DuBard School for Language Disorders
Research - Childhood Apraxia of Speech and Resilience
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Name of Project: Changes in Articulation and Perceived Resilience in Children with Childhood Apraxia of Speech (CAS)
Population: Twelve students, ages 3-8 to 10-3, diagnosed with CAS were enrolled full-time in the DuBard School for Language Disorders. Most students presented with significant comorbid conditions. Articulation skills were measured on the Arizona Articulation Proficiency Scale-3 (AAPS-3) prior to the implementation of two years of intensive speech-language therapy.
Service Delivery Model: Therapy was delivered through the DuBard School's intensive full-time enrollment program over a period of two years by nationally certified speech-language pathologists or nationally certified educators of the deaf.
Assessment Instruments:
Arizona Articulation Proficiency Scale Third Edition (AAPS-3)
- Total score values range from 0 to 100.
- Standard scores have a mean of 100 and a standard deviation of 15.
- Mean Length of Utterance (MLU) scores were derived from a spontaneous speech sample. The MLU is the average length of oral expressions as measured by a representative sample of oral language.
Resilience Assessment of Exceptional Students (RAES)
- Teacher Rating Form (completed by SLP)
- Parent Rating Form
- Resilience Behaviors Rated:
- Positive peer relations
- Self-efficacy/Locus of control
- Positive adult relations
- Modeling/Active social skills
- Items rated in terms of Frequency and Need to Improve
- Higher ratings on the Frequency scale indicated increased behaviors.
- Higher ratings on the Need to Improve scale indicated less need to improve behaviors.
Length of time between pre- and post-test: Approximately 20 months; Pre-test: August 2006, Post-test: May-June, 2008
Statistical Analyses: Repeated measures ANOVA
Students diagnosed with CAS who were enrolled full-time for two years in the USM DuBard School for Language Disorders had statistically significant increases in AAPS-3 total scores, F(1,11)=25.98, p<0.001.
| AAPS-3 Total Scores | |
| Pre-test total score mean | 56.38 |
| Post-test total score mean | 91.08 |
Students diagnosed with CAS who were enrolled full-time for two years in the USM DuBard School for Language Disorders had statistically significant increases in AAPS-3 standard scores, F(1,11)=41.35, p<0.001.
| AAPS-3 Standard Scores | |
| Pre-test standard score mean | 64.75 |
| Post-test standard score mean | 85.83 |
Students diagnosed with CAS who were enrolled full-time for two years in the USM DuBard School for Language Disorders had statistically significant increases in MLU, F(1,11)=25.98, p<0.001.
| AAPS-3 MLU | |
| Pre-test total score mean | 3.80 |
| Post-test total score mean | 7.00 |
Intelligibility ratings based on AAPS-3 scoring improved following intensive intervention for students enrolled full-time in the USM DuBard School for Language Disorders.
Interpretation Legend:
- Speech is unintelligible.
- Speech usually is unintelligible.
- Speech intelligibility is difficult.
- Speech is intelligible with careful listening.
- Speech is intelligible, although noticeably in error.
- Sound errors are occasionally noticed in continuous speech.
Positive Peer Relations1
| Rater | Time | Interactions | |
| Frequency | F(1,9)=13.393, p=.005 |
F(1,9)=13.716, p=.005 |
NS2 |
| Need to Improve |
NS2 |
F(1,7)=14.016, p=.007 |
F(1,7)=16.091, p=.005 |
1Starts conversations with peers, stands up to bullies, shows others how to do things, shows leadership with peers, able to introduce people to one another, attends social events such as parties, popular with peers due to friendliness
2Indicates non-significant findings
Interpretation of significant results for Positive Peer Relations:
Rater – Parent ratings were higher than SLP ratings for the Frequency of Positive Peer Relations behaviors.
Time – Post-test ratings were higher than pre-test ratings for Frequency of Positive Peer Relations behaviors and for the Need to Improve Positive Peer Relations behaviors. This indicated that both parents and SLPs saw increased behaviors in the area of Positive Peer Relations and less need to improve these behaviors.
Interaction – Need to Improve ratings by parents increased from pre-test to post-test; Need to Improve ratings by SLPs remained about the same from pre-test to post-test.
Self-Efficacy/Locus of Control1
| Rater | Time | Interactions | |
| Frequency | F(1,9)=12.154, p=.007 |
F(1,9)=10.548, p=.010 |
NS2 |
| Need to Improve |
NS2 |
NS2 |
F(1,8)=14.570, p=.005 |
1Completes homework independently, seeks help only when needed, shows enthusiasm about learning, attributes grades to ability, attempts new tasks without fear, self-reliant in carrying out tasks, self-confident about ability to learn
2Indicates non-significant findings
Interpretation of significant results for Self-efficacy/Locus of Control:
Rater – Parent ratings were higher than SLP ratings for the Frequency of Self-efficacy/Locus of Control behaviors.
Time – Post-test ratings were higher than pre-test ratings for Frequency of Self-efficacy/Locus of Control behaviors. This indicated that both parents and SLPs saw increased Self-efficacy/Locus of Control behaviors from pre-test to post-test.
Interaction – Need to Improve ratings by parents increased from pre-test to post-test; Need to Improve ratings by SLPs decreased slightly from pre-test to post-test.
Positive Adult Relations1
| Rater | Time | Interactions | |
| Frequency |
NS2 |
F(1,9)=5.486, p=.044 |
NS2 |
| Need to Improve |
NS2 |
F(1,7)=12.071, p = .010 |
NS2 |
1Helps family with daily living tasks, volunteers to help parents/teacher, follows parents’/teachers’ rules, will attempt work such as running errands, responsible to personal belongings at home
2Indicates non-significant findings
Interpretation of significant results for Positive Adult Relations:
Time – Post-test ratings were higher than pre-test ratings for Frequency of Positive Adult Relations behaviors and for the Need to Improve Positive Adult Relations. This indicated that both parents and SLPs saw increased behaviors in the area of Positive Adult Relations from pre-test to post-test and less need to improve these behaviors.
Modeling/Active Social Skills1
| Rater | Time | Interactions | |
| Frequency | F(1,9)=25.850, p=.001 |
NS2 |
NS2 |
| Need to Improve |
NS2 |
F(1,8)=8.482, p=.020 |
F(1,8)=5.634, p=.045 |
1Acts as positive model of helpful behavior, attempts to compensate for learning problems, tries to stop arguments, models or imitates positive behavior of others, strives for perfection when completing tasks, understands how others feel
2Indicates non-significant findings
Interpretation of significant results for Modeling/Active Social Skills:
Rater – Parent ratings were higher than SLP ratings for the Frequency of Modeling/Active Social Skills behaviors.
Time – Post-test ratings were higher than pre-test ratings for Need to Improve Modeling/Active Social Skills behaviors. This indicated that both parents and SLPs saw less need for improvement of Modeling/Active Social Skills behaviors at post-test as compared to pre-test.
Interaction – Modeling/Active Social Skills Need to Improve ratings by parents increased from pre-test to post-test; Modeling/Active Social Skills Need to Improve ratings by SLPs decreased slightly from pre-test to post-test.
Interpretation of overall results:
For students diagnosed with CAS who were enrolled full-time at the DuBard School for Language Disorders, total scores, standard scores, MLU scores, and intelligibility ratings on a test of articulation showed significant increases following two years of intervention using the DuBard Association Method®. In addition, significant changes in resilience behaviors were found.
References:
Fudala, J. B. (2000). Arizona Proficiency Scale: Third Revision. Los Angeles: Western Psychological Services.
Perry, J. D. and Bard, E. M. (2001, April). Construct validity of the Resilience Assessment of Exceptional Students (RAES). Paper presented at the annual conference of the National Association of School Psychologists, Washington, DC.