Therapies for apraxia

[Guest guest]

Hi Aman,

Historically ABA even modified ABA is known not to be appropriate for

those diagnosed with just apraxia (not autism) since the child needs

to be taught how to speak -and no amount of rewards can tempt or

worse not amount of punishments can force an apraxic child to speak.

Your child has weakness issues as well which is not unusual in

apraxic children and for the dysarthria would benefit from

strengthening and oral motor therapies. I'm not sure what extra

needs he has from his CP as there are degrees of severity.

If your child is apraxic there are proven appropriate motor planning

methods of therapy for them that are known to work for years and many

speech language pathologists are aware that they may need to take

from various approaches to find success with each individual child.

Some approaches that are appropriate are Kaufman, Prompt or touch

cue, and Easy Does It. Knowledgeable apraxia therapists know how to

push without breaking. They know how to get an apraxic child to

repeat for their motor memory appropriately. You have an apraxic

child so you know what I mean. You can't just ask an apraxic child

to repeat " again " " again " " again " These are children that are

already on the brink of frustration -they don't need help getting

there!

Those who are not familiar with apraxia are not aware that the more a

child may want to do or say something -the less likely they will be

able to and the more frustrated they will become. And even if an

apraxic child attempts a sound or word, they are not aware that by

rewarding them for any attempt to say a word without teaching them

how to say it is actually worse because once things are in their

motor memory they will continue to use those inappropriate

approximations. Again apraxics don't need to be encouraged -they

need specific therapies to be taught how to speak.

Other therapies that may be necessary for any child diagnosed with

apraxia even without the diagnosis of dysarthia or hypotonia may

still include strengthening therapies, oral motor therapies and

occupational therapies. Most children with apraxia need almost daily

intensive appropriate therapies and on top of that most of us

explored some type or types of alternative therapies that may have

helped as well including therapeutic listening, hippotherapy, music

therapy, cranial sacral therapy etc.

Many of us also found that placements in preschools for the hearing

impaired were amazing for apraxic children and years ago Dr. Joan

Sheppard presented about teaching hearing apraxic children at schools

for the hearing impaired at an ASHA conference. I just posted for

example about the FM systems. Most preschool apraxic children with

appropriate therapies view their therapists as their " friends " that

they " play " with. They are not aware that they are being taught

specific motor planning strategies to help them learn to speak. You

could have your child in some sort of therapy 6 days a week either

through preschool, private, early intervention...but it may just be

for 1/2 hour a day. You could be in the room with your child during

therapy and encouraged to follow through at home.

Of course positive reinforcements, typically through play or treats,

are part of any good SLPs or OTs or parents bag of tricks -but it's

not what's used to get the speech out. Apraxic children desperately

want to be able to speak -they just can't. There are numerous

professionals that back up what I'm saying and numerous archives you

can find yourself by accessing the archives here -and here's one

story which one mother wrote from her heart through tears. Her

daughter was misdiagnosed as autistic or MR most of her life and thus

never received appropriate therapy for apraxia. was

diagnosed with post traumatic stress syndrome on top of her apraxia

due to the inappropriate ABA therapy. I thank Robin for sharing. My

hope is that what happened to never happens again -and that

one day will be able to overcome.

http://www.cherab.org/news/.html

If your child has both apraxia and autism most agree that some form

of modified ABA can be appropriate as long as the therapist is aware

of that child's motor planning limitations.

If your child is autistic most agree that ABA is the appropriate

therapy of choice.

Today in this group (and this is new) apparently there are children

being diagnosed as " autistic " that are social -play appropriately

with toys -have eye contact -but can't speak and have sensory

issues. That used to be the description of apraxic children not

autistic. The parents in this new group are passionate about ABA

therapy and I don't know them or their children to know whether their

children are diagnosed appropriately or not. Rule of thumb is if you

do not see progress within 3 months re-examine therapy, therapists,

or even diagnosis.

Of course when you check the archives you'll find out that most with

apraxic children that were put into ABA therapy the parents learned

within a few sessions not 3 months it was inappropriate as the

frustration builds to the screaming, crying child no longer wanting

any therapy at all. Does your child enjoy therapy and is your child

progressing and reaching set 3 and 6 month goals? Those are the best

questions.

Here are some links on the verbal aspects of apraxia

http://www.cherab.org/information/speechlanguage/therapyintensity.html

http://www.cherab.org/information/speechlanguage/therapies.html

http://www.cherab.org/information/aginmdapraxia.html

http://www.cherab.org/information/speechlanguage/verbalapraxia.html

Children with apraxia may have years of therapy ahead of them to get

them up to speed in speech and motor skills. You want them to be

progressing -but having fun doing so. You don't want to burn them

out at 3.

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