APRAXIA of SPEECH vs DEVELOPMENTAL DELAY
By Sharon Gretz of Apraxia-Kids

Apraxia of Speech is a motor speech disorder. "Praxis" is the ability to execute skilled movement. A child with the diagnosis of apraxia of speech has difficulty in sequencing and executing speech movements.

A true developmental delay of speech is when the child follows the "typical" path of childhood speech development, but at a rate slower than normal. Sometimes this rate is relative to cognitive skills.

In typical speech/language development, the child's receptive and expressive skills are pretty much moving together. In a child with apraxia of speech, the child's ability to understand language is broadly within normal limits, but his or her expressive speech is seriously deficient, or severely unclear. This is an important factor and one indicator that the child may be experiencing more than "delayed" speech and should be evaluated for a specific speech disorder such as apraxia. However, certain language disorders may also cause a similar pattern in a child.

FINDING A GOOD SPEECH THERAPIST

It is important to know that not all speech-language pathologists are equally skilled in providing treatment to children with apraxia of speech. Some are better-trained than others and some have evolved through years of experience.

Parents should look for a speech- language pathologist with experience and success in working with children with apraxia of speech. Don't hesitate to ask prospective therapists about their experience, credentials, and success with these children. A good therapist: takes into account the uniqueness that a child brings; involves parents in the therapy process; understands how important the parent is in the ultimate success of the child; invites parents to observe therapy sessions; gives techniques parents can use at home; listens to ideas and concerns; communicates with others in the child's life; tries to provide helpful information; respects parent's knowledge about the child; readily admits what they don't know; is concerned if the child is not progressing; does not let unproductive treatment go on indefinitely; seeks out additional information, changes techniques, consults a colleague, or refers parents to someone else.

It may be also helpful to identify some "warning signs" regarding speech-language pathologists, to consider finding a new therapist.

The therapist says that: children with apraxia will never develop intelligible speech; it doesn't matter what a child's diagnosis is, their treatment will be the same as for other speech problems. The therapist does not have experience working with children who have apraxia of speech and appears unwilling to learn.

Will my child ever be able to speak "normally"?

With appropriate therapy (see above) and a lot of follow-through by parents and others, many children with apraxia of speech can become effective verbal communicators. Will speech ever be entirely "normal"? Research in this area is lacking.

THINGS TO DO AT HOME: Disclaimer: The following ideas are culled from both parents and/or speech-language pathologists (SLP).

That means most if not all of these ideas have been taken out of the context in which they originally occurred. Please use discretion and don't push kid(s) too hard. It would be wise to talk with the child's SLP prior to initiating any of these ideas or techniques to ensure that the child is ready and that particular activities are appropriate for the child.

Overview:

Speech therapists are trained to teach kids to talk, but therapists are with our children for only a very short time compared to the amount of time parents spend with them. It stands to reason that the best method of therapy is one that includes training and encouraging parent participation in helping kids learn to talk.

Therapy for apraxia includes some or all of the following: auditory, visual, and tactile cues; individual sounds practiced with varying rate, intensity, and pitch; word practice; and syllable practice. Bring these tactics into your daily life in creative ways. In general, follow these guidelines: overenunciate; repeat words; vary pronunciations: say words slower, deeper, higher; break the word or sentence down into syllables; define words often ; give positive feedback; accept approximations ; avoid power struggles. If your child isn't cooperative, stop and try something else later. Look for and think of opportunities to practice speech.

Your objective is to help your child speak, but speech will be inhibited if too much pressure is put on him. And finally, aim for these activities with your child to be FUN for both of you.