Principles of Motor Learning in Speech Therapy for Childhood Apraxia of Speech
When providing speech therapy to children, many of you are likely already incorporating elements of the principles of motor learning without even realizing it. To ensure the most effective and evidence-based therapy, it’s important to apply these principles purposefully and systematically.
In this post, we’ll explore the principles of motor learning and their application to Childhood Apraxia of Speech (CAS), focusing on three main components: pre-practice, structure of practice, and feedback.
Motor learning is defined as “a set of processes associated with practice or experience leading to relatively permanent changes in the capability for movement” (Schmidt & Lee, 2000). For children with CAS, these processes are crucial for developing the motor planning and execution skills necessary for clear and intelligible speech.
Pre-Practice: Setting the Stage for Success
Before diving into structured practice, pre-practice is essential to prepare the child for success. This phase helps ensure the child is motivated, engaged, and ready to participate. Consider the following:
Ask Yourself These Questions:
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Is the child able to imitate?
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Does the child have joint attention?
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Does the child understand why they are there?
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Does the child understand what is expected?
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Does the child understand the difference between a correct and incorrect response?
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Does the child understand the parameters of speech (e.g., clear articulation, appropriate prosody)?
Pre-practice may also include stimulability activities to ensure the child is ready to practice specific sounds or movements. For children with attention or motivation challenges, consider implementing a behavior management plan to set clear expectations and foster engagement.
The way practice is structured has a significant impact on motor learning. Here are two critical aspects to consider:
Practice Schedules
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Massed vs. Distributed Practice:
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Massed practice involves fewer but longer sessions, which can promote quick skill development but may lead to poorer generalization.
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Distributed practice spreads the same total duration of practice across more sessions. While it takes longer, this approach supports better retention and motor learning.
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Blocked vs. Random Practice:
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Blocked practice involves practicing one target repeatedly before moving to the next. This approach often leads to better performance during the session.
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Random practice mixes targets within a session, leading to better retention and generalization over time.
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Repetitive Drill (Motor Drill)
Repetition is critical for motor learning. For motor patterns to become habitual and automatic, there must be sufficient trials within each practice session. Keep these points in mind:
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Ensure enough repetitions without excessive interruptions.
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Use engaging activities to facilitate repeated opportunities for target production.
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Balance reinforcement to avoid disrupting the flow of practice.
Feedback helps children refine their motor skills and progress toward accurate speech production. It’s important to tailor feedback to the child’s needs and the stage of therapy.
Types of Feedback
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Knowledge of Performance (KP): Focuses on how the movement was performed (e.g., “You need to keep your tongue behind your teeth for that sound”).
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Knowledge of Results (KR): Focuses on the outcome of the movement (e.g., “That was the correct /s/ sound”).
Frequency and Timing of Feedback
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Immediate Feedback: Given right after the child’s attempt; useful during the early stages of learning.
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Delayed Feedback: Allows the child to process and evaluate their own performance; beneficial for long-term retention.
Self-evaluation is a critical skill for success in speech therapy. Encourage children to reflect, rate, and monitor their own performance from the very first session. This not only makes them active participants in their therapy but also helps them develop the skills needed for self-correction and carryover outside of the therapy setting. Check out our NEW Self-Rating deck to help with self-rating!
To implement principles of motor learning effectively, keep the following in mind:
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Motivation and Attention: Ensure the child is engaged and understands the goals of therapy.
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Goals and Targets: Clearly define what is being practiced and how often.
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Repetition: Provide sufficient opportunities for the child to practice target behaviors.
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Vary Practice Conditions: Use a mix of blocked and random practice schedules to enhance learning and generalization.
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Feedback: Adjust the type and frequency of feedback based on the child’s progress and therapy goals.
Conclusion
Using the principles of motor learning purposefully can greatly enhance the effectiveness of speech therapy for Childhood Apraxia of Speech. By focusing on pre-practice, structured practice, and tailored feedback, you can help children achieve meaningful and lasting improvements in their speech abilities. Remember, motor learning takes time and consistency, but with the right approach, progress is always possible.
For more detailed guidance and evidence-based strategies, consult resources like Maas et al. (2008) and Bislick et al. (2012), which provide invaluable insights into applying motor learning principles in therapy.