Speech Treatment for Minimally Verbal Children With ASD and CAS (TxMVASD+CAS)

Comorbid Childhood Apraxia of Speech (CAS) may be one factor that limits speech development in some minimally verbal children with autism. CAS is a disorder affecting speech movement planning. This study tests whether CAS-specific treatment, appropriately modified for minimally verbal children with autism, improves their speech.

Study Overview

• Status: Recruiting
• Conditions: Autism Spectrum Disorder; Developmental Verbal Dyspraxia
• Intervention / Treatment: Behavioral: CAS Treatment for Minimally Verbal Children with Autism

Detailed Description

Although one in four children with autism remain minimally verbal past age five, not all the factors that limit spoken language in these minimally verbal children are known. One powerful contributor may be a motor speech disorder, Childhood Apraxia of Speech (CAS). CAS is an impairment in the ability to plan and sequence for speech, which makes speech inconsistent and imprecise. This project proposes to investigate whether CAS makes the speech of minimally verbal children with autism unintelligible, and then to test whether treating the CAS improves children's speech.

First, a cohort of 20 minimally verbal children with both autism and CAS is identified. The prediction is that the more severe the CAS, the more inconsistent and imprecise a child's speech, and therefore the lower their intelligibility will be. Then, a set of mono- and bisyllabic words is selected that contain the disordered movements that each child shows and use those in treatment.

Treatment will take the form of 15 one-hour sessions where speech practice is embedded in a naturalistic, play-based milieu that is centered on each child's own developmental level. It will involve principles of motor learning (intensive practice of a few words, sometimes all in a row and sometimes mixed up). Different types of cues (touch cues, simultaneous production, etc.) will also be employed to help children say their words correctly, fading back these supports as the child's speech improves. Both of these techniques have been shown to be effective for treating CAS.

Our outcome measures will include both (1) "by-ear" assessments of intelligibility and (2) acoustic and kinematic measurements of children's speech after 15 treatment sessions. The findings will inform clinical practice for minimally verbal children with autism and may lead to the development of novel interventions for this severely affected population.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Karen V Chenausky, Ph.D.; Phone Number: 617-726-2405; Email: kvchenausky@mghihp.edu
• Study Contact Backup: Name: Michael Moody; Phone Number: 617-643-4658; Email: mjmoody@partners.org

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02129
      • Recruiting
      • MGH Institute of Health Professions
      • Contact: Steve Meyer; Phone Number: 617-726-2405; Email: ihpspanlab@mghb.org
      • Contact: Karen Chenausky, PhD; Email: kvchenausky@mghihp.edu
      • Principal Investigator: Karen V Chenausky, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years to 18 years (Child, Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Meets criteria for Autism Spectrum Disorder
• Able to correctly repeat at least 2 syllables
• Meets criteria for Childhood Apraxia of Speech
• Lives in an environment where child is exposed to English at least 50% of the time

Exclusion Criteria:

• Poorly controlled seizures
• Factors such as blindness or deafness that contribute to minimally verbal status
• Lives in an environment where English is not spoken at least 50% of the time
• Child experiences behavioral challenges that preclude participation in the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: CAS Treatment for MV ASD; Participants will receive CAS treatment, modified for minimally verbal children with autism	Behavioral: CAS Treatment for Minimally Verbal Children with Autism; Treatment involves principles of motor learning embedded in a naturalistic developmental milieu

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attempts Correct	Number or percent of target items that were produced correctly	5 weeks
Phonemes Correct	Number or percent of phonemes (vowels, consonants) in the target items that were produced correctly	5 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lip aperture movement variability	Amount of variability in lip opening area during production of multiple attempts at the same target	5 weeks
Phoneme distinctiveness	Acoustic distinctiveness of different phonemes	5 weeks

Collaborators and Investigators

• Sponsor: MGH Institute of Health Professions

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2024
• Primary Completion (Estimated): November 30, 2024
• Study Completion (Estimated): November 30, 2024

Study Registration Dates

• First Submitted: September 16, 2021
• First Submitted That Met QC Criteria: September 22, 2021
• First Posted (Actual): October 4, 2021

Study Record Updates

• Last Update Posted (Actual): March 13, 2024
• Last Update Submitted That Met QC Criteria: March 10, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: autism; speech development; childhood apraxia of speech; motor speech disorder
• Additional Relevant MeSH Terms: Mental Disorders; Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Psychomotor Disorders; Neurodevelopmental Disorders; Child Development Disorders, Pervasive; Autism Spectrum Disorder; Apraxias
• Other Study ID Numbers: 2021P002598

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No