Children with childhood apraxia of speech (CAS) are likely to experience severe and persistent spoken and written language disorder. There is a scarcity of intervention research, however, investigating techniques to improve the speech and literacy outcomes of this population. The series of 5 experiments reported in this thesis investigated phonological awareness and early reading development in children with CAS and trialled a new intervention designed to advance the spoken and written language development of those affected. In the first experiment (presented in Chapter 2), a comparison of 12 children with CAS, 12 children with inconsistent speech disorder (ISD), and 12 children with typical speech-language development (TD) revealed that children with CAS may be particularly susceptible to phonological awareness and reading deficits. There was no difference in the articulatory consistency and speech severity of the CAS and ISD groups, and no difference in the receptive vocabulary of the CAS, ISD, and TD groups. The children with CAS exhibited poorer phonological awareness scores than the comparison groups and had a greater percentage of participants performing below the expected range for their age on letter knowledge, real word decoding, and phonological awareness normative measures. The children with CAS and ISD performed inferiorly than the children with TD on a receptive phonological representation task. The results showed that the children with CAS had a representational component to their disorder that needed to be addressed in intervention. In the second experiment (presented in Chapter 3), a follow-up pilot study was conducted to examine the long-term effects of a previously conducted intensive integrated phonological awareness programme (7 hours of intervention over 3 weeks) on 2 children with CAS. The children aged 7;3 and 8;3 at follow-up assessment had previously responded positively to the intervention. Results showed that the children were able to maintain their high accuracy in targeted speech repeated measures over the follow-up period. One child was also able to maintain her high accuracy in phonological awareness repeated measures. The children performed superiorly on a standardised phonological awareness measure at follow-up than at pre-intervention. Non-word reading ability showed a sharp increase during the intervention period, while minimal gains were made in this measure over the follow-up period. The findings suggested that an integrated intervention was a potential therapeutic approach for children with CAS. In the third experiment (presented in Chapter 4), the effectiveness of an integrated phonological awareness programme was evaluated for the 12 children (identified in the first experiment) aged 4 to 7 years with CAS. A controlled multiple single-subject design with repeated measures was employed to analyse change in trained and untrained speech and phoneme segmentation targets. A comparative group design was used to evaluate the phonological awareness, reading, and spelling development of the children with CAS compared to their peers with TD over the intervention. The children participated in two 6- week intervention blocks (2-sessions per week) separated by a 6-week withdrawal block. Seven children with CAS made significant gains in their production of trained and untrained speech words with 7 of these children demonstrating transfer of skills to connected speech for at least one target. Ten children showed significant gains in phoneme awareness, and 8 of these children demonstrated transfer of skills to novel phoneme awareness tasks. As a group, the children with CAS demonstrated accelerated development over the intervention period in letter knowledge, phonological awareness, word decoding, and spelling ability compared to their peers with typical development. In the fourth experiment (presented in Chapter 5), the speech, phonological awareness, reading, and spelling skills of children with CAS and TD were re-evaluated 6- months following completion of the intervention programme. A measure of reading accuracy and reading comprehension in a text reading task was administered to the children with CAS. There was no difference in the performance of the children with CAS in post-intervention and follow-up assessments. The children with CAS and children with TD presented with similar relative change in phonological awareness, reading, and decoding measures over the follow-up period. The connected reading performance of children with CAS mirrored their phonological awareness and decoding skills. The findings demonstrated that children with CAS were able to maintain gains achieved during the intervention but may need further support to promote sustained development in written language. In the fifth experiment (presented in Chapter 6), the long-term effects of the integrated phonological awareness programme for identical twin boys who participated in the research intervention at pre-school were examined. The study examined Theo and Jamie's spoken language, phonological awareness, reading, and spelling development during their first year of schooling. The results pointed to the benefit of providing phonological awareness within a preventative framework for children with CAS. Theo and Jamie experienced continued growth in speech and phonological awareness skills. They exhibited age-appropriate reading and spelling development during their first year of formal literacy instruction. It was concluded from this series of experiments that children with CAS are particularly vulnerable to phonological awareness and early reading difficulty, and that an integrated phonological awareness intervention is an effective means of developing speech, phonological awareness, reading, and spelling skills in most children with CAS. The intervention appears to target processes underlying spoken and written language development in this population. The results are discussed within a phonological representation deficit hypothesis of CAS and clinical implications of the findings are highlighted.

