Sunday, February 17, 2008

Apraxia Information and Resources

Nea, who will be 4 in June, was diagnosed last year with severe apraxia. I thought I would post today more about what that really means. I did find out recently that there is a stage beyond "severe" -- "profound." I consider that good news for us (we aren't at the bottom).

Right now she receives 90 minutes of ST (speech therapy) at special ed preschool every week, one-on-one with the SLP (speech and language pathologist). In addition, we go to Easter Seals for a 60 minute session once a week, where I can observe and learn. We also get better homework there. This week we got new Kaufman cards (which have words to practice on them with pictures, like puppy, turtle, teddy). From the school we get pretty stupid homework, like straw and horn therapy and vocabulary to learn. Nea's receptive speech (what she hears) is totally fine.

Nea also receives 60 minutes a week of OT (occupational therapy) at school, where they work on her pencil grip and scissors and things like that. Nea has some limb apraxia, too, which means she has some trouble coordinating her fingers. She probably won't be able to button her clothing for a few years yet.

We use PECs cards, signs, and the standard "point and grunt" modes of communication, plus a few word approximations.

She has been making good progress lately. Her spontaneous words (in other words, not repeated after a direct model) have ballooned up to almost 10 words. Mama, Papa, beh (bear or Bert), no, yea, puh (up), tootie (cookie), hello, buh buh (bye bye). I've been sort of laughing about how at this rate, someday she will be hitting the bottom of a normal speech problem. Tootie is a classic example. The K sound comes very late, and many kids start out saying cookie that way.

So here's how a typical ST session sounds. They are still using a lot of direct prompting. Here are her best (not consistent) results, with the first word being what the SLP says and the second word being Nea's response.
no more=no ma
muddy=puh-de or muh-ee

And yet occasionally she will produce a very nice "wow" or "cheese" or "yes."

Two excellent resources for more information:

The two best ST methods for apraxia are the Kaufman method and the PROMPT method, which uses touch cues for each sound.

The groups that I receive the most useful information from are the Windy City yahoo group and the Apraxia-KIDS website (I recommend signing up for the listserv they offer).

Also useful if you are new to the diagnosis or are unsure whether your child may have apraxia is the book: The Late Talker: What to Do If Your Child Isn't Talking Yet


Anonymous said...

Hi, It is a useful blog, thx for posting all these info. My niece is newly diagnosed with apraxia and it gave me a good insight. I have to learn more abt prompt method and kaufman's. We recently moved out of US so, I don't think my slp in India knows much abt prompt atleast.... Wonder if there is a good book on it.
Thx a lot, Wish you & Nea the best!

Mike said...

poor Nea I hope all this therapy helps her.