Random Versus Blocked Practice in Treatment for Childhood Apraxia of Speech

Purpose: To compare the relative effects of random vs. blocked practice schedules in treatment for childhood apraxia of speech (CAS). Although there have been repeated suggestions in the literature to use random practice in CAS treatment, no systematic studies exist that have directly compared random with blocked practice in this population. Method: Using an alternating treatments single-subject design with multiple baselines across behaviors, the authors compared random and blocked practice in 4 children diagnosed with CAS in terms of retention and transfer. Random and blocked practice were implemented in the context of a version of Dynamic Temporal and Tactile *Cueing treatment (Strand, Stoeckel, & Baas, 2006). Perceptual accuracy of target utterances was scored, and effect sizes were calculated to quantify the magnitude of treatment effects. Results: Findings were mixed, with 2 children showing a blocked practice advantage, 1 child showing a random practice advantage, and 1 child showing no clear improvement in either condition. Conclusions: These findings suggest that the random practice advantage observed in the nonspeech motor learning literature may not extend to treatment for CAS. Furthermore, the findings add to the small body of literature indicating that integral stimulation treatment can lead to improvements in speech production for children with CAS.