Principles of Motor Learning (PMLs) refers to patterns of learning that have emerged from research into human movement. The bulk of this research has evolved from disciplines outside of Speech-Language Pathology (e.g. exercise and sport), and the research within our field though growing, is still in its very early stages. Nevertheless, PMLs are increasingly being investigated as they apply to speech therapy in the hopes that a solid understanding of PMLs can help Speech-Language Pathologists optimize their work with patients/clients struggling with motor speech challenges, such as Childhood Apraxia of Speech. Dr. Edwin Maas has been at the forefront of synthesizing the applications of PML research to Speech-Language Pathology. He has an excellent video on the Apraxia Kids On-Demand Webinars library, and his team's tutorial on Principles of Motor Learning in the Treatment of Motor Speech Disorders is published in Volume 17 of the American Journal of Speech-Language Pathology. This blog post series will summarize some of the key PMLs has outlined in those sources.

Principles of Motor Learning as they pertain to speech therapy apply to two broad categories of intervention: Practice Conditions and Feedback Conditions. Practice Conditions in a nutshell are what the patient/client/student does, Feedback Conditions are what the therapist/communication partner does. Practice conditions refer to aspects such as how much the individual practices, and how often, while feedback conditions refer to how and when the therapist/communication partner responds to what is being practiced.

This post is the first of a series on PMLs, and will highlight the Feedback Conditions: Knowledge of Results and Knowledge of Performance. For additional PMLs and more in-depth discussion, please refer to the sources listed above.

 Knowledge of Performance (KP) vs. Knowledge of Results (KR)

Knowledge of Performance and Knowledge of Results are two feedback types that differ in context. Knowledge of Results (KR) is binary - think: wrong vs. right with nothing else in terms of direction. Responses such as "You got it!" or "That wasn't quite right" would fall in this category. Knowledge of Performance (KP) involves more specific directives: "Your tongue needs to move slightly forward, back etc." Knowledge of Performance feedback is more detailed, descriptive, and open-ended. I find associating the mnemonic of Results = Right/Wrong and Performance = Precise Placement, helps me remember which is which! Research into limb motor movement suggests KP is more beneficial in the early stages of therapy - when establishing a new movement, while KR is preferable as therapy progresses.

KP vs. KR in Action: Providing Feedback during Therapy

How feedback is provided during therapy need not be limited to verbal feedback. Knowledge of Results Feedback - Right vs. Wrong can be communicated non-verbally by: 

Body Language: nod vs. head shake

Show it: Use a visual to show the correct target and a blank or neutral separate visual to show incorrect. Show correct/incorrect by displaying the corresponding image.

Write It: X vs. checkmark (that the student can see)

Gamify it! Collecting objects (e.g. for a game), and sorting into the pile for correct incorrect. E.g. you can have a pile of monopoly money, when production is correct dollar goes in student's pile, incorrect goes in the instructor's pile. After X amount of trials, student and instructor play the game with hat they've earned. Bonus of the last two approaches is that they serve as easy data collection as well.  

Verbal Knowledge of Performance Feedback can be reinforced with visuals.

Here is an example from the What's that Sound? Speech Sound Cards box:

Principles of Motor Learning in Treatment of Motor Speech Disorders, Maas Edwin, Robin Donald A., Austermann Hula Shannon N., Freedman Skott E., Wulf Gabriele, Ballard Kirrie J., Schmidt Richard A. (2008) American Journal of Speech-Language Pathology

doi: 10.1044/1058-0360(2008/025)