Apraxia

Help for individuals with childhood verbal apraxia

When a child has difficulty speaking due to impaired motor programming, it is called "childhood verbal apraxia (CVA)", or "apraxia of speech" or "dyspraxia". Impaired motor programming means the signal sent from the brain to the articulators (speech muscles) indicating what sounds should be said in what order gets confused. Some children with CVA are non-verbal, whereas other children with CVA make speech errors related to sound confusion in a word. These types of errors are variable, as opposed to other speech impairments that result in consistent error patterns. For example, a child with CVA might say "tight" and "tike" for "kite". Longer words are more difficult resulting in errors such as "baskickball" and "bastickball" for "basketball".

Children with CVA need specific intensive therapy to develop their speech. The following quote from the American Speech and Hearing Association (ASHA) details the important features of therapy for these children:
"Research shows the children with CAS have more success when they receive frequent (3-5 times per week) and intensive treatment. Children seen alone for treatment tend to do better than children seen in groups. As the child improves, they may need treatment less often, and group therapy may be a better alternative.
The focus of intervention for CAS is on improving the planning, sequencing, and coordination of muscle movements for speech production