In addition to direct speech therapy, many therapists recommend the use of sign language, picture books, communication devices and other means to augment speech in the child who is not clearly understood. This approach may be called “total communication.” Having the child pair a vocal word attempt with a sign enhances the chance that the listener will be able to “catch” the communication (if the spoken word isn’t understood, perhaps the sign will be). Having others understand the communication can offer the child motivation and the feeling of success in using their voice to communicate.
Today, newer technology is coming into play in a big way. Electronic tablets such as the iPad and special communication “apps” are being used more and more as support for communication in children with all kinds of speech problems. These devices are catching on because they are relatively inexpensive compared to dedicated augmentative communication devices; parents and children can catch on quickly at home; and speech therapists are able to use apps and tables in their practice for multiple children.
Many children with apraxia of speech, even at young ages, have some awareness of their difficulty. Parents should not fear using other forms of communication, even if temporarily, in order to support successful communication. Providing successful communication experiences only encourages the child.
Of particular usefulness for children with apraxia of speech, signs can become important visual cues to help them know how to place their mouths, etc. in order to produce the desired word. When pairing of spoken word and sign is consistent, the child may come to associate the visual image of the sign with the placement of their articulators and thus, the sign alone may become a “cue” for the speech attempt. In a few children, sign may not be appropriate. For example, for some children signing might be too distracting or their ability to consistently form a sign may be impaired.
Also, parents should never see iPad apps as “the answer” for their child’s speech improvement. Nothing – nothing – can replace direct person to person interaction and support to teach and help our children with apraxia of speech. Young children should not be using the iPad speech therapy apps by themselves. Rather, parents should be with the child to enable the most appropriate and successful practice opportunities and provide direct human interaction at the same time.