A Randomized Controlled Trial for Children With Childhood Apraxia of Speech Comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme-Third Edition

Purpose: This randomized controlled trial compared the experimental Rapid Syllable Transition (ReST) treatment to the Nuffield Dyspraxia Programme-Third Edition (NDP3; Williams & Stephens, 2004), used widely in clinical practice in Australia and the United Kingdom. Both programs aim to improve speech motor planning/programming for children with apraxia of speech (CAS), but they differ in types of stimuli used, level of stimulus complexity at initiation of treatment, and the principles of motor learning that they apply. Method: Treatment was delivered to 26 children with mild to severe CAS aged 4-12 years through trained and supervised speech-language pathology students in 1-hr sessions, 4 days a week for 3 weeks at a university clinic. Articulation and prosodic accuracy were assessed at pretreatment, 1 week, 1 month, and 4 months posttreatment using blinded independent assessors to compare treatment, maintenance, and generalization effects. Results: The ReST and NDP3 treatments demonstrated large treatment effects. ReST maintained treatment gains from 1-week to 4-months posttreatment more effectively than the NDP3. Significant generalization to untreated stimuli was observed for both ReST and NDP3. Conclusions: ReST and NDP3 have strong evidence of treatment and generalization gains in children with CAS when delivered intensively. Overall, ReST has greater external evidence from multiple sources but both treatments have support for clinical use.