CAS apraxia questions
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Anonymous
| 3 year old just diagnosed of apraxia last week, and he has some words, maybe 20 words in total. Does that mean he needs to be taught (with a lot of repetition & practices) to learn to say every/each new sounds & new words? Or is apraxia something that once he masters some sounds & oral motor skills, it helps & he can self-learn & self-figure out to learn to say new sounds & new words? He never has language explosion when he was little, could there still hope that he might have a language explosion at an older age? Or he completely missed it already? He knows some vowels sounds (a,e,i,o, except u), and consonants (f, s, t, z), and have big problems on (b,d, p, m). He has IEP. There is a waiting list, and he will start to see private speech therapist in July twice a week. In the mean time, anything I can help with those sounds? Thanks. |
Anonymous
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Yes he will probably need to be taught many sounds and blend. But some will come easier than others. He is also behind in language.
I would honestly leave the articulation work to the SLP and work on basic or modified sign language with him (see signing time videos). And read read read to him. He can understand it all. Have you reached out to your school district about their program for 3 yo with disabilities? That could get your more services and put him in a language rich environment. Finally to learn more go to the apraxia kids website. Lots of resources there. Good luck. It is a very slow journey but can be rewarding. My DC has resolved apraxia. |
Anonymous
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Your child isn’t learning the sounds but how to execute the motor plan for the sounds. So even if your know ‘b’ you also have to learn ba / be / br/ etc etc. Thrn expand to a word and then a sentence. Honestly speech is miracle to me when it happens normally.
When my CAS kid was little we were told it would take 10,000-12,000 hours of therapy to get to typical speech. That turned out to be about right, but my kids case was severe. Two sessions per week may not be enough. Depends on your kids level of cooperation, ability and experiemcevof the therapist. |
Anonymous
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Sit in on the therapy sesssions. Watch what the SLP does to cue speech. This was a huge help for us. I repeated what she did in between sessions. We also made up silly songs when we were working on a word. I remember with the word up we built towers while singing “up up up...” then we’d say down while we knocked it down. He thought that was hysterical and he tried to sing along. We had many of these one or two word songs where we just repeated the word. We also read stories that emphasized simple words. I would read and then pause to see if he could fill in the word. These were the words we worked on in speech not random ones. In the early years it definitely felt like every single word had to be learned on its own. I never ever drilled him. Instead we did it all through play and cues. If our SLPs hadnt let me watch, he wouldn’t have made as much progress. Early on we did speech almost every day. He has private, county and attended LEAP at UMD.
Unlike the above PP, our son didn’t require 10,000 hours. I would say it was a year or so of daily, then maybe 2x a week for a few years and the last 2 years were 1x a week. He exited speech at 7. |
Anonymous
| These videos from Mayo Clinic are good; they what effective therapy for CAS should look like . https://www.youtube.com/watch?v=x15nL_MicOw |
Anonymous
| I would be concerned about a diagnosis at age 3. Who did the diagnosis? I would do intensive private speech. If it is Apraxia, you want to do PROMPT. |
Anonymous
While CAS requires highly specialized intensive therapy, I wamt to chime in here. There are other effective methods for treading CAS. PROMPT is definitely a great way to go but there are CAS therapists who use other approaches so don’t rule somehow out because they aren’t using PROMPT. Ask for an explanation of why they use their approach. I read about a lot of success with the Kaufman method on the Apraxia Kids group on Facebook. My sons SLP used an eclectic method that was similar but not exactly PROMPT. What you don’t want is a therapist treating your child with traditional articulation therapy. That won’t work. You also don’t want a therapist who isn’t experienced with CAS. I highly recommend apraxia-kids.org for more information on CAS and treatment. If you’re on FB, join the group. It’s what got me through the early years of treatment. |
Anonymous
You took the words right out of my mouth. PROMPT became known as the "go to" program for CAS only because it is a packaged program that parents discuss. The approach is typical oral-motor learning theory with wrapping paper and a bow on it. What is more important is that the SLP has knowledge and experience in treating CAS. |
Anonymous
NP. I don't know what the bolded means but I can tell you that it wasn't until my DS started seeing a PROMPT certified SLP at age 5 that he made any notable progress with his speech. He'd been in ST since 2. DS is now 15. I recommend it because of all the excellent SLPs we'd seen, the PROMPT certified SLP was the first to identify the weaknesses in the muscles of his face/mouth. And, when she pointed it out to me, I could see it as well. That's what she started to work on first as they are foundational to sound production. As his strength/control improved, so did his articulation and intelligibility. It was a developmental pediatrician who referred me to a PROMPT certified SLP, not another parent. |
Anonymous
| How many session per week does PROMPT require? |
Anonymous
It’s not really about the method. There are several that are effective with apraxia. Converts swear by PROMPT but my son does well with Kaufman and a variety of others. CAS responses best to the intensity of therapy. Once a week is not enough. We are had 3-4x/ week and the improvement has been massive. If you work find a therapist who can come to you. It’s a lifesaver. Also to your question, the word “plan” is an issue of muscle memory. CAS kids have to learn it manually and then practice it hundreds of times to lock it in. But most of the time, unless they are very tired very sick, that plan will be permanent muscle memory. One of the best pieces of advice I ever got, was to be a parent first and let the speech therapist do their work. It’s so tempting to drill them when they’re that young but it’s really not that effective. Make it play based and fun. Reinforce what your SLp says. Practice however you can without your kid realizing it’s speech. Give them lots of time to answer questions and practice not translating for them - if you know they can say “juice” make them say it first instead of filling in the word for them. Rhyme a lot. Do a lot of reading - even better if the book rhymes they can start to fill in the sounds. Good luck! It’s hard but it’s possible to be completely and totally fine with CAS. |
Anonymous
18:52 here. It depends on the child. ST was work for my DS whether it was PROMPT or not. We did 30-45 minute sessions twice a week - our schedules didn't allow for any more than that (DH and I WOH FT and we've got 2 other kids). Sessions longer than that were pointless as he was too fatigued to benefit from them. No matter what approach is taken for ST (or OT or PT), to really benefit from it, you need to do the 'homework' and practice at home what was done at therapy. My DS's speech is still atypical because in addition to the apraxia, he also has a language disorder. By the time he hit MS, he had few problems with the motor planning aspects of speech (even in spontaneous speech) but still lags (and probably always will) on actually processing speech. Interestingly, he is an above average reader. |
Anonymous
| Who do you recommend for speech therapy for Apraxia in MOCO? |
Anonymous
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Is a diagnosis of apraxia at age 3 not common?
My son is 2 1/2 with severe expressive language delay- our doctor told us he is too young to diagnose for apraxia so just curious about that comment |
Anonymous
Apraxia is not that common. However, in those that have it, age 3 is the idea time for diagnosis. They are still young enough to benefit from intensive early intervention but old enough that a differential diagnosis can be made. CAS is often suspected prior to age 3 though. When it’s suspected, children can receive earlier treatment without the formal diagnosis. Our son was suspected at age 2.5. |