Poster W12 - Gaps in methodologies for treating Childhood Apraxia of Speech: exploring engineering techniques utilizing sensory substitution and social robots

Introduction: The purpose of our investigation is to display the need for new modalities (a tactile, sensory substitution-type, and social robotic methodologies) to train children suffering from childhood apraxia of speech (CAS).CAS is a motor speech disorder which involves a disconnect between planning and coordinating the motions of the articulators (e.g., tongue, lips, jaw), which affects the ability to generate speech [1] and is estimated to occur in 1 out of 1000 children [2]. With this condition there is a neurodivergence between what the child intends to say and sounds that are produced, leaving the child feeling locked in, frustrated and isolated. Deficits will not resolve without intervention and there is a consensus that motor-based training is required for rehabilitation tied to CAS [2,3]. Most commonly, tactile cueing techniques (i.e., visually, audibly and tactily through touch through word demonstration) are administered by the speech language pathologist (SLP) to the patient with CAS. Dynamic Temporal and Tactile Cueing (DTTC) is one of only few evidence-based motor-based treatment approaches for CAS [4] (Figure 1 [7]). However, effectiveness, repeatability of the technique, as well as engagement and attention of the child are considerations.

Materials and

Methods: All study activities are to be conducted within the Center for Biomechanical & Rehabilitation Engineering at the University of the District of Columbia and will involve IRB approval. As an initial step, we will perform a metanalysis of previous relevant research. Here, we discuss Socially Assistive Robots (SARS) in Speech Language Therapy (SLP) to enhance communication disorders in juveniles [5] and a second paper tied to Dynamic Temporal and Tactile Cueing (DTTC) treatment for CAS participants, focusing on the impact of the treatment of frequency on DTTC outcomes [6].

Results, Conclusions, and Discussions: The use of Socially Assistive Robots (SARS) and virtual reality (VR) presents promising assistive technologies for promoting social interaction and communication among children with neurodevelopmental disorders. These technologies offer benefits like increased motivation and attention during individual therapy sessions. However, there are notable areas for improvement, particularly in emotional expression and engagement which are increasingly being assessed through eye tracking technologies. SARs encounter technical limitations like high costs, potential malfunctions, and limited speech recognition and emotional intelligence capabilities. Addressing these limitations requires innovation, standardized protocols, user acceptance, and robust ethical guidelines to ensure privacy, prevent bias, clarify responsibility, and monitor dependence. Reviewed articles serve as blueprints for future applications, including using social robots in interventions for stuttering and autism therapies, providing visual and auditory feedback during sessions. This study underscores SARs' significant potential in rehabilitating communication disorders in children and adolescents, highlighting their utility across various aspects of speech and language therapy. SARs can aid in vocabulary and language development, articulation therapy, social skill enhancement, storytelling, and real-time feedback provision. Future research aims to optimize SARs' role by integrating advanced technologies such as Natural Language Processing (NLP), adaptive dialogue systems, virtual reality (VR), augmented reality (AR), mixed reality (MR), affective computing, and biofeedback algorithms. Additionally, research will focus on addressing challenges like cost, accessibility, and technical limitations to enhance human-robot interaction and efficacy in speech and language therapy. [6]. Our investigation highlights the necessity for innovative modalities in treating Childhood Apraxia of Speech (CAS), proposing the use of tactile, sensory substitution techniques, and social robots. While the use of DTTC has been proven effective, there are concerns about engagement, repeatability, and long-term effectiveness. This study also seeks to explore the role of SARs in speech language therapy in promoting social interaction and communication in children with neurodevelopmental disorders. Further research is needed to optimize the role of SARs and DTTC in SLT and overcome existing challenges, ultimately improving outcomes for children with CAS and other communication disorders.

Acknowledgements (Optional): Acknowledgements: National Science Foundation #2229575 (Alan T. Waterman Award).

References:
[1] American Speech-Language-Hearing Association. (2007). Childhood Apraxia of Speech [Technical Report]. ASHA.org.
[2] Murray, E., McCabe, P., & Ballard, K. J. (2015). A Systematic Review of Treatment Outcomes for Children With Childhood Apraxia of Speech. American Journal of Speech-Language Pathology, 24(2), 483–497. https://doi.org/10.1044/2015_AJSLP-14-0053
[3] Maas E, Gildersleeve-Neumann C, Jakielski K, Stoeckel R. Motor-based intervention protocols in treatment of childhood apraxia of speech (CAS). Curr Dev Disord Rep. 2014;1(3):197–206.
[4] Strand EA. Dynamic Temporal and Tactile Cueing (DTTC): A Treatment Strategy for Childhood Apraxia of Speech. Am J Speech Lang Pathol. 2020;29(1):30–48.
[5] Georgieva-Tsaneva, G., et al. "Exploring the Potential of Social Robots for Speech and Language Therapy: A Review and Analysis of Interactive Scenarios. Machines 2023, 11, 693." (2023).
[6] Iuzzini-Seigel, Jenya, et al. "Dose frequency randomized control trial for dynamic temporal and tactile cueing (DTTC) treatment for childhood apraxia of speech: Protocol paper." (2023).
[7] Thrive Autism Center. Retrieved from https://www.thriveautismcenter.com/apraxia-of-speech-or-childhood-apraxia-of-speech-cas