Motor learning principles are key! We practice repetition and multi-sensory learning. There may be comorbid conditions such as hearing loss. Unclear vowels can be improved with direct cues like “open” and gestures or sign language to increase intelligibility. To help sequence sounds we sometimes fingerspell the sounds/letters or use pacing boards. To expand utterances, we use carrier phrases and sentence strips, tiles or manipulatives to visualize each word. For prosody and intonation we sing songs, chant and use biofeedback like recording and rating self-made videos.
I was lucky to gain practical experience with a large caseload of children with mild to severe apraxia during my externships and clinical fellowship. I use David Hammer’s treatment videos and had read Edythe Strand’s writings on apraxia and DTTC. Apraxia and motor speech disorders are a passion of mine as a school-based SLP.
I conduct parent trainings, provide simple but repetitive daily homework to support motor learning, share pictures of student work on a secure messaging platform and report regular progress monitoring to discuss gains or areas of need.
I completed assessment documentation to get a client a Lingraphica device. Some students have.worked using manual boards for “yes” and “no.” Other students could verbalize 1-2 words but needed to use dynamic display devices (TouchChat, LAMP) to access academic language. I also use ASL as another form of AAC. I follow Total Communication to acknowledge all for,s as communication, but I still ask my students to vocalize or approximate the utterance verbally to solidify the motor speech loop.