Sunday, December 21, 2014

Help for Childhood Apraxia of Speech

by Jolynn Thomas, MS Ed.

Help for Childhood Apraxia of Speech

With apraxia, children like Billy may know what they want to say but have difficulty forming the sounds or words correctly. They often have a difficult time being understood by family, teachers and peers. Reading, spelling and writing skills are often challenging for children with apraxia.
With apraxia, children like Billy may know what they want to say but have difficulty forming the sounds or words correctly. They often have a difficult time being understood by family, teachers and peers. Reading, spelling and writing skills are often challenging for children with apraxia.

by Jolynn Thomas, MS Ed.

As many as 1 in 100 little kids may have childhood apraxia of speech (CAS) – when a child knows what she wants to say, but muscles of the lips, jaw and tongue aren’t coordinated enough to form the words. Numbers are rising because CAS is being recognized in more kids and at earlier ages, when it’s easiest to correct.  In this guest post, speech and language pathologist Jolynn Thomas, describes CAS – and tells the story of a young boy’s diagnosis and treatment.

Meet Billy. At five years old, Billy’s vocabulary only consists of a few single functional words like stop, no, home and all done. Like thousands of other young children, Billy has Childhood Apraxia of Speech (CAS) - a speech sound disorder with impaired planning and production of the movements for speech production and melody of speech.

With apraxia, children like Billy may know what they want to say but have difficulty forming the sounds or words correctly. They often have a difficult time being understood by family, teachers and peers. Reading, spelling and writing skills are often challenging for children with apraxia.

The First Steps: Frustrated by Billy’s minimal progress in speech and language development, Billy’s parents consulted a speech and language therapist looking for information and treatment options for his speech challenges. At his evaluation, baseline data was collected to determine the appropriate speech sound shapes to use as beginning targets for Billy’s treatment. His evaluation revealed a receptive and expressive language delay and a moderate to severe diagnosis of CAS.

Billy’s treatment plan included an intensive, specialized speech and language program with a speech pathologist. Children with CAS like Billy can benefit from a customized speech production practice, like the one Billy enrolled in, to meet his individual needs and intensive speech targets, which are distributed through a variety of motivating and functional small group activities and daily individual speech therapy sessions. As additional support, an occupational therapist worked with Billy. His family met with a Speech and Language pathologist weekly to offer education and training to facilitate his speech development at home.

Progress: Initially, Billy did not initiate conversation with the speech pathologist or other children in the group. He didn’t engage verbally in social greetings or circle time activities and his speech sounds were not produced accurately.  But Billy did actively participate in group activities and appeared to have communication intent through pointing and use of environmental sounds. As his work continued, Billy began to participate verbally in the individual sessions and was soon able to produce select sound shapes with more consistent accuracy. Utilizing principals of motor learning and providing intense practice over time, activities and setting, Billy began using these sound shapes accurately in the small group activities. Within four weeks, Billy progressed to adding additional utterances and sound shapes. And at home, Billy’s parents also reported improved attempts with speech at home – further proof that family support and self-awareness of the child are key components in positive practice and motor planning skills for speech and language development.

What you should know: What characteristics of apraxia can parents look out for in their children? 

  • Limited use of vowels and/or vowel errors in speech
  • Inconsistent consonant sound production in speech
  • Visual struggle to make speech sounds
  • More errors as words become longer and more complex
  • Automatic speech may be easier than purposeful speech
  • Speech may sound slow, “choppy” or monotone

What should parents do if they suspect that their child may have a speech sound disorder like apraxia?

Visit a speech and language pathologist. A speech and language pathologist is qualified to answer questions and provide assessment and therapeutic information related to apraxia. Parents should look for a speech and language program that specializes in CAS and other speech disorders using a rich, language-based curriculum in a small group environment.

Additional resources for families of children with apraxia can be found through:

Jolynn Thomas, M.S.Ed., is the Speech and Language Pathologist for Speech and Language Explorers, a program that provides support for children with Childhood Apraxia of Speech and other speech and language disorders that is offered at The Luma Center for Development and Learning in Malvern, PA. Thomas has 18 years of working experience with children and adults with a variety of speech and language impairments. She received a M.S. in Education from the College of Saint Rose and a B.A. from Temple University. She holds a Certificate of Clinical Competence and a Pennsylvania State License in Speech Language Pathology and advanced training and knowledge in the treatment of motor speech disorders.

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Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
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Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
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