A Novel Treatment of Error Awareness for Acquired Apraxia of Speech and Aphasia: Effects of a Single-Case Experimental Design Investigation

Purpose: Error awareness (EA) is the ability to identify errors in one's speech productions. Persons with aphasia and apraxia of speech (A-AOS) have been found to vary widely in their EA abilities. EA, as measured by the accuracy of self-judgments of word production accuracy, has been found to be moderately associated with response to AOS treatment. EA training has rarely been included in AOS treatments, and the impact of EA as a treatment ingredient has not been studied. This study was designed to examine the effects of a novel treatment for impaired EA in individuals with A-AOS—the Treatment of Error Awareness (TEA). Method: Two participants with chronic A-AOS received TEA applied to multisyllabic words in the context of a multiple-baseline design. TEA therapeutic ingredients included repetition of modeled words, judgment of self-productions, and a response-contingent hierarchy focused on facilitating awareness of auditory and somatosensory feedback. The dependent variables were (a) the percentage of words judged accurately and (b) the percentage of words produced without articulatory errors. Probe data collected throughout all study phases were analyzed using visual analysis supplemented by the conservative dual criterion method as well as tau U and d statistics to measure effect sizes. Results: Both participants demonstrated very large treatment-based improvements for EA in treated sets. Word production accuracy also improved for both participants' treated sets. Conclusion: TEA was a successful new intervention for these individuals with A-AOS and impaired EA. Supplemental Material: https://doi.org/10.23641/asha.32288469