Apraxia Treatment

Children Apraxia of Speech (CAS) is a disorder of speech coordination, not strength.

Child with Children Apraxia of Speech (CAS) presents with:

• Poor self-monitoring,
• Poor imitative skills for articulation,
• Many voicing errors.

Resurge proves that:

• Child with CAS should receive frequent (3-5 x per week) and intensive treatment.
• Child with CAS should be seen alone for treatment.
• As the child improves, he may receive treatment less often and be seen in group.
• Child with CAS should practice speech often.
• Child with CAS needs a supportive environment to feel successful with communication.

The focus of intervention for CAS is on improving the planning, sequencing, and coordination of muscle movements for speech production. Isolated exercises designed to "strengthen" the oral muscles will not help with speech. To improve speech, the child must practice speech. Feedback from a number of senses, such as tactile "touch" cues and visual cues (e.g., watching him/herself in the mirror) as well as auditory feedback, is often helpful. Some kids can benefit from using sign language or Augmentative Alternative Communication system, e.g., a portable computer that writes and/or produces speech. Check my posts about AAC devices

http://slpzone.blogspot.com/2013/10/webinars-to-learn-about-augmentative.html

http://slpzone.blogspot.com/2013/10/list-of-augmentative-and-alternative.html

Once speech production is improved, the need for these systems may lessen, but it can be used to support speech or move the child more quickly to higher levels of language complexity. With this multi-sensory feedback, the child can more readily repeat syllables, words, sentences and longer utterances to improve muscle coordination and sequencing for speech. Practice at home is very important. One of the most important things for the family to remember is that treatment of apraxia of speech takes time and commitment.

REMEMBER TO

Speak up, Talk big, Say it loud and Practice often.

USE rhythmic, melodic, and visually marked syllable presentation.

To improve awareness of oral mechanism :

1. Use a mirror for visual feedback.
2. Teach appropriate speech movements using verbal and visual cues, e.g. “Press your lips together”.
3. Engage in imitation game, “You are a mirror”.
4. Exaggerate oral and facial postures (first without and after with voicing element).
5. Use: dry / wet / chewy / liquids, worm / cold snacks, tooth brush, tongue depressor, straws, dental floss, chewy toys, blow toys, bubbles, musical instruments, cold/hot objects/food (i.e. gum, noodles, metal spoon, lotion, own fingers, string).

Work on sounds:

1.      Imitating sounds [i.e. bye / baa-baa / peep / bee / oops!].

2.      Old/familiar not new words (i.e. go, up, eat).

3.      Two syllable words:

• The some syllable words (i.e. mama, dada, night-night, bye-bye, oh-oh, ooh-ooh).
• Different syllable presentation.

4.      Work on phonological skills:

• Use the sound a child has already in his repertoire.
• Add new sounds:

1.      ­V - vowels

·         V-V identical vowels (i.e. /a-a-a/, /e-e-e/, /i-i-i/, /o-o-o/, /u-u-u/)

·         V-V different vowels (i.e. /a-i-a-i/, /a-o-a-o/, /a-u-a-u/)

2.      C – labial visually marked consonants /b/, /p/, /m/ + V

·         CV-CV identical syllables (i.e. /ba-ba/, /be-be/, /bi-bi/)

·         CV-CV different vowels (i.e. /ba-be/, /be-bi/, /bo-bu/, /be-ba/, /bi-   be/, /be-bo/, /be-bu/, /ba-bi/, /ba-bo/, /ba-bu/)

·         CV-CV different consonant (i.e. /ba-ma/, /ba-pa/, / ma-ba/, /mapa/)

·         CV-CV different consonant and vowels (i.e. /ba-mi/, /pa-bi/, /be-mi/).

3.      C – other less visually marked consonants /t/, /d/, /k/, /g/, /h/ + V.

5.      Use phrases to repeat.

6.      Use sentences to repeat.

List of words to work on

P Pal, Pam, pan, pat, peg, pen, pet, pie, pig, pill, pin, pit, pod, pop, pot, pup pony,	M Mad, make/ made, man, mat, many, map, mat, men, met, mom, moon, mop, mud, mug, my, music	K Key, kiss, kick, kid/kids, king, kiss, kit, kite, kitten, kitty	T Tag, tail, tall, tan, tap, tape, Ted, ten, tin, tip, top, two, tub	H Hair, ham, hand, hat, has, have, hay, head, hen, he, her, hill, hip, hit, hoe, hop, hot, hug, hum, hut, house, happy
B Bag, bag, bank, bang, bat, ball, bee, Ben, bet, bib, bid, bin, box, boy, bad, bug, bun, bus, but	N Nail, nap, net, nest, nose, not, nut	G Gag, gas, gate, get, gift, goat, gone, goody, gum, gut	D Dad, dam, day, dell, desk, dig, dip, dock, dog, dot, down, duck	L Lake, lamp, lap, left, leg, like, lip, lion, lock, log, long

To learn more about CAS read my post

http://slpzone.blogspot.com/2013/03/childhood-apraxia-of-speech-casis-also.html