How to Treat Childhood Apraxia of Speech | Tips from a speech Therapist

When you're treating a child who has apraxia of speech, you have to remember you are teaching two things, all right? Number one is to give the child enough functional ways of communicating with you, whether if it's teaching them as many functional words as possible or teaching them some functional sign language or using some sort of AAC or pecs. And I'm sure if you're watching this video, it means that you've been searching around. So these terms might, if it bothers you, just comment below. But I'm sure if you landed on this video, it means that you haven't done some prior research. Okay? The second thing is you are teaching your child's base ability, their flexibility, their ability to sequence sounds, so on. And in this video, we'll be talking about that. Okay? My name is Ming from Agents of Speech, and here I'm going to talk about how to teach a child who has a practice of speech. Okay? A practice of speech is something rather difficult to treat. That doesn't mean we're not going to treat it. It's just that it's going to take a little more time. And obviously there's a severity towards practice speech. There's light, like what we call mild severity. There's moderate all the way severe and so on. And this is what I use inside of my practice and what has been working for myself. Okay, I'm not going to talk about what is apraxia of speech. Does a different video for that. Maybe I'll link it down below as well for you. But generally there are loads of information out there about what it is. What's more important is what to do about it. Okay? So the first thing again, establishing functional speech and communication. All right? So you must have a way for your child to talk to you. If your child is severe in apraxia speech and it's actually making it very hard for him to. Or her to talk to you daily, you need to have some sort of like signaling or hand signing or you have a picture communication system that you can use or even like an iPad, like a AAC going on, like a. Like a communication board that they can talk to you with. But most of all, I will split the speech session into two. One is for teaching some very. It can be intertwined with it. I won't cut it right in the middle. Right. What I mean is I will put emphasis on teaching words that will be functional for the child. It might be words like mama, like eat or turn on, sit down, take, give me toilet, wee wee, pee, pee, whatever that you guys say in your language for going to the toilet. And there are many, many words that you need to jot down. You know, write down what words that your child will want from you, and you need to give them a means to do so. So in this session, it might be the gesture plus the word, or they're using the cards or using the iPad, using it together to tell you what they want. Okay? And this is super important because the more you talk and teach a certain word, the easier it is for the child to do it automatically. And this is very important because a practice of speech is all about the inability to do. To do things voluntarily, right? To plan a motor ahead in time and then to execute it perfectly. So the thing about it, the more you do something over and over again, the more automatic it will become and it will be, the easier it will be for the kid to. To perform or say the word. Okay, all right. The second thing is to teach flexibility and sequencing. This is where it gets a little bit. Whoa. When you're in a speech therapy room, you're like, what. What are you doing with my kid? Why is this even. Why are you even recommending this? What are you doing? So for younger children, us speech therapists will usually do a lot of syllable sequencing. And what that is, is that we go from one syllable to another. So if you've seen a lot of therapists, they will train children who are apraxic. They will try to do vowel sequencing. Even so, they might do seven hours in one go, and you'll be scratching your head and everything. What. What's going on? Why are you doing that? How is this appropriate? And there is a theory behind it. I won't bore you about it, but basically, it's about. For a child they have. When you're talking, you have two things, right? If you have enough sounds, right? If you have enough sounds. If I have all the speech sounds, can I use it together? Right? And if. If I use it together, right? How difficult? Like playing an instrument. I can play the A note, okay, but if I go from an A to a C, can I do that? If I can't do that, what's the step down? Which is playing the A note over and over again. And which is why we do the same sound, the same syllable, over and over again. So that the child will learn and increase the base level, his base ability in. In sequencing syllables, and. Which means sometimes it's the same syllable. All right? For that. That's. For younger children below word level, we will do loads of Stuff I myself, I don't do seven times. I think that's kind of crazy because how many syllables do you need to sequence in order to make a word? Right? In Chinese, my mother tongue, our words span from like one syllable to like three. And the most is four. Right. And one word, what we call a word. Right. And also in English, of which I'm speaking to you, right. One word has around from one syllable all the way maybe to like five sometimes, but five, four and five already are very rare. So therefore I stick to usually three syllable sequences. So it depends on your child's diagnosis and your, the therapist tests on your kid. And usually speaking, we will start off with vowels and then some consonants at CV level, meaning consonant and a vowel. Right. So that's something you have to, you have to understand. Right. It depends on what your therapist thinks and what your therapist marks down. And what's the errors of your child? What were the weaknesses, where the strengths in terms of producing speech sounds. Right. Okay. For all the children, we don't really use that as many syllable sequencing. All right. Sometimes we might do a little bit. Most of all, we. At least for me, I've done. What I've done is I followed a protocol called rapid syllable transition treatment. So I'm reading off something because it's super long. I don't usually tell the client like I'm doing rapid syllable transition treatment right now. I don't do that. I don't remember it. Okay. Okay. So this is from a University of Sydney. If I'm not, if I'm mistaken, please tell me because I learned it from them. Okay. I learned it from the website, looked over the protocol, copied the word list and so on. So I've actually used this a few times already with apraxic children in my own practice. And I'm. I must say it's pretty intuitive for older children, especially ones who can read words. Okay, so why is it good? Is because it teaches them with non words. So even for syllable sequencing, we also use non words. Why do we do that? Because for a lot of speech sounds, speech sound disorders, if a child already knows the words, it's very easy for them to jump back to their habit. I'm putting air quotes here because it's not really a habit, but it's. They're. They already have like, it's not like a good exercise because they're already used to saying the word in this way. Right. Therefore, if we use a non word, it's just treating the bare basic of their speech production. All right? No language involved, just speech. So there are some meanings behind words that will make it harder for us to say certain kind of words. Okay, I'm not going to deep dive on that right now. But so basically, for teaching flexibility and sequencing for younger children, you use syllable sequencing, as I told you. And then for older children, we use rapid syllable transition treatment. There are a whole load of other treatments out there. Okay. And you might say, how about prompt treatment? How about whatever I do, use it in conjunction. Okay. Because prompt in itself is a queuing method. Which brings me to the next section, the last section I want to talk about, which is cueing and prompting apraxia of speech. Finding an effective cue is very important when you're treating any kid, especially for speech disorder children. And, you know, back then, when I was still a student, the professor would say, oh, us therapists, why we're people pay us money is because we can find the most effective way of killing a kid and then administering it at the right time, at the right way, at the right place. Right. So that's something that you need a therapist help sometimes. But I see a lot of parents, especially those who have been with the kid since forever, you know, like, if the kid is around teenager level, then the mom is actually a really good prompter. Okay. So finding effective cue is hard. But then overall, I would say overall, from listening to senior therapists, working with apraxic children, myself, talking to apraxic people, what I see is the most effective cue is what we call simultaneous production. And it's all in the textbooks, everything. It's true. And I can attest to it. Right. What does that mean? Simultaneous means together. Right. Production means to produce something which is, in this context, means talking. So it's saying the words together whilst the child or the person looking at your mouth saying it together. And it's the. You know, I've done that before because when I was learning musical instruments when I was young, it was far easier when the teacher was, like, playing the music with me. And when I was looking at his face and his instrument, it was easier for me to produce the same quality. When I was on my own, it was much harder. And that's basically the same reason why it's. It's effective. Right. And the other thing is, if you see a practicing child, they're always looking at your mouth. They're always trying to find cues to help them with the motor planning and to give them something like that is great. So where does the prompt, you know, like the, the hand prompts. And so on where does it come from? You know, it's like some therapist doing some magic on the child's face or, like doing some, like using a red triangle and then like an acrylic piece and making them like. Or whatever. You know, those are great. At the same time, we use it as a cue and a prompt. It's not like a protocol. You know, I'm saying there are protocols that they. They do sell and they do tell you about. But all in all, I really think those are how you prompt. Okay. How you cue them, and ultimately you need to take it away from them, so you need to think about how to slowly fade it out. So for the hand prompts, I can't talk much about. It's here because it depends on the sound, and we'll be here for a very long time, and. Or else this video would be like three hours long. Right. And the other thing is, this is very individualized, and it really depends on your child's. What cues are effective on your kid. Right. So that's the end of this video. If you have more questions about our practice of speech or anything related to speech sound disorders, please put them in the comments below. I'm trying my best to increase the number of teachings I have about speech sound disorders. So I also have a free framework for you to teach your speech sound disorders, and you can get it at agents of speech.com speech. Okay. And it's really just a very short PDF for you to read and understand. I also have a video going through how to use it, how to think about it, and it will at least give you a little idea about how to go about teaching any sort of speech sound to your child. All right, so that's it. I'll see you next week in next week's video. Bye. Bye.