Special communication needs
What is developmental apraxia of speech?
By Diane Paul-Brown and Roseanne Clausen
A child with developmental apraxia of speech has trouble correctly producing and sequencing sounds, syllables, and words. Generally, there is nothing wrong with the muscles of the face, tongue, lips, and jaw. The problem is thought to arise from difficulty accessing the "motor plan" from the brain for saying a sound or word.
This means that children with developmental apraxia of speech may know what they want to say, but they just cant say it. For example, an older child with the disorder may know the answer to your question is "buckle my seatbelt". He can think the words. He may even have said those same words in the past. But it is not under his control to say them when he wants-no matter how hard he tries. Somehow, his brain just isnt telling his face, tongue, lips and jaw how to produce the words.
The cause of the disorder is unknown.
What does this mean for my child?
Knowing what you want to say and not being able to say it can be a very frustrating experience. And as the child grows, difficulty producing speech and being understood can lead to other difficulties with written language and academic and social skills.
Children who have apraxia of speech can have other communication and developmental problems as well. These problems can include oral-motor weakness, expressive language problems, delayed language development, "soft signs" of neurological involvement such as difficulty coordinating fine motor movement, and/or oral sensory-perceptual deficit (a problem with tactile/motor feedback that is also known as "oral stereognosis",perceiving an object or form through the sense of touch.)
How do I get help?
Help starts with professional diagnosis and a treatment program. Any child who has difficulty communicating or who does not seem to be developing communication abilities at an age-appropriate rate should be assessed for possible speech, language, and hearing problems.
ASHA-certified speech-language pathologists and audiologists can pinpoint the types of problems your child is having and set up a treatment program specific to your child.
For children who show symptoms of developmental apraxia of speech, as ASHA-certified speech-language pathologist will coordinate diagnosis and treatment.
How will my child be assessed?
Assessing apraxia of speech is a multidimensional activity that includes several important steps. Hearing problems should be ruled out by an ASHA-certified audiologist as a necessary first step. The speech-language pathologist will assess your childs speech sound production and sequencing, muscle development, speech mechanism function, and other physiological functions such as breath control and voice intonation patterns.
What will a treatment program consist of?
The treatment program your childs speech-language pathologist develops will likely focus on improving skills in planning, programming, storing, and retrieving motor patterns related to speech production. The success of treatment will depend on several factors:
One focus of your childs treatment will be to create a supportive environment that helps the child feel successful in communicating his or her ideas. The speech-language pathologist will provide intensive treatment that will probably involve several shorter treatment sessions each week rather than one longer session per week. Parents also may be involved through short home assignments requiring daily practice.
Your speech-language pathologist may use treatment strategies that include oral-motor, tactile, auditory, visual, imitative, and phonemic development activities.
Repetition or drill is important for rehearsing syllables, words, and phrases to make them automatic. Improved communication is the most important goal of your childs treatment, and consideration of an augmentative or an alternative communication system may be an important first step toward achieving that goal.
Resources for parents
Probably one of the most important things for a parent to remember is that treatment for developmental apraxia of speech will take time and commitment. Without it, the problems associated with the disorder may persist into adulthood.
The following are resources available to parents of children with developmental apraxia of speech. Your speech-language pathologist also can point you to local support and informational resources.
Signs that can indicate developmental apraxia of speech
Very young children
ASHA November/December 1999: In older children
Other names for Developmental Apraxia of Speech
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Articles written by Pediatric Services
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