Childhood Apraxia of Speech

Signs, Symptoms & Tips for Parents

When we speak, we make quick and well-organized movements of the ‘speech muscles’ – our lips, tongue, and other parts of the mouth, nose, and throat. Some children have trouble making speech sounds clearly. One type of speech sound disorder is called Childhood Apraxia of Speech. Children with Apraxia of Speech have normal speech muscles, but they have difficulty moving the speech muscles for speech. Their brain tries to tell the muscles what to do but somehow that message gets scrambled resulting in unclear speech.

SIGNS & SYMPTOMS

• A baby may
  • only coo or babble a little
  • make only a few consonant and vowel sounds
  • point and grunt to communicate even after age 2
• A child may
  •  say the same word a different way each time they say it
  • say one syllable for many words
  • say single sounds clearly, but have trouble combining sounds
  • sound less clear when saying longer words and sentences
  • say a word very clearly once but be unable to repeat it
  • sometimes, speech muscles are weak, and drooling is common
• Even though producing speech sounds is difficult, the child usually
  • knows what he/she wants to say
  • understands what is said to him/her

Signs & Symptoms adapted from Nancy Kaufman’s Presentation at Kaufman Children’s Centre Workshop

TIPS FOR PARENTS
Keep your child talking!!!

• Encourage your child to continue to TRY to communicate as best as he/she can
• Praise your child when he/she tries to say a word
• Respond to what your child is saying rather than always correcting him/her

Your child can become frustrated when his/her speech is not understood, and may stop trying to communicate. Usually, parents are best at understanding their child’s speech. Focus on what you do understand so your child continues to WANT to communicate. The more practice your child gets with talking the better. With more practice, your child’s motor speech patterns become more automatic and less effortful.

Use simple language that repeats
When you use the same words each time you do an activity with your child, your child will know what words you are going to say. In time, your child will try to fill in some of the words. This is like when you repeat a nursery rhyme or song and your child fills in some of the words. For example, when you sing The Wheels on the Bus song, pausing before the word ‘bus’ will invite a child to try to say ‘bus’ as they know the song so well. In the same way, if you make you say the same words each time you do a daily activity or create songs you sing each time, children will learn the words and may try to say them.

We want to increase the number of opportunities your child has to practice saying words by making the language they hear as predictable as possible. Some familiar phrases can be “I want…”, “Help me”, “Open….”, “my turn”, “more…” Keep a list of words that your child uses. Post a list of words your child uses on the fridge. Family members will know to encourage your child to keep using those words. Leaving it on the fridge allows you to easily add to it when your child learns a new word. Give this list to extended family members and daycare staff who spend time with your child.  This will give them a chance to learn and understand the words your child is using and praise your child for trying these words. Again, it is important for your child to be comfortable attempting to speak often and in many different situations with different people. Intense practice will help speech become more automatic for your child.

Teach your child some basic signs
Teaching your child some basic signs to communicate immediate needs such as ‘drink’, ‘eat’, ‘more’, ‘all done’, ‘help’ and ‘want’. The signs may help reduce your child’s frustration when their speech isn’t understood. When your child uses a sign, respond as if they have spoken the words and say the word at the same time.

Keep a picture communication book handy to help during communication breakdowns.
Create a picture book with common everyday vocabulary. When your child is trying to communicate something and you don’t understand them, bring out the picture book. Ask your child if he/she can find a picture of what they are talking about in the book. You can use the book too to point to pictures of words you say. Your child will be more likely to use the book if you do too. Even if your child needs reminders to use the book, keep trying. At daycare, a picture book can be used as a communication tool for families and daycare staff to ask about things your child has done at home or at daycare. You can ask your child “Show me in your book what you did at daycare today”.

Practice, Practice, Practice
If your child is working with a Speech Language Pathologist and you have been given target words to practice at home, make sure you build in time to work on these target words. Set aside 10-15 minutes of practice time each day. Make different games with the words your child is practicing. For example, hide picture cards around a room, ask your child to find one, bring it to you, and tell you the name of the picture 3 times. Your practice time should feel like play to your child. The more practice your child gets with specific target words, the more likely those words will become automatic and less effortful.

A helpful analogy: Learning to drive a standard car.
Have you ever tried to drive a standard car? It requires quick and well-organized movements of many muscles. If you practiced only sometimes, it would take you a long time to learn and to build up confidence with your skill. However, if you practiced daily, you would learn the motor sequence much more quickly and be more confident in your ability to drive a standard car.

For more information talk to your child’s Speech-Language Pathologist

Author: Kim Spylo, Speech-Language Pathologist, Western University, H. A. Leeper Speech and Hearing Clinic

Reviewed 2019