By: Elizabeth
Redhead Kriston, MS/CCC-SLP
This blog was commissioned by Medbridge and originally appeared on there website:
Please visit there website to find more information on ways you can continue your education on this topic and many others. Medbridge provides training videos for and by OT's, PT's and SLP's. Let them know I sent you there.
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Working with
busy toddlers and preschoolers is an exercise in patience that requires energy
and creativity. This reality becomes most evident when our young clients
present with severe speech sound disorders like suspected Childhood Apraxia of
Speech sometimes referred to as Pre-Apraxia. It can be challenging to make
speech sound disorder intervention feel like play.
Some Common Signs of CAS/Pre-Apraxia
Though we
often do not diagnose these kids until they get to be school aged, we may
recognize the symptoms as early as one or two years old.
1.
Receptive ability exceeds expressive
ability.
2. Characterized
as a” quiet baby” with limited babbling/sound play.
3. Limited
number of consonant sounds and/or vowel errors and distortions
4. Communicates
with gestures or other nonverbal actions.
5. Connected
speech is more unintelligible.
6. Voicing
errors.
7. Groping.
8.
Prosodic disturbances.
In many cases,
as children mature and develop, their neurological systems become more complete
and the signs and symptoms of Pre-Apraxia disappear. However, because we do not
know which kids will just develop out of this stage and which ones need
targeted intervention to overcome the symptoms, we should incorporate
techniques into our play and routines based therapy to help these kids develop
the speech skills they need to become competent communicators.
Using what we
know about how sounds are produced and how we can help clients develop better
speech, I have found much success using the following strategies to help kids
speak proficiently at an early age.
The 5 FUNctional Strategies
1.
Work on breath support. Teaching a child how to control the
air flow we use for all speech is a great way to move them into more volitional
speech. By incorporating harmonicas, whistles, recorders, etc.… into therapy we
are appealing to what kids like to do (be loud) while teaching them to control
their airflow. We move from random blowing to specific patterns. Eventually,
kazoos can be introduced to pair breath support with intentional phonation.
2.
Work on producing distinguishable
vowels. We can play
with toys and books that promote the use of animal and vehicle sounds. We can
draw simple scribbles as we vocalize a variety of vowel sounds pairing movement
with sound play. We can model exclamatory sounds as we play outdoors swinging
and sliding.
3.
Work on singing. Singing songs can help children learn
to connect words while building intonation and prosody skills. Any songs will
do. I like to build songs into daily routines like handwashing or putting on
shoes. Be creative. Make them up.
4.
Work on talking loud vs. soft. Playing games that encourage kids to
be loud and then quiet will help build the control of their loudness level to support
over all control of the suprasegmentals of speech.
5.
Work on increasing proficiency with
gestures and simple
sign language to create a functional communication system until a child can
speak spontaneously.
Over the years I have found great
success in building a foundation of pre-speech skills with young children who
present with Pre-Apraxia signs and symptoms. All of the above strategies can be
easily presented in play or routines based activities that young children
enjoy. They have fun while building their expressive speech abilities. When
parents see how much their kids enjoy the activities, they might be more likely
to do them even after you leave. We all know that practice makes perfect. It is
a win win!
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