What is the mechanism of action of this treatment?

Dynamic Temporal and Tactile Cueing (DTTC) is a common treatment for Childhood Apraxia of Speech (CAS) that focuses on improving speech motor planning and execution. It involves structured, repetitive practice with temporal and tactile cues, breaking down speech into smaller units and gradually increasing complexity. Temporal cues help in timing speech movements, while tactile cues provide physical feedback for correct articulation. This method is essential for CAS patients as it directly addresses their impaired motor planning and coordination, leading to more accurate and consistent speech production.

What side effects are associated with this type of intervention?

The most common treatments for Childhood Apraxia of Speech (CAS), such as Dynamic Temporal and Tactile Cueing (DTTC), generally have minimal physical side effects. However, they can be demanding and may lead to fatigue or frustration in children due to the intensive and repetitive nature of the practice. Additionally, there may be emotional or psychological impacts, such as decreased motivation or increased anxiety, particularly if progress is slow. It is important for caregivers and therapists to monitor the child's emotional well-being and adjust the therapy approach as needed to maintain a positive and supportive environment.

What prior FDA approvals exist?

As of now, there are no specific FDA-approved drugs for the treatment of Childhood Apraxia of Speech (CAS). The primary treatment approach for CAS, including methods like Dynamic Temporal and Tactile Cueing (DTTC), involves speech therapy rather than pharmacological interventions. DTTC is a well-regarded method that improves speech motor planning and execution through structured, repetitive practice with temporal and tactile cues. This therapeutic approach is central to managing CAS, focusing on enhancing the child's ability to produce clear and accurate speech through intensive practice and feedback.

What other types of research exist?

Promising, novel alternatives to Dynamic Temporal and Tactile Cueing (DTTC) for Childhood Apraxia of Speech (CAS) patients include: 1) Caregiver-mediated interventions, which involve training caregivers to support speech practice at home, potentially enhancing treatment outcomes. 2) Task-specific balance training, which, although primarily aimed at improving balance, has shown potential benefits in sensory-motor integration that could be adapted for speech therapy. 3) Transcranial Direct Current Stimulation (tDCS), which has shown efficacy in improving motor functions and could be explored for enhancing speech motor planning and execution in CAS patients.

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Behavioral Intervention

DTTC with Caregiver Training for Childhood Apraxia of Speech (DTTC Trial)

N/A

Recruiting

Research Sponsored by New York University

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

2;6-7;11 years of age at the start of treatment

Primary speech diagnosis of Childhood Apraxia of Speech (CAS) based on auditory-perceptual, expert diagnosis and/or Dynamic Evaluation of Motor Speech Skills (DEMSS) score classification of 'significant evidence of CAS' with score <323

Must not have

Hearing impairment

Primary diagnosis of dysarthria or other speech sound disorder (e.g., phonological impairment)

Timeline

Screening 3 weeks

Treatment Varies

Follow Up pre- to post-treatment (16 treatment sessions over 8 weeks); 1-week and 4-week post-treatment follow-up

Awards & highlights

No Placebo-Only Group

Summary

This trial tests which type of caregiver training helps children with childhood apraxia of speech improve their speaking abilities more effectively. Children receive specialized speech therapy and practice at home with their caregivers. The study aims to see which method leads to better speech accuracy and communication skills.

Who is the study for?

This trial is for children aged between 2 years and 5 months to 7 years and 11 months with a primary diagnosis of Childhood Apraxia of Speech (CAS) who speak English as their main language. Kids with autism, global developmental delay, Down syndrome, or severe hearing or visual impairments can't join. Those already receiving speech treatment elsewhere are also excluded.

What is being tested?

The study tests the effects of caregiver training on DTTC therapy outcomes in kids with CAS. Forty children will receive standard DTTC treatments twice weekly at a clinic over eight weeks. They'll be split into two groups: one gets direct coaching for home practice; the other doesn't.

What are the potential side effects?

Since this trial involves speech therapy techniques rather than medication, there aren't typical drug side effects. However, it's possible that participants may experience frustration or fatigue from intensive practice sessions.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

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I am between 2 and 11 years old.

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I have been diagnosed with Childhood Apraxia of Speech.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

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I have hearing loss.

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I have been diagnosed with a speech disorder.

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I have abnormalities in the structure of my mouth.

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My child's cognitive score is below 70, indicating a significant delay.

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I have vision problems that glasses or contacts can't fix.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ pre- to post-treatment (16 treatment sessions over 8 weeks); 1-week and 4-week post-treatment follow-up

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~pre- to post-treatment (16 treatment sessions over 8 weeks); 1-week and 4-week post-treatment follow-up

This trial's timeline: 3 weeks for screening, Varies for treatment, and pre- to post-treatment (16 treatment sessions over 8 weeks); 1-week and 4-week post-treatment follow-up for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Changes in word accuracy

Secondary study objectives

Changes in phoneme accuracy

Changes in speech intelligibility

Changes in the FOCUS-34 score

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: Direct Training (DTTC + Coaching + Home Practice)Experimental Treatment1 Intervention

Children in the Direct Training Arm will receive DTTC treatment 2x/week for 8 weeks with half of each session administered only by the SLP. In the other half of the session, DTTC will be administered by the parent/caregiver with online coaching by the SLP. During the coaching portion of treatment sessions, the SLP will provide direct training to guide the parent/caregiver in the administration of DTTC to support home practice sessions. Parent/caregivers in this Arm will also complete an online, self-paced educational module on CAS prior to the start of treatment and review home practice guidelines with the clinician at the end of each therapy session. Parent/caregivers will engage their children in home practice during the treatment phase and follow-up phase. Home practice will consist of 30-minute practice sessions 3x/week during the 8-week treatment phase and 6x/week during the 4-week follow-up phase.

Group II: Indirect Training (DTTC + Home Practice)Active Control1 Intervention

Children in the Indirect Training Arm will receive DTTC treatment 2x/week administered by an SLP for 8 weeks. Parent/caregivers in this Arm will complete an online, self-paced educational module on CAS prior to the start of treatment, observe all treatment sessions, and review home practice guidelines with the clinician at the end of each therapy session. Parent/caregivers will engage their children in home practice during the treatment phase and follow-up phase. Home practice will consist of 30-minute practice sessions 3x/week during the 8-week treatment phase and 6x/week during the 4-week follow-up phase.

0 / 7Eligibility criteria met

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.

Mechanism Of Action

Side Effect Profile

Prior Approvals

Other Research

Dynamic Temporal and Tactile Cueing (DTTC) is a common treatment for Childhood Apraxia of Speech (CAS) that focuses on improving speech motor planning and execution. It involves structured, repetitive practice with temporal and tactile cues, breaking down speech into smaller units and gradually increasing complexity. Temporal cues help in timing speech movements, while tactile cues provide physical feedback for correct articulation. This method is essential for CAS patients as it directly addresses their impaired motor planning and coordination, leading to more accurate and consistent speech production.

HABIT+tDCS: a study protocol of a randomised controlled trial (RCT) investigating the synergistic efficacy of hand-arm bimanual intensive therapy (HABIT) plus targeted non-invasive brain stimulation to improve upper extremity function in school-age children with unilateral cerebral palsy.Bimanual Skill Learning after Transcranial Direct Current Stimulation in Children with Unilateral Cerebral Palsy: A Brief Report.Transcranial Direct Current Stimulation (tDCS) in Unilateral Cerebral Palsy: A Pilot Study of Motor Effect.