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- Meghan
- Chow
- 3555 Kenyon Street, Suite 102
San Diego
California
92110
United States - North Star Speech and Language Pathology Center
San Diego
California
92110
United States
I will be using specific treatment methods that are evidence based therapy for targeting the movement of speaking which is how you treat apraxia. Research about apraxia has a dosage recommendation regarding sessions. Sessions should be short, frequent and high intensity. We are aiming for a minimum of 6-100 correct productions of the target movement. Some of the things I will be doing are:
- Providing dynamic cuing. This means I will use verbal cues (describe how to make the movement, like faster slower, bigger), visual cues (watch me and do this), tactile cues (touching the face to feel the part movement), and kinesthetic cues (help them feel the movement with me)as needed to support your child say the word.
-I will be using a cuing hierarchy which includes the following:
-giving a lot of feedback about what the mouth is doing and helping the mouth make the movements
-fading the cues
-fading the feedback about what to do with the mouth
-support independence by providing less specific feedback (yes/no) and let the child see if they can figure out how to make any necessary changes
- fading the overall feedback so the child has more opportunities to self monitor as they become more successful
-The method I will be doing may include integral stimulation (watch me, say what I say), speech motor chaining, or syllable sequencing using nonsense words (called ReST). With any of these evidence based practices, we may be using our ultrasound for biofeedback about your child's movement. Our assessment will help us figure out which of these evidence based methods is a best fit for your child as a treatment.
It is important to include you as parents in the process of therapy because you need to understand how therapy looks different for apraxia, and carry on home practice using the correct methods. The principles of the therapy for apraxia are specific protocols based on something called the principles of motor learning. The child and I will start together to establish a small set of words they are successful at given supports. I will fade these supports so the child is more independent. That is where you come in for an important role. There will be homework to keep practicing these same words they are succeeding at in therapy, to ensure they are maintaining them at home. I am going to show you how to give them different kinds of feedback (knowledge of performance, or knowledge of results), based on how much they are struggling with the word, or how independent they are at saying it correctly. This will empower you to know how to practice, and how to identify success. We want you to be able to understand how your child is making progress and help them achieve their goal.
Augmentative and alternative communication are simply using different ways to communicate. These can include gestures, sign language, picture communication boards or speech generating devices. In order to support your child becoming an independent communicator who can confidently communicate any message, and also to support their continued vocabulary and language development, it is important to provide access to a way to functionally communicate language . Because apraxia impacts their ability to be understood, using augmentative and alternative forms of communication can help bridge the gap in expressing themselves. When there is a communication breakdown and you do not understand the child, giving them a different way to communicate will help you know what they want to say. Knowing what they want to say helps inform which word targets to practice verbally so that they are meaningful and relevant to your child. Having alternative and augmentative communication will not hinder your child making progress in using verbal speech. Research has shown that AAC can help support expressive as well as receptive language development.
