I notice that a number of people who come to my site are searching for and interested in information on apraxia and speech therapy for apraxia. Parents want to know when and how it is diagnosed and what kinds of therapy they should be looking for to help their child.
I have blogged on this topic a number of times, often related to my view that children are often diagnosed too early or misdiagnosed in this area. I ran across a helpful interview that addresses this issue as well as appropriate therapy approaches, feedback and practice. In the professional magazine, www.advance.com., blogger and speech language pathologist Stephanie Bruno Dowling, interviews Sharon Gretz, MEd., founder and current executive director of CASANA, the Childhood Apraxia of Speech Association of North America. Her interview is very informative and helpful to parents as well as therapists. Several points are emphasized that I agree with:
- Effective apraxia therapy must be approached from a motor planning and programming approach, understanding that children with CAS practice movements that lead to permanent change in their motor system.
- Effective therapy is delivered individually and in short, frequent sessions. I have had parents call me, telling me that their child was diagnosed with Childhood Apraxia of Speech and they were getting therapy in a group, once or twice a week for an hour. Therapy needs to be very specific for a child and include repeated execution of motor movements which is not conducive to group therapy. Several shorter sessions per week have been found to be more effective. In fact, the American Speech and Hearing Association recommends therapy 3-5 times per week for children who are diagnosed with severe to moderate CAS.
- Effective practice by the therapist and parents as well as feedback is important for progress with CAS
- Effective speech therapy for apraxia appears “to include multi-sensory feedback in the form of visual, verbal, or even tactile/touch cues to help guide the child’s speech movements.” Unfortunately there isn’t one method that is right for each child so it is necessary to try different approaches that involve strengthening the child’s internal sensory systems, while giving feedback for correct motor movements. I have blogged in the past about success I have found in using the Kauffman approach as well as PROMPT.
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Here are some more Valentines Day books to use in speech therapy to liven up your sessions:
Love, Splat by Scotton
Splat has made a special valentine for his secret crush, Kitten. A little bashful about giving it to her, he also discovers that his rival, Spike, has eyes for Kitten too. In fact, Spike has a bigger valentine for her than Splat. Losing his nerve, Splat drops his valentine for Kitten in the trash. Turns out that Kitten finds it, and prefers Spat over Spike inspite of his rumbling stomach and bendy tail.
- A cute story to use to re-tell, talk about the beginning, middle and end, as well as the problem and solution.
- Extend the story to talk about how kids treat you at school. What makes a friend? What do they appreciate in you?
- Make some valentines for friends. Talk about what you appreciate in each one and dictate or write a message telling them that.
- Talk about the difference between being good at something like soccer or drawing versus a character trait like generous, kind or helper
- Talk about the comparatives, “I love you higher than the highest bird ever flew,” or taller than the tallest tree.” Encourage the student to make their own comparatives: bigger than…., wider than……happier than….. and illustrate your words.
- Point out the descriptive words, “swirly skies,” “sneaky shadows” or “wavy waters.” Collect pictures or objects around the room and add a descriptive word to the noun. See how many you can brainstorm.
- Talk about places your student has gone, and add a descriptive word to it.
In today’s New York Times, the article, “Dealing with the Financial Burden of Autism,” offers a look into the financial side of providing the best program for a child on the autism spectrum. Konrad’s article gives several practical suggestions for navigating the insurance obstacles while pushing for the best program for your child.
According to the article, direct medical and non-medical costs for a child with autism can cost between $67,000 and $72,000 a year. Parents already deal with the challenge of finding the right set of therapies to benefit their child since the treatments aren’t one size fits all. Since many therapies are given several hours a week, the cost adds up.
The article gives some practical advice for seeking financial reimbursement and assistance. The father highlighted in the story obtained financial assistance through a special part of the Medicaid program. He talked about planning therapy deliveries according to caps you might have in your insurance program, coordinating with services covered by the schools, and utilizing resources such as community chapters of the Autism Society of America or Autism Speaks for help with practical advice.
Let me know what has been helpful in your journey with trying to get services covered for your child with autism. Use the comments below.
I am excited about the upcoming International Toy Fair in New York City, February 14-17. Just walking through the Javits Center, one feels surrounded by innovative, creative people. Inventors of children’s toys and games have to be incredibly intelligent but also have a child’s whimsy to relate to their market.
Yesterday I was in a wonderful toy and hobby shop in Fairfield, Connecticut, Hobbytown. I explained to Celeste, the knowledgeable employee, that I reviewed children’s media for its language value and asked her about some of the products that I liked–if they sold well and just what was popular among parents who selected toys and games for their kids.I had specifically pointed out International Playthings’ Playdate puppet show. She said that it was a popular item because it met the criteria she sees parents using in selecting toys for their kids:
- Kids play independently with the toy.
- They can finish the game or pretend play and have a sense of pride in completing something.
- The toy or game is interesting to play with over and over as they play with it in a new way.
It’s time to talk about love, hugs and kisses and use some fun stories to work on children’s speech and language goals. More books are included in last year’s blogs.
Here are some fun books for preschoolers and early elementary aged students to encourage language:
Max’s Valentine by Rosemary Wells
Max of course wants to sabotage Ruby’s activity making valentines by eating the candy, yum yum glitter and all. Finally Max gets his own valentine delivered from Grandma, full of chocolate ants!
- Use the story to talk about sequence–making valentines, mail them, receive them.
- Create your own valentines with lots of options for fun candies to glue on the hearts
- Practice sounds and language structures as the child re-tells the story.
- Re-tell the story using drawings, or objects representing the different steps a letter or package goes through to get to its recipient–letter sorter, truck driver, airplane captain, mail truck driver and mailman.
- Change the story with each child offering what gesture or words they would like to “send” through the mail.
- Talk about the words that describe each kiss. Add more thoughts or adjectives to each one–a breakfast kiss could be slurpy, buttery or tasty.
- Draw and cut out pictures of different lips to represent each kiss, add your own and write out the words that describe the kiss.
This past week, the The New York Times reported that William Clark, co-founder of the company that produced “Baby Einstein” videos, has asked a judge to release information from the University of Washington studies that showed the negative influence of TV viewing on young children. Clark is asking for the raw data and analytical methods used in the studies since “other research studies have not shown the same outcomes.
Clark and his wife started the company the produced the Baby Einstein videos but no longer have a financial stake in the company, after selling it to Disney in 2001. Last October, Disney offered refunds for those who bought the DVD’s, due to the “threat of a class-action lawsuit due to unfair and deceptive marketing suggesting that the videos boosted baby brain power.
According to the article, “the Clarks said they went to court to protect their legacy.”
What are your thoughts on the Baby Einstein videos? Did you see learning occur with your child? Did you even show them to your baby? I know what the research says but I also know what some parents have told me. This is a hot topic. One of the top viewed blogs of last year concerned the topic of Baby Einstein videos on the Wall Street Journal’s blog, Juggle.
Let me know your thoughts in the comments below.
I was talking to a mom the other day who has a child with a language disorder. She described a breatkthrough with her child that illustrates the importance of language and communication for a child.
This is a soft-spoken, loving mom who saw that her child was getting up from the dinner table before he even started. She asked him to return, he got upset, she asked him more firmly and he returned, crying. Finally he said, “Can you wipe off my meatball?” Wow, she realized that he didn’t like the sauce but couldn’t initially communicate that.
She reinforced his communication by saying, “Thanks for telling me what you needed, so I can help you.” Saying a simple phrase like that not only reinforces his using his words, but also tells why it is important, the cause-effect of the situation. “When you tell what is wrong, then I can help you.” Obviously this mom had no idea what was troubling her son when he didn’t want to sit at the dinner table. Sometimes we can infer what the problem is and model the words for our child to repeat and praise them, “I don’t want to eat the peas.”
It feels so good to communicate!
It has always been my objective to have parents involved in their child’s therapy process. Sometimes I feel like I get almost twice the progress when parents watch, learn and implement my strategies for their child’s speech and language goals. It is important to work with the child and explain to the parents as you go along, what words, pauses, and methods you are using to encourage their child’s language. Explain how you are getting their child to practice certain sounds or language concepts.
At times, I pull back and have the parent work with the child in the same manner that I have modeled so when I am gone and they are playing, the parent is confident in the methods to elicit speech and language.
Occasionally, it doesn’t work to have a parent sit in on the sessions. For whatever reason, the child is less cooperative, wants to sit in mommy’s lap instead of play with me or is distracted. In that case, I ask the parent to leave the room (usually they sit around the corner so they can hear what we are doing) and they see the benefit as their child is settling in and responding. I use the last few minutes of the session to invite the parent back and show what we were doing.
I know including parents is difficult in a school setting with groups of children when you have to be concerned about confidentiality.
Let me know how you therapists deal with that in a school setting. Leave a comment below.
One of the things that I consult with parents about is organizing their playroom. Often I see multiple deep baskets or bins that the toys are scooped up into at the end of the day.
Today I was at a house where things are getting organized for play. I commented on this great see through, three-sectioned toy bin and Mom went over to her 3 year-old and asked him what went in each section. He said, “Cars, animals and instruments.” I love how you can see into the bins so you know what options there are for play. When toys are organized by category, kids can more easily select objects for play and it helps them build these language categories.
If play is a child’s job, aren’t we all better at our job when we are organized?
Mom got this bin at Target.
When I work with parents of children with language delay, I advise them on what toys are helpful to encourage language development. It is fun to watch as they start to understand the characteristics of good language toys and are more discerning about what they buy for their child.
I had advised one mom of a 2 year-old to get some play sets with people that are around a theme that is within the experience of her child–a farm, a playground, a car wash or gas station. She understood but apparently the grandparents didn’t!
After a visit there following Christmas, I found out that both sets of grandparents gave their grandson the Leapfrog Tag Junior Book Pal. I tried it out. You place the book pal on a picture or text and it reads the words, asks questions, says a rhyme, or talks about the picture. According to the product features on Amazon.com, “The Tag Junior book pal encourages toddlers to explore while helping build confidence with books.” I just don’t get it. I think toddlers love to explore a well-written, beautifully illustrated book for what it is–especially if an adult reads it or narrates the pictures. I found as I followed the pictures on the page with the “pal” it was almost disjointed, with an animal sound followed by a rhyme or text. The flow of the book was lost.
Let me know what you think of products like these and if they have been beneficial to your kids. I am open to changing my mind!
