Child Apraxia Therapy Ideas

  • Posted to on May 14, 1999 by Donna Quesal

  • Posted to on April 24, 1999 by Suzanne Rao, M.Sc., B.Sc.(C.D.), S-LP(C) Reg. Speech-Language Pathologist ACHIEVE Speech, Language & Learning Clinic B.C., Canada

    The treatment program for children with speech apraxia must be individualized and flexible. Here are some general strategies I have used effectively over the past 15 years for children with developmental speech apraxia and normal hearing. I hope these ideas will be of some help to you.

    1. Frequency, type and consistency of intervention are important. To treat speech apraxia, the speech-language pathologist needs to provide intensive direct therapy. The child's caregivers/assistants need to participate by doing daily follow-up activities with the child at home/school.
    2. Divide the larger (longterm) goals into smaller (short-term) steps which are concrete and measurable, so that the child and caregivers can see progress. This maintains their motivation for doing home follow-up/practice activities. If the steps are too longterm, the family may feel frustrated because they do not perceive the more subtle (but still meaningful) changes in the child's speech.
    3. Help the child develop a positive self-image of himself/herself as a communicator.
    4. If the apraxia is severe to profound and intelligibility is poor, introduce augmentative communication (e.g. sign language, communication boards) as a bridge to oral communication, while still working on oral speech. This way, the child can continue to develop linguistic and social interaction skills, which would otherwise be held back by the articulation impairment. When selecting a sign language, keep in mind that the idea is to integrate the child into their English-speaking environment, not into deaf culture (if the child is also hearing impaired/deaf, then you have other considerations as well). Choose an English-based sign language (e.g. Signing Exact English or Signed English). Use "universal" gestures instead of signs wherever possible, e.g. nod head to mean "yes" rather than doing the hand sign for "yes", because "naive" (untrained) communicative partners in the child's environment will all understand nodding.
    5. Teach pacing: a slower and more rhythmic rate of speech
    6. Teach early developing and frequently occurring consonants first.
    7. Teach oral-motor awareness.
    8. Associate tactile and visual symbols with sounds. I have developed a set of phoneme-grapheme association picture symbols which have been effective for both speech training and literacy training. If the child does not have limb apraxia or motor planning problems, sign language and gestures also provide effective associations. An example of a simple gesture is running the index finger of one hand down the opposite forearm, to represent continuity of a sound (e.g. for fricatives).
    9. Practice the sounds in the context of frequently occurring words and vocabulary relevant to the child's daily life. Progress from individual consonants (e.g. "p") to nonsense syllables (e.g. "po") to single syllable words (e.g. "pop", "pee", "up").
    10. Multisyllabic words need to be taught separately, using pacing and tactile cues. The biggest challenge for people with apraxia is coordinating articulatory movements during quick movement sequences, e.g. diphthongs, consonant blends, progressions between syllables and in conversation.
  • Things to do at home to encourage speech - suggestions for parents from Apraxia Kids.
  • Beyond Speech Therapy provides information and therapy materials for neurological speech and swallowing disorders including Aphasia, Dysphagia, Apraxia and Dysarthria.

  • Time to Sing is a specially-designed, slow-paced CD of children's favorite musichere or here
    last modified April 1, 2002