Children who cannot say many words need help learning how to imitate sounds and words. The best way to do this is to imitate the child.
Helping Non-Verbal Children Speak
By Pam Marshalla
Tag: Apraxia
Advice for Pierre-Robin Syndrome
By Pam Marshalla
Q: Can you give our family advice about stimulating speech, language, and feeding in a 14-month old girl with Pierre-Robin Syndrome? She is making some sounds and is pretty smart. We have read your book Becoming Verbal with Childhood Apraxia and it has helped us understand about stimulating sound and word productions. Although she continues to be fed through a G-tube, she now is eating many different foods orally. Let me just make some straightforward statements about how I would…
When /d/ Is the Only Consonant
By Pam Marshalla
There is a question that arose in a seminar recently that I want to share. I was teaching on apraxia, and using the 23 methods of jaw, lip, and tongue facilitation as the main focus of the class. The question was about a three-year-old boy who had no other consonants but /d/. He was speaking single words of 1-3 syllables, but his productions were limited to CV structure. Thus, telephone would be produced as “deh-duh-doh.” The question the therapist had…
Initial /h/
By Pam Marshalla
Q: I have a 1st grade student with moderate to severe apraxia who can make the /h/ sound in isolation but cannot co-articulate it. I’ve written the letter /h/ on an index card, and a vowel on another card. I have had him touch the H card and make /h/, and then touch the vowel card and make it. And we have increased the speed as we go but he ends up dropping the /h/ every time. Is there another…
Before /r/ Can Emerge – Early /r/ Therapy
By Pam Marshalla
Q: I have a severely apraxic sixth grader who omits /r/ in blends. Is it appropriate to teach her to use /w/ instead in order to increase intelligibility? For example, can I teach her to say “bwick” for “brick”? I always take the liberty of teaching w/r in these cases. The /w/ holds the place until the client is ready for /r/. This is exactly what many typically developing children do in the younger years. I also add a schwa…
Down Syndrome
By Pam Marshalla
Q: My son has Down syndrome and possible apraxia. Can you give me advice about this? Many therapists today are labeling children with Down syndrome as apraxia, but this is an incorrect diagnosis. The expressive speech and language problems of children with Down syndrome are the result of dysarthria and cognitive deficit. Dysarthria “A generic label for a group of motor speech disorders caused by weakness, paralysis, slowness, incoordination, or sensory loss in the muscle groups responsible for speech” Brookshire, R. H….
Piaget on Apraxia
By Pam Marshalla
Q: I have a question regarding some information in your book called Becoming Verbal with Childhood Apraxia. I have found the information in this book to be quite valuable in my work in early intervention. Where can I find more information on Piaget’s four basic stages in the development of imitation skills? I am the only person I know who has abstracted Piaget’s information in this way, and that is why I spelled it out in that book. I originally…
Cerebral Palsy and Intelligibility
By Pam Marshalla
Q: My 12-year-old grandson has cerebral palsy. He understands everything at age level but he is very hard to understand. He is getting very little speech help. How can we help him at home? Expressive speech is divided into Consonants, Vowels, Syllables, and Intonation Patterns. Most SLP’s focus on Consonants. I would suggest that you focus on Vowels, Syllables and Inflection instead. In other words, have your grandson practice important words, and instead of focusing on getting the consonants correct,…
Definition of Apraxia
By Pam Marshalla
Q: Does apraxia affect classroom learning? Strictly speaking, “apraxia” is a motor speech disorder. Therefore, it only effects the production of speech. But many of these children also have other problems- in comprehension, vocabulary, question comprehension, etc. To me, that means that the child has apraxia AND something else. The apraxia should only effect the expression of speech. That is a “purest” view. And you will read and hear of other views. This is my favorite definition of apraxia. Apraxia…
Diet Modifications and Apraxia
By Pam Marshalla
Q: I have a three-year-old client with apraxia. The mother recently has put the child on a fish oil regiment. I was wondering what your take was on this and if you have had experience with diet modifications. In 33 years as an SLP, I have seen many diet fads come and go – fish oil, whip cream, no potatoes and tomatoes, excess protein, limited protein, vegetarianism, veganism, increased electrolytes, no sugar, no food dyes or additives of any kind,…