Untangling Childhood Apraxia of Speech

girl_post4Childhood Apraxia of Speech is disorder that impacts a child’s ability to coordinate their speech movements. The child knows what he/she want to say, but the sounds come out mixed up.   It is sometimes frustrating for parents when they have heard their child produce that “F” sound perfectly, but then when it comes time to applying it to phrases or sentences it all falls apart. Or sometimes their child can say certain phrases perfectly, but then when using the same sound set in  more novel combinations, it comes out all mixed up.   “Is he being lazy?” I am asked.

No, your child is not being lazy.  It is just really hard for your child’s brain to coordinate all of those sounds together.  Apraxia therapy considers your child’s sound repertoire and at what point the motor coordination becomes taxing. It then seeks to systematically expand the repertoire and coordination. Children with Apraxia of Speech usually present with multiple sound errors, but for the sake of  keeping it simple for this post I will just use the phoneme /f/ as an example.  Apraxia therapy involves a lot of intense practice and repetition as it is seeking to build motor coordination for speech production.

Therapy would start at the level at which your child is able to coordinate their speech.  Maybe that is just imitating a single sound.  Whatever that level is, through a hierarchy of cueing techniques we would want to work toward expanding that coordination ability.

There are levels of cueing that can be used to accomplish this, including:

  • Verbal Explanation:  “Bite your lip”, if coordinating /f/
  • Hand Cues:  placing a finger on your bottom lip, feeling the air from the /f/.
  • Visual Modeling:  Showing child the placement of the articulators on yourself
  • Fill in the Blank:  My toes are on my_____________.
  • Written cues:  Showing the child where the /f/ is in the word.
  • Assimilation:  Using a sound that is consistent in the child’s repertoire and is closely related to the targeted sound as a spring board to the new target sound.

There are a host of other cues that can also work.  The idea is to find the least restrictive combination of cues that are effective and then reduce the dependence on those cues over time.  And with time and practice and practice and more practice and patience  you will see your child being able to independently coordinate longer strings of speech.

Finding a speech-language pathologist that can conduct a thorough evaluation of your child’s sound repertoire and speech coordination skills and then set up an intense treatment program that you can be a hands on part of will enhance and promote your child’s progress toward his/her best communication.

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