Education and Human Sciences, College of (CEHS)


Date of this Version



A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Doctor of Philosophy, Major: Human Sciences (Communication Disorders), Under the Supervision of Professor David R. Beukelman. Lincoln, Nebraska: May 2011

Copyright 2011, Amy S. Nordness


Children with childhood apraxia of speech (CAS) need intensive and accurate practice to establish an accurate motor plan and improve their speech production. Computer-led practice led to a greater quantity of practice and was preferred over parent-led practice. Further knowledge regarding children’s accuracy of speech during independent practice is needed to determine if computer-led practice is a viable practice tool. Twelve children diagnosed with CAS, between 3-0 and 7-11 years of age, participated in speech practice during computer-led, parent-led, and clinician-led practice. Comparisons of perceptual accuracy of consonants and vowels, acoustical accuracy of stops, vowels, and fricatives, and variability of stops, vowels, and fricatives were examined.

The first study found no significant differences between perceptual accuracy of consonants and vowels during the three practice conditions. Additionally, speech productions in the computer-led condition led to greater precision in back sounds and fewer out-of-class substitutions and deletion errors compared to the parent-led and clinician-led conditions. Therefore, computer-led practice led to speech productions that were as accurate as current practice.

The second study found vowel productions were consistent across all three conditions. Production of fricatives were consistent across all three conditions, with greater accuracy in the computer- and clinician-led condition on two fricatives compared to the parent-led condition. There were no significant differences in over half of the stop productions. The computer- and clinician-led conditions led to the longest durations, which may have led to increased accuracy, while the parent-led condition led to the shortest durations. Overall, the greatest variability occurred in the parent-led condition across all manners of production, followed by the clinician-led condition, and the computer-led condition revealed the least variability. These findings suggest that computer-led practice led to speech productions that were comparable or better than clinician-led and parent-led conditions.

These studies provide evidence that computer-led speech practice is a viable practice tool for children with CAS to achieve accurate speech productions.

Adviser: David R. Beukelman