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Childhood Apraxia of Speech

What is apraxia?

Childhood Apraxia of Speech (also known as verbal apraxia or dyspraxia) is a disorder of a child’s verbal coordination skills for speech.  Speech is a very complex motor activity for any child to develop, but when CAS is involved, it may be very difficult for a child to control the mouth movements for precise sound production and sound sequencing.

What are the signs of apraxia in a young child?

The child…

·         may have been very quiet as an infant and not much of a babbler.

·         shows that he/she wants to communicate but either isn’t or is struggling when trying.

·         seems to understand what you say to him/her.

·         may “refuse” to speak when asked to do so.

·         may use a word once, but then does not use it again, even when asked to do so.

·         may show extreme frustration by his/her limited communication.

·         may have speech that sounds like “jibber jabber” when talking.

·         may be able to say a sound correctly in one word but not in another.

·         may also show some difficulty with non-speech oral tasks, such as licking and chewing.  (This may be due to an accompanying oral apraxia).

When should I be concerned as a parent?

Parents have excellent intuition when it comes to their children.  Recognizing that your child wants to communicate, but can’t or won’t, is a good sign that help may be needed.  A child’s (or parent’s!) frustration over communication difficulties is enough to warrant a speech screening or evaluation.  A speech-language pathologist can help sort out a child’s abilities and weaknesses.  If it is determined that there is a need for therapy, the therapist will create a treatment plan and provide the family with home programming suggestions. 
We may determine that the child does not have apraxia, but is developing speech but with a delay.  Therapy can provide such a child with the ability to catch up to his/her peers.  In some cases, particularly when a child is not speaking at all or very minimally, a therapist may need to defer an apraxia diagnosis until the child has been talking for a while.   Therapy in these situations will first target helping a child to just begin using sounds, syllables and words.

What can I do to help my child who has speech difficulties (especially apraxia)?

The number one recommendation is to let what your child is saying (or trying to communicate, even via gestures and pointing) be more important than how he/she is saying it.  Most often, a parent is a child’s safe harbor, knowing what he/she is trying to communicate when no one else does.  If your child just grunts and points, act as if he/she actually said the word, model the word, and acknowledge what your child wants. 

 Do not pressure your child to speak.  If a child has apraxia, it may be extremely difficult for him/her to say something when asked to do so (even if the child often says the same thing spontaneously).  One of the difficulties of apraxia is that sometimes the child can say something without thinking about it, but when asked to speak, cannot get it out.  This leads to frustration on the part of both the child (who wants to comply) and the parent (who thinks the child is being stubborn).  Instead, make simple comments about things and then pause.  Your child just may surprise you and say something back.  Listen to what your child is trying to say and do your best to interpret his/her intent, so that you can make a comment back.  For example, if your child points to a dog and says, “dah”, you can say, “Yes, I see the dog.  Do you want to pet the dog?”  Letting a child know that his/her best is good enough will propel your child to feel successful and to try more and more. 

Try to provide opportunities for your child to need to communicate.  Put a desired toy up on a shelf (or a clear jar with a tight lid) so that your child will need to communicate with you to get it.  Even a tug on your shirt and a point toward the toy is communication.  Use the opportunity to model the word (e.g., “Oh, you want the bear.  Buh.  Bear.” ) Then just wait with a smile to see if your child will try saying the word.  If not, that’s OK.  Just say, “Buh.  Bear.  Here’s your bear.”   Take a jar of bubbles with the child’s anticipation that you will blow them.  Hold the wand and say, “Bubbles? Buh.”  Then just wait (again with a smile).  If your child makes any sound, say, “Bubble!” and then blow them.  If your child doesn’t say anything, just repeat the word and then blow the bubbles.  Gradually, your child will understand that using “words” is very powerful!

Model some “routines” for your child.  For example, when pretending to feed a teddy bear, say “Eat, eat, eat.”   “Mmmmmm.”  Then when putting the bear to bed, say, “Night, night bear.”  “Shhhhh.”  Remember to pause and provide your child with silent time to see if he/she will try the same.   If we do all of the talking, the child doesn’t have the opportunity to do so.  Plus, the child’s motor system may need that extra time to be able to speak.

Providing a simplification of words is a great technique, as long as you include the true word in your model (e.g., “Buh.  Bubbles.  Buh.”)  While a child may not be able (or thinks he/she is not able) to say the full word, a sound or syllable may be simple enough to give your child confidence to try.

Relax and have fun!!  You will see that, with the right support, your child will get there!!  Oh, and beware….they do make up for lost talking time later!!

– Donna Conti M.A., CCC-SLP

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Patient Reviews

LLA Therapy

Patient Reviews

Crystal Scheibe

Great place, glad we found them. Been going to Medina over 2 months now and he loves Lauryn and Kyler. Wish they had more ABA therapy places available... live in Wooster and long drive everyday.

Karrie Swan LaRock

My 11 year old son has dyslexia and has made noticeable gains in working At LLA THERAPY. Katie is strong in her approach toward him and also keeps him comfortable enough to perform well. We will continue visiting both the Fairlawn and Hudson offices and recommend them highly.

Ron Monroe

My 9 year old just completed about 9 months of weekly speech sessions (due to his stuttering) with Matt Hagge at LLA and we are thrilled with the experience and results. What I thought might be a negative (what kid really wants to go to speech class?) was made very positive by Matt, and my son never hesitated or complained when we talked about class. He really enjoyed it and really took what Matt taught him to heart. His speech has been greatly improved and we definitely recommend LLA. Thank you so much!

Heather Dougherty-Pantoja

My son’s Occupational Therapist, Jess, is an amazing OT! She gives practical tips on working with my son at home and school!

Terri Apgar

I cannot say enough good things about LLA Therapy. My daughter was a client of Teal Simmons’ for approximately 2 years and was just released from speech therapy! She was diagnosed with Apraxia in 2015 and worked with Teal twice a week. Through Teal’s application of PROMPT therapy, my daughter had age-appropriate speech after one year. All of the staff we interacted with at LLA were absolutely wonderful. They really care about what they do and making sure your child achieves their goals.

Kelli Geisler Davisson

LLA Therapy has been an excellent experience for my son as well as my family! My son always asks, "When can I go see Ms. Jeannine again, is it Monday??" He has also made huge gains in only 5 months! I would highly recommend LLA and have already shared my experience with friends looking for services!

Victoria Hansford-Price

We are so grateful for our Speech Therapist Ms.Teal. We have seen a great improvement with our sons confidence and communication abilities since we have started "Prompt" therapy. What we love the most about LLA and Ms. Teal is that Kohl feels comfortable and relaxed which has played a critical role in his progress. Thank you Ms. Teal for all you have done.

Laura Lee Hogsett

They have helped in numerous ways. Speech, OT and behavioral. I've had numerous compliments on my son's progress thanks in very large part to LLA. I would recommend LLA before I recommend our local children's hospitals, though they are good, they don't have the staff that LLA does.

Amy Furukawa

We had a great experience with Matt Hagge at LLA! Our Middle School age son was becoming very conscious of his voice, which is nasal due to a cleft palate. Matt helped him to better form his sounds and project his voice in a way that makes the unavoidable nasality less noticeable.Our son is more confident and outgoing & even took on a speaking role in the church play. Matt has the perfect personality to relate with our son, and we would recommend him to anyone needing speech therapy services!

Jessica Havalotti

LLA Therapy has been an excellent experience for our daughter. I would highly recommend LLA. Miss Grace was so amazing and I can't believe how quickly our daughter showed improvement. Thank you!
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