What better way to kick off the introduction of our NW Speech Therapy blog then to talk about Apraxia. Tomorrow is after all the first ever Apraxia Awareness Day and we do see a good number of kids come through NW Speech Therapy with a diagnosis of Apraxia of Speech. For those of you who do not know what Apraxia is, here is the definition of Childhood apraxia of speech as defined by the American Speech-Language and Hearing Association (www.asha.org):
Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.
WARNING SIGNS of Childhood Apraxia of Speech include:
For Younger children:
- Limited or no babbling/cooing
- Overuse of nonverbal forms of communication (such as hand grab or pointing)
- Limited use of consonants and vowels
- First words are late developing
- May have swallowing/chewing difficulties
- Distorts vowels
For Older Children:
- Receptive language (what they can understand) is stronger than expressive language
- Inconsistent speech sound errors
- Difficulty with utterances that increase in length
- Multiple syllable words are difficult to produce
- Intelligibility is a major concern
- Visible groping often with no sound being produced
Language Difficulties that can co-occur with Apraxia of Speech:
- Decreased vocabulary as a child will often overuse words in an attempt at not having to use words that are too difficult
- Grammar difficulties (incorrect verb tense, mismatching gender pronouns as in "He washed her hair", omission of possessive "s")
- Sentence structure is often jumbled and does not follow typical SVO (subject-verb-object) form
When explaining Childhood apraxia of speech to parents, we often compare a child's speech to a faulty lamp. Lets imagine that the outlet in the wall is the brain, the cord is the neuropathways that send messages from our brain to our mouth and that the light bulb itself is the mouth. Now what usually happens when you plug in a faulty lamp??? You could see the light come on, you could see it flicker/ come on/ turn back off (or any combination of this) or you could see it not turn on at all. This is similar to the speech of a child with apraxia. Sometimes they can get the word out (light on), sometimes they can't get the word out (light off) and sometimes the word comes out all jumbled (the flicker).
Children with apraxia of speech often work much harder in acquiring speech sounds. Most children can easily move through consonant-vowel shapes once a sound is learned. For example, once a child can produce a /k/ sound such as in "cat", that child usually can produce it in various forms with varying vowels "cat, cop, coat, kite, etc". A child with apraxia of speech however, may have just as much difficulty producing a /k/ sound followed by an /oe/ as he did producing a /k/ sound followed by an /ee/.
One of my favorite websites to pass along to parents of children that have been diagnosed with apraxia of speech is www.apraxia-kids.org. This website is filled to the brim with resources for parents. They put on various events and help parents connect with other parents in order to provide support during the therapy process.
Apraxia of speech can definitely come with its own set of challenges but fortunately it makes the triumphs that much bigger!!