior
,
36
(2), 212–224.
Guenther, F. H. (2006). Cortical interactions underlying the
production of speech sounds.
Journal of Communication
Disorders
,
39
, 350–365.
Schmidt, R. A. (1975). A schema theory of discrete motor
skill learning.
Psychological Review
,
82
, 225–260.
Schmidt, R.A. & Lee, T.D. (1999).
Motor control and
learning: A behavioural emphasis
. (3rd ed.). Champaigne, IL:
Human Kinetics.
Wambaugh, J.L., Duffy J.R., McNeil, M. R., Robin, D. A.,
& Rogers, M. A. (2006). Treatment guidelines for acquired
apraxia of speech: A synthesis and evaluation of the
evidence.
Journal of Medical Speech-Language Pathology
,
14
(2), xv–xxxiii.
Investigating word intelligibility in
Parkinson’s disease
Neel, A. (2009). Effects of loud and amplified speech on
sentence and word intelligibility in Parkinson disease.
Journal
of Speech, Language and Hearing Research
,
52
, 1021–
1033.
Kylie Mulcahy
In management of hypokinetic dysarthria related to
Parkinson’s disease, the effects of increased vocal effort (or
loud speech) as opposed to simple amplification are unclear.
In this study, the authors aim to explain the mechanisms that
contribute to deficits in speech intelligibility by dichotomising
Principles of motor learning
Maas E., Robin, D., Austermann Hula, S.N., Freedman, S. E.,
Wulf, G., Ballard, K. J., & Schmidt, R. A. (2008). Principles of
motor learning in treatment of motor speech disorders.
American Journal of Speech-Language Pathology
,
17
,
277–298.
Erin Godecke
At last! An article that incorporates all you need to know
about treating apraxia of speech (AOS). This tutorial-based
article incorporates a critical review of existing AOS literature
and presents a theoretical framework to better guide clinical
management of the disorder. The authors describe the
founding principles of general motor learning and go on to
apply these principles to speech motor learning. Essential to
the development of the links between speech and general
motor learning is the concept of “learning versus
performance”, which the authors believe to be intimately
associated with the holy grail of all speech intervention,
namely “improved generalisation and carryover”.
The authors draw heavily on the “Schema Theory”
(Schmidt, 1975, 2003; Schmidt & Lee, 2005) which assumes
that in the intact motor learning system, motor programs
are retrieved from memory and subsequently adapted to
a specific situation. The motor programs are shaped and
honed with increased practice and eventually stored as
learned chunks of behaviour. The authors postulate that
the principles of motor learning (Schema Theory) extend
to impaired speech systems, and demonstrate that with
optimal conditions of practice, improved generalisation
and carryover can be achieved. Additionally, the authors
present a synopsis of the “Challenge point framework” by
Guadagnoli and Lee (2004) which augments the theoretical
underpinnings of the Schema Theory and introduces
the concept of optimal (motor) learning environments to
treatment of AOS.
In order to assimilate a large amount of theory, the
authors discuss key issues, including the structure of
practice, attentional focus, movement complexity, and
feedback type. The structure of practice is partitioned into:
1) amount, which refers to the overall time spent practising
the movements; 2) distribution, which is how the practice is
aportioned over time; 3) variability, which describes practice
performed in different variations; and 4) schedule, which
refers to different movements being used to achieve an
unpredictable target. Attentional focus relates to either the
internal focus, which is concentrating on kinetic, kinematic,
and somatosensory information; or the external focus which
describes attention to movement of an object (e.g., golf club)
to achieve a goal. Movement complexity relates directly to
the Challenge point framework and breaks tasks into simple
(part) or whole (complex) movements. Feedback type is
divided into knowledge of results (KR) and knowledge of
performance (KP). KR is information about the movement
outcome, in relation to the goal (provided at the completion
Around the journals
Motor speech disorders