Apraxia Awareness Day 2020: Information on Apraxia

In the UK this is known as Developmental Verbal Dyspraxia.

Dr Edythe Strand is the Emeritus Professor and Consultant in the division of Speech Pathology, the Department of Neurology at the Mayo Clinic. In this video she provides detailed information for parents on Childhood Apraxia of Speech (CAS). 

My US-based speech and language therapy programme focuses on developing oral motor planning. Dr Strand describes there are many differences in terms of severity and impact but emphasises in many instances, it is an oral motor planning disorder. My apraxia of speech comes from generalised dyspraxia, so as well as oral motor speech work, my programme works on body strength and vision therapy. 

Please note – these are things that helped me, but it was all under the supervision of a specialist SaLT. I am just sharing with you my experience of strategies that have promoted improvement. I have no affiliation with any of them.  

The things that have helped me are:

  • Having a speech and language therapist who is a specialist in apraxia. This is the most important aspect. I went to America as there is more understanding and practical specialism in this condition. I feel we wasted time trying to find a specialist in UK.
  • Identify any hindrances to speech: three years ago, I was assessed with a tongue tie and had it released (frenuloplasty) by an otolaryngologist in Los Angeles. It sounds cool but I didn’t eat or see much in LA other than Santa Monica. This was never identified in UK. This surgery was a significant milestone in improving my speech.
  • Daily therapy with many opportunities for speech development and disseminated speech practice, delivered by a well-trained team; reviewed and revised regularly by your SaLT so that the programme is developmental. A focus on independence in speech.
  • A focus on imitation as even now I can watch someone’s mouth which helps me with my oral motor planning.
  • Use of the ForBrain Headset. This is one of the strategies that helped me made significant progress in a very short time. It is a headset that uses bone conduction, dynamic filter and auditory feedback loop. It helps me hear my voice more clearly during speech practice so I identify how to improve. There is a signidficant about of research available on the site.
  • Use of the IOPI device. I started using this tongue strengthening medical device five days  after surgery. IOPI stands for Iowa Oral Performance Instrument. My tongue strength was so low initially but after three years, it is now within the normal range for my age. 
  • Smart Palate: this device is quite unique, I have used it for several years. It provides bio-feedback with an image of my tongue placement during different speech sounds. It helps me to gain a clear understanding of what changes need to be made. We also set interim goals against the standard tongue patterns for different sounds based on my best one so that it’s developmental.
  • Rapid Syllable Transition Treatment (ReST; University of Sydney): the focus on this is blending, rhythm and extending syllables. There are several information documents: for parents and SaLTs. Training videos are available of the site.
  • Pam Marshalla’s techniques. Sadly Pam died a few years ago but her website and publications are still live and extremely valuable. We still use them; this publication has been particularly helpful for us. It is clear and specific.
  • Specific use of tools identified by your SaLT to help develop sounds: Ark therapeutic tools; TalkTools and Speech Buddies. These can all help jaw stability, tongue independent movement, lip closure and cheek strength. Using these were an important foundation for my oral motor development. However, fading the use of these is equally important; example: speech practice with the tool followed by one without the tool. It is important not to create dependency.
  • The use of techniques such as:
  • PROMPT speech technique helped me when I was starting out but is no longer needed.
  • Voice Aerobics for fluency/prosody and singing which we still use; it is also great fun.

NOTE:

All of these have been part of my programme at some time; their use overseen and developed by a specialist SaLT.

I am not recommending these as a programme they are purely for awareness-raising and information.

The critical part is to find a specialist speech and language therapist who will provide you with the right programme. Every person with speech apraxia is different.

These are purely part of my journey and as the end-user of a SaLT programme have helped me to make such progress. It is my opinion.

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