DTTC with Caregiver Training for Childhood Apraxia of Speech
(DTTC Trial)
Recruiting in Palo Alto (17 mi)
+1 other location
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: New York University
Disqualifiers: Autism, Global delay, Down syndrome, others
No Placebo Group
Approved in 3 jurisdictions
Trial Summary
What is the purpose of this trial?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.
Will I have to stop taking my current medications?
The trial does not specify whether participants need to stop taking their current medications. However, children with ADHD can participate if they can attend sessions with medication and/or strategies.
What data supports the effectiveness of the treatment Dynamic Temporal and Tactile Cueing (DTTC) for Childhood Apraxia of Speech?
Research shows that DTTC, a motor-based treatment, can improve speech intelligibility in children with Childhood Apraxia of Speech. Additionally, training parents to use DTTC at home has been found effective in providing more intensive treatment, especially in rural areas.
12345Is Dynamic Temporal and Tactile Cueing (DTTC) safe for humans?
The research articles provided do not contain specific safety data for Dynamic Temporal and Tactile Cueing (DTTC) in humans. They focus on the effectiveness and implementation of the treatment for childhood apraxia of speech, but do not address safety concerns.
13567How is the DTTC treatment different from other treatments for childhood apraxia of speech?
DTTC (Dynamic Temporal and Tactile Cueing) is unique because it focuses on motor-based intervention, using specific timing and touch cues to help children with childhood apraxia of speech improve their speech intelligibility. This approach is different from other treatments that may not emphasize the same level of motor planning and tactile feedback.
12458Eligibility Criteria
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.Inclusion Criteria
I am between 2 and 11 years old.
English as the primary and preferred language
I have been diagnosed with Childhood Apraxia of Speech.
Exclusion Criteria
I am not receiving speech therapy from another provider during this study, but I may be getting language or AAC therapy.
I have hearing loss.
I have been diagnosed with a speech disorder.
+5 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Pre-Treatment
Caregivers complete an online self-guided educational module about CAS and DTTC
1 week
Treatment
Participants receive DTTC treatment 2x/week for 8 weeks with home practice 3x/week
8 weeks
16 visits (in-person)
Follow-up
Home practice continues at a higher frequency (6x/week) to monitor treatment outcomes
4 weeks
1 visit (in-person), 1 visit (virtual)
Participant Groups
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.
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.
Dynamic Temporal and Tactile Cueing (DTTC) is already approved in United States, Canada, European Union for the following indications:
🇺🇸 Approved in United States as Dynamic Temporal and Tactile Cueing for:
- Childhood Apraxia of Speech (CAS)
🇨🇦 Approved in Canada as Dynamic Temporal and Tactile Cueing for:
- Childhood Apraxia of Speech (CAS)
🇪🇺 Approved in European Union as Dynamic Temporal and Tactile Cueing for:
- Childhood Apraxia of Speech (CAS)
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Hofstra UniversityHempstead, NY
New York UniversityNew York, NY
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Who Is Running the Clinical Trial?
New York UniversityLead Sponsor
Hofstra UniversityCollaborator
References
Naive Listener Ratings of Speech Intelligibility Over the Course of Motor-Based Intervention in Children With Childhood Apraxia of Speech. [2023]The aim of this study was to describe changes in speech intelligibility and interrater and intrarater reliability of naive listeners' ratings of words produced by young children diagnosed with childhood apraxia of speech (CAS) over a period of motor-based intervention (dynamic temporal and tactile cueing [DTTC]).
Articulatory Control in Childhood Apraxia of Speech in a Novel Word-Learning Task. [2020]Articulatory control and speech production accuracy were examined in children with childhood apraxia of speech (CAS) and typically developing (TD) controls within a novel word-learning task to better understand the influence of planning and programming deficits in the production of unfamiliar words.
Look at Mummy: challenges in training parents to deliver a home treatment program for childhood apraxia of speech in a rural Canadian community. [2021]Children requiring speech pathology services in rural and remote locations face many barriers in accessing adequate services. This has particular consequences for children who need intensive treatment for therapy to be effective, such those with childhood apraxia of speech (CAS). Parent training has been used to overcome speech pathology service delivery barriers for a range of other communication disorders. However, the effectiveness of training parents to deliver a motor-based treatment for CAS within rural and remote contexts has not been evaluated. This study examined the effectiveness and feasibility of training parents in a rural community to use the treatment approach of dynamic temporal and tactile cueing (DTTC) in order to provide more intensive treatment sessions at home.
Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series. [2022]We report a case series of children with childhood apraxia of speech, by describing behavioral and white matter microstructural changes following 2 different treatment approaches.Five children with childhood apraxia of speech were assigned to a motor speech treatment (PROMPT) and 5 to a language, nonspeech oral motor treatment. Speech assessment and brain MRI were performed pre- and post-treatment. The ventral (tongue/larynx) and dorsal (lips) corticobulbar tracts were reconstructed in each subject. Mean fractional anisotropy and mean diffusivity were extracted. The hand corticospinal tract was assessed as a control pathway. In both groups speech improvements paralleled changes in the left ventral corticobulbar tract fractional anisotropy. The PROMPT treated group also showed fractional anisotropy increase and mean diffusivity decrease in the left dorsal corticobulbar tract. No changes were detected in the hand tract. Our results may provide preliminary support to the possible neurobiologic effect of a multimodal speech motor treatment in childhood apraxia of speech.
Reliance on auditory feedback in children with childhood apraxia of speech. [2015]Children with childhood apraxia of speech (CAS) have been hypothesized to continuously monitor their speech through auditory feedback to minimize speech errors. We used an auditory masking paradigm to determine the effect of attenuating auditory feedback on speech in 30 children: 9 with CAS, 10 with speech delay, and 11 with typical development. The masking only affected the speech of children with CAS as measured by voice onset time and vowel space area. These findings provide preliminary support for greater reliance on auditory feedback among children with CAS.
Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech. [2021]Purpose The purpose of this article is to describe a treatment approach, Dynamic Temporal and Tactile Cueing (DTTC), and to provide clinicians and clinical researchers a clear understanding of the theory and principles that contributed to the design of the treatment as well as the clinical decisions that must be made when implementing it. While brief descriptions of DTTC have been provided in textbooks, a complete summary of the rationale, essential elements, method, and procedures has not yet been published. Such a summary is important so that clinicians can gain a better understanding of and more confidence in using the method for appropriate children. Furthermore, this article provides clinicians and clinical researchers essential information for measurement of fidelity. Method The important elements of the DTTC method with rationale for their inclusion are described. The temporal hierarchy of DTTC is depicted, and the dynamic procedure is described in detail, with suggestions for fidelity measurement. Finally, a discussion of important decisions clinicians must make when implementing DTTC is presented. Conclusions The goal of DTTC is to improve the efficiency of neural processing for the development and refinement of sensorimotor planning and programming. The rationale for DTTC in general, as well as the key elements important to its administration, are supported by models of speech production and theories of motor learning. Important clinical decisions regarding stimuli, organization of practice, and feedback are based on principles of motor learning in order to facilitate acquisition, retention, and continued improvement of motor speech skills.
The Effect of Hand Gesture Cues Within the Treatment of /r/ for a College-Aged Adult With Persisting Childhood Apraxia of Speech. [2022]Despite the widespread use of hand movements as visual and kinesthetic cues to facilitate accurate speech produced by individuals with speech sound disorders (SSDs), no experimental investigation of gestural cues that mimic that spatiotemporal parameters of speech sounds (e.g., holding fingers and thumb together and "popping" them to cue /p/) currently exists. The purpose of this study was to examine the effectiveness of manual mimicry cues within a multisensory intervention of persisting childhood apraxia of speech (CAS).
Comparing global motor characteristics in children and adults with childhood apraxia of speech to a cerebellar stroke patient: evidence for the cerebellar hypothesis in a developmental motor speech disorder. [2021]Individuals with childhood apraxia of speech (CAS) have motor deficits in systems beyond speech and also global deficits in sequential processing, consistent with cerebellar dysfunction. We investigated the cerebellar hypothesis of CAS in 18 children and adolescents with CAS, 11 typical controls, an adult with a probable CAS history, and an adult with a history of a cerebellar stroke. Compared to the controls, children and adolescents with CAS had the greatest difficulty with rapid syllable repetition when alternating between two different syllables types, less difficulty when switching among three different syllables, and no difficulty when repeating the same syllable. They also showed difficulty with alternating but not repetitive key tapping. Motor speeds during the syllable repetition and key tapping tasks where correlated, consistent with a central motor delimiter that governs both systems. Participants with CAS obtained low scores in a test of fine motor ability, where the tasks required rapid integration of complex hand movement sequences. The adult with the probable CAS history obtained motor performance scores that generally resembled those in the children and adolescents with CAS, consistent with motor deficits that persist into adulthood. The participant with the cerebellar stroke history showed deficits in tests of fine and gross motor ability as well as balance. His repetitive and alternating key tapping was slow in the ipsilateral hand relative to the stroke lesion. The shared deficits in sequential motor functions among all participants with CAS and the cerebellar stroke patient are consistent with persisting cerebellar dysfunctions in CAS.