Maria I Grigos, Panagiota Tampakis, Emily W Wang, Nicole Kolenda, Edythe A Strand, Julie L Wambaugh, Ying Lu, Zhuojun Lyu, Julie Case
{"title":"儿童言语失用症运动语言干预中治疗保真度的测量框架。","authors":"Maria I Grigos, Panagiota Tampakis, Emily W Wang, Nicole Kolenda, Edythe A Strand, Julie L Wambaugh, Ying Lu, Zhuojun Lyu, Julie Case","doi":"10.1044/2025_AJSLP-24-00570","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Examining adherence to a treatment protocol is a critical component of intervention research. This is particularly challenging in treatment involving young children with childhood apraxia of speech (CAS) where treatment is provided in a dynamic manner. The purpose of this work was to first present a framework for measuring fidelity of Dynamic Temporal and Tactile Cueing (DTTC), a motor-based treatment designed for children with CAS. This framework includes the DTTC Fidelity Checklist and a collaborative review process between investigators and treating speech-language pathologists (SLPs). We then quantify the fidelity of SLPs trained to administer DTTC to young children with CAS.</p><p><strong>Method: </strong>Three SLPs provided 8 weeks of intervention to 19 children with CAS (ages 2;9-6;7 [years;months]). Two investigators and the SLPs independently rated fidelity at multiple time points across the intervention period. Regression analyses were used to estimate the change in fidelity over time and across specific categories of the DTTC Fidelity Checklist. Reliability between the investigators and SLPs was examined using an adjusted Spearman correlation.</p><p><strong>Results: </strong>SLPs demonstrated high levels of adherence to the DTTC protocol. Ratings were found to be lower for one category of the DTTC Fidelity Checklist related to providing the child movement-based cues and giving explicit instructions to feel speech movements. Investigator and SLP ratings were highly consistent with one another, and correlations were very strong across all categories.</p><p><strong>Conclusions: </strong>This study presented a framework for measuring treatment fidelity during DTTC. Strong interrater reliability between investigator and SLP ratings supports the DTTC Fidelity Checklist as an evidence-based tool, providing a foundation for improving the precision of DTTC implementation in clinical and research settings.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"2827-2845"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452826/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Framework for Measuring Treatment Fidelity in Motor-Based Speech Intervention for Children With Childhood Apraxia of Speech.\",\"authors\":\"Maria I Grigos, Panagiota Tampakis, Emily W Wang, Nicole Kolenda, Edythe A Strand, Julie L Wambaugh, Ying Lu, Zhuojun Lyu, Julie Case\",\"doi\":\"10.1044/2025_AJSLP-24-00570\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Examining adherence to a treatment protocol is a critical component of intervention research. This is particularly challenging in treatment involving young children with childhood apraxia of speech (CAS) where treatment is provided in a dynamic manner. The purpose of this work was to first present a framework for measuring fidelity of Dynamic Temporal and Tactile Cueing (DTTC), a motor-based treatment designed for children with CAS. This framework includes the DTTC Fidelity Checklist and a collaborative review process between investigators and treating speech-language pathologists (SLPs). We then quantify the fidelity of SLPs trained to administer DTTC to young children with CAS.</p><p><strong>Method: </strong>Three SLPs provided 8 weeks of intervention to 19 children with CAS (ages 2;9-6;7 [years;months]). Two investigators and the SLPs independently rated fidelity at multiple time points across the intervention period. Regression analyses were used to estimate the change in fidelity over time and across specific categories of the DTTC Fidelity Checklist. Reliability between the investigators and SLPs was examined using an adjusted Spearman correlation.</p><p><strong>Results: </strong>SLPs demonstrated high levels of adherence to the DTTC protocol. Ratings were found to be lower for one category of the DTTC Fidelity Checklist related to providing the child movement-based cues and giving explicit instructions to feel speech movements. Investigator and SLP ratings were highly consistent with one another, and correlations were very strong across all categories.</p><p><strong>Conclusions: </strong>This study presented a framework for measuring treatment fidelity during DTTC. Strong interrater reliability between investigator and SLP ratings supports the DTTC Fidelity Checklist as an evidence-based tool, providing a foundation for improving the precision of DTTC implementation in clinical and research settings.</p>\",\"PeriodicalId\":49240,\"journal\":{\"name\":\"American Journal of Speech-Language Pathology\",\"volume\":\" \",\"pages\":\"2827-2845\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452826/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Speech-Language Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1044/2025_AJSLP-24-00570\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Speech-Language Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2025_AJSLP-24-00570","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
A Framework for Measuring Treatment Fidelity in Motor-Based Speech Intervention for Children With Childhood Apraxia of Speech.
Purpose: Examining adherence to a treatment protocol is a critical component of intervention research. This is particularly challenging in treatment involving young children with childhood apraxia of speech (CAS) where treatment is provided in a dynamic manner. The purpose of this work was to first present a framework for measuring fidelity of Dynamic Temporal and Tactile Cueing (DTTC), a motor-based treatment designed for children with CAS. This framework includes the DTTC Fidelity Checklist and a collaborative review process between investigators and treating speech-language pathologists (SLPs). We then quantify the fidelity of SLPs trained to administer DTTC to young children with CAS.
Method: Three SLPs provided 8 weeks of intervention to 19 children with CAS (ages 2;9-6;7 [years;months]). Two investigators and the SLPs independently rated fidelity at multiple time points across the intervention period. Regression analyses were used to estimate the change in fidelity over time and across specific categories of the DTTC Fidelity Checklist. Reliability between the investigators and SLPs was examined using an adjusted Spearman correlation.
Results: SLPs demonstrated high levels of adherence to the DTTC protocol. Ratings were found to be lower for one category of the DTTC Fidelity Checklist related to providing the child movement-based cues and giving explicit instructions to feel speech movements. Investigator and SLP ratings were highly consistent with one another, and correlations were very strong across all categories.
Conclusions: This study presented a framework for measuring treatment fidelity during DTTC. Strong interrater reliability between investigator and SLP ratings supports the DTTC Fidelity Checklist as an evidence-based tool, providing a foundation for improving the precision of DTTC implementation in clinical and research settings.
期刊介绍:
Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.