By Pam Marshalla
Q: I have a five-year-old child with cerebral palsy, developmental delay, severe apraxic and dysarthria. Jaw control is limited, she drools, and the tongue retracts when feeding. I am told by her speech reports she needs oral motor work 3 times to 5 times a day. Might you have any suggestions on what I could do? She is in school speech three times per week for 30-minutes and she does see a PROMPT therapist. My experience has taught me that…
By Pam Marshalla
Q: One doctor says my two-year-old daughter has apraxia and another does not believe so. Can you tell me what is going on here? I am afraid that you have entered the “apraxia twilight zone.” The subject of apraxia in children is a controversial and confusing one. First, some professionals insist that apraxia in children does not exist. Others insist it does. Since we have no formal way to diagnose the problem medically (e.g, no CAT scan) the diagnosis is…
By Pam Marshalla
Q: Do you have any computer software recommendations for a student with verbal apraxia? I am not your resource for this kind of information. Find a therapist in your area who has expertise in computer hardware and software. Most school districts and children’s hospitals have at least one person on staff whose job it is to keep up with these products. Also talk to the software companies that sell the equipment. They have salespeople who will teach you all about…
By Pam Marshalla
Q: My six-year-old daughter has oral and verbal apraxia and developmental coordination disorder. She has a difficult time keeping up her levels of concentration throughout the school day. One teacher tells me that Hannah needs to “attend” and that she is concerned about Hannah’s “attention deficit.” Do you know of any resources that would help explain how her diagnosis affects her ability to focus? Probably the best place to begin is The Out-of-Sync Child and succeeding books (The Out-of-Sync Child…
By Pam Marshalla
Q: We have a 7-year-old son who has a diagnosis of moderate autism. About a year ago it was suggested that he has apraxia as well. He is completely nonverbal. We have read Becoming Verbal with Childhood Apraxia. Using some of your suggestions, he now imitates about four sounds. It is so frustrating because as soon as we get him to imitate a sound, he loses mastery of an old one – one step forward, one step back. He attends…
By Pam Marshalla
Q: My granddaughter, Stephanie, is 4-1/2 years old and diagnosed with apraxia. She was born with the cerebellum not fully developed and is classified as having cerebral palsy. Her speech is non-existent, although I can get her to make a variety of sounds in different pitches. In class she seems not to be attending at all. The SLP reported that until Stephanie can let her touch her face and put a spatula on her tongue, she can do little. She…
By Pam Marshalla
Q: I am a speech-language pathologist at a children’s hospital. I have a boy that I see for therapy who is severely (whole body) apraxic. He has been coming to therapy for years at this hospital and has been through multiple therapists. He is intelligible and we are currently working on /l/ and /l/-blends. He substitutes n/l. I feel like he has reached a plateau. He also receives therapy in school. He has most sounds except vowels, diphthongs, some blends,…
By Pam Marshalla
Q: I have just picked up a young man of 14 years with a moderate degree of learning difficulties and a range of speech difficulties. He is in special school but has received very little direct therapy. He has a particularly hyponasal quality, and some hypernasality too. Would you view this as a priority? He is interested in singing and has been unmotivated by therapy, possibly due to its repetitive nature. He wondered if this might be a way to…
By Pam Marshalla
Q: My preschool client with apparent childhood apraxia is not willing to participate and often walks away from or gets annoyed with therapy plans and procedures. What should I do? He sounds like most of the kids on my caseload. Childhood apraxia comes with its pure stubbornness at times. But I don’t think that “behavior” itself is always the issue. There is a reason for the stubborn behavior. What I usually see with preschool kids like this is that they…
