METRICAL

PACING
TREATMENT
➢ Rhythm-based treatment methods have been considered successful in the
remediation of AOS, not only with positive consequences at the
suprasegmental level, but also with improvements concerning the segmental
aspects of speech.

➢ The Metrical Pacing Therapy (MPT) relies on a rhythmical cueing technique

using acoustic stimulation.

➢ Metrical Pacing Treatment is a type of pacing technique that uses rhythmical

sequences of tones to guide production of target utterances.

➢ Similar to metronome pacing

➢ The patients are presented rhythmical sequences of tones, which constitute metrical templates
of pre-specified training utterances and are required to articulate the target utterances
synchronously with the pacing signals.
➢ The pacing tones generated by a computer and can be varied by rate (corresponding to speech
rate) and metrical structure (syllable number and stress pattern) to simulate the natural stress
patterns of speech (Brendel & Ziegler, 2008).
➢ The tones of a pacing sequence (tone frequency: 1500 Hz; duration: 30 ms) represents the
syllable onsets of the target utterance, hence the number of tones of a sequence corresponded
to the syllable number of the utterance to be trained.
➢ Even though metrical pacing is similar to metronome pacing it has considerable advantages
over metronome pacing since the natural rhythm or prosody of the target utterances is
maintained (Brendel & Ziegler, 2008; Brendel et al., 2000).
STEPS IN METRICAL PACING THERAPY

Preparation of
metrical templates.
PREPARATION OF METRICAL TEMPLATES

➔ Before the training session the therapists devises a set of training utterances of
appropriate length and complexity considering the patient’s individual articulatory
skills.
➔ Each utterance is then recorded in a natural prosody and with a normal speaking rate,
and the syllable onsets of the utterance are determined
➔ Syllable onset times, are entered into the computer program controlling the
presentation of the pacing signal.
SELECTION OF PACING RATES
METRICAL PACING TASK
EFFECTIVENESS OF MPT

Studies done by Brendel and Ziegler in 2008 shows that

➢ MPT resulted in a prominent and significant decrease of sentence durations and of the
proportion of hesitations or repairs relative to total sentence duration except in some
cases
➢ Improvements in segmental accuracy
➢ Increased rate and fluency
REFERENCES

1. Hurkmans, J. J. S. (2016). The treatment of apraxia of speech: Speech and music

therapy, an innovative joint effort. [Groningen]: University of Groningen.
2. “American Speech-Language-Hearing Association.” ASHA, ASHA,
https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942115§ion.
3. Brendel, Bettina, and Wolfram Ziegler. “Effectiveness of Metrical Pacing in the
Treatment of Apraxia of Speech.” Aphasiology, vol. 22, no. 1, 2008, pp. 77–102.,
doi:10.1080/02687030600965464.