Children with childhood apraxia of speech (CAS) are likely to experience severe and persistent spoken and written language disorder. There is a scarcity of intervention research, however, investigating techniques to improve the speech and literacy outcomes of this population. The series of 5 experiments reported in this thesis investigated phonological awareness and early reading development in children with CAS and trialled a new intervention designed to advance the spoken and written language development of those affected. In the first experiment (presented in Chapter 2), a comparison of 12 children with CAS, 12 children with inconsistent speech disorder (ISD), and 12 children with typical speech-language development (TD) revealed that children with CAS may be particularly susceptible to phonological awareness and reading deficits. There was no difference in the articulatory consistency and speech severity of the CAS and ISD groups, and no difference in the receptive vocabulary of the CAS, ISD, and TD groups. The children with CAS exhibited poorer phonological awareness scores than the comparison groups and had a greater percentage of participants performing below the expected range for their age on letter knowledge, real word decoding, and phonological awareness normative measures. The children with CAS and ISD performed inferiorly than the children with TD on a receptive phonological representation task. The results showed that the children with CAS had a representational component to their disorder that needed to be addressed in intervention. In the second experiment (presented in Chapter 3), a follow-up pilot study was conducted to examine the long-term effects of a previously conducted intensive integrated phonological awareness programme (7 hours of intervention over 3 weeks) on 2 children with CAS. The children aged 7;3 and 8;3 at follow-up assessment had previously responded positively to the intervention. Results showed that the children were able to maintain their high accuracy in targeted speech repeated measures over the follow-up period. One child was also able to maintain her high accuracy in phonological awareness repeated measures. The children performed superiorly on a standardised phonological awareness measure at follow-up than at pre-intervention. Non-word reading ability showed a sharp increase during the intervention period, while minimal gains were made in this measure over the follow-up period. The findings suggested that an integrated intervention was a potential therapeutic approach for children with CAS. In the third experiment (presented in Chapter 4), the effectiveness of an integrated phonological awareness programme was evaluated for the 12 children (identified in the first experiment) aged 4 to 7 years with CAS. A controlled multiple single-subject design with repeated measures was employed to analyse change in trained and untrained speech and phoneme segmentation targets. A comparative group design was used to evaluate the phonological awareness, reading, and spelling development of the children with CAS compared to their peers with TD over the intervention. The children participated in two 6- week intervention blocks (2-sessions per week) separated by a 6-week withdrawal block. Seven children with CAS made significant gains in their production of trained and untrained speech words with 7 of these children demonstrating transfer of skills to connected speech for at least one target. Ten children showed significant gains in phoneme awareness, and 8 of these children demonstrated transfer of skills to novel phoneme awareness tasks. As a group, the children with CAS demonstrated accelerated development over the intervention period in letter knowledge, phonological awareness, word decoding, and spelling ability compared to their peers with typical development. In the fourth experiment (presented in Chapter 5), the speech, phonological awareness, reading, and spelling skills of children with CAS and TD were re-evaluated 6- months following completion of the intervention programme. A measure of reading accuracy and reading comprehension in a text reading task was administered to the children with CAS. There was no difference in the performance of the children with CAS in post-intervention and follow-up assessments. The children with CAS and children with TD presented with similar relative change in phonological awareness, reading, and decoding measures over the follow-up period. The connected reading performance of children with CAS mirrored their phonological awareness and decoding skills. The findings demonstrated that children with CAS were able to maintain gains achieved during the intervention but may need further support to promote sustained development in written language. In the fifth experiment (presented in Chapter 6), the long-term effects of the integrated phonological awareness programme for identical twin boys who participated in the research intervention at pre-school were examined. The study examined Theo and Jamie's spoken language, phonological awareness, reading, and spelling development during their first year of schooling. The results pointed to the benefit of providing phonological awareness within a preventative framework for children with CAS. Theo and Jamie experienced continued growth in speech and phonological awareness skills. They exhibited age-appropriate reading and spelling development during their first year of formal literacy instruction. It was concluded from this series of experiments that children with CAS are particularly vulnerable to phonological awareness and early reading difficulty, and that an integrated phonological awareness intervention is an effective means of developing speech, phonological awareness, reading, and spelling skills in most children with CAS. The intervention appears to target processes underlying spoken and written language development in this population. The results are discussed within a phonological representation deficit hypothesis of CAS and clinical implications of the findings are highlighted.

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The diploma thesis deals with the topic of field language and speech therapy for people with dysphagia. The work is divided into four chapters, while the first three define the theoretical framework of the work, the fourth chapter is empirical. The introductory chapter provides an insight into the physiology of swallowing and the anatomy of the orofacial area. The following chapter is devoted to the issue of dysphagia. The final theoretical chapter offers an insight into speech therapy intervention in patients with dysphagia. The fourth chapter presents a mixed design of a research survey focusing on the provision of field speech therapy care for people with dysphagia in the Czech Republic. The main goal of the research survey was to analyze the provision of this care in our country. This was followed by setting partial goals of the work and research questions. Within them, the work tries to analyze the specifics and barriers to the provision of field speech and language therapy care for patients with dysphagia. A questionnaire survey among clinical speech therapists and interviews with some of them was developed. The conclusion of the work is a summary of the results of the research survey supplemented by recommendations for speech therapy practice. The appendix contains a list of contacts of...

The topic of the thesis is speech therapy for people with aphasia. The thesis is divided into four chapters, the first three chapters are concerning the theory, the fourth chapter is empirical. The first chapter contains the definition of communication and the definition of disturbed communication ability, it dedicates the central and peripheral nervous system and its impact on the communication ability. The second chapter focuses on the aphasia as a kind of disturbed communication of ability gained by adults. Herein is described the etiology, symptomology and speech therapy intervention, the part of this is diagnostics, therapy and prevention. The third chapter mentions the system of organization of the speech therapy intervention in the Czech Republic which is divided into three sectors. Further is described the speech therapy in home care as an ordinary part of speech therapy abroad. The fourth chapter presents the combined research focused on provided speech therapy in home care in our country. The main purpose of such research was to analyse the specifics of speech therapy in home care for persons with aphasia and to record availability of providing this service. Then the minor goals and the research questions were determined. This was obtained by the questionnaire survey among the speech...

The topic of this diploma thesis is speech therapy and intervention of people after stroke with a diagnosis of aphasia. The thesis consists of four chapters. The theoretical framework is presented in three chapters, the fourth one is an empirical part of thesis. The first theoretical chapter deals with the concept of communication and defines the basic terminology, it also describes the area of the central and peripheral nervous system and its influence on the human's communication ability. The second chapter approaches the issue of ictus focusing especially on etiology and symptomatology of the disease, diagnostics, therapy and prevention. The third theoretical chapter describes aphasia - a kind of communication disorder arising from a stroke. It focuses on the definition, etiology and symptomatology of aphasia, the process of diagnosis and therapy. In conclusion, this chapter also describes the possibilities of providing speech therapy and intervention in the Czech Republic. The fourth chapter of diploma thesis describes a qualitative research that was conducted within two-weeks complex rehabilitation stays for people after stroke. The main objective of the research was to analyze speech therapy and intervention in adult clients after stroke with a diagnosis of aphasia in the chronic phase. Then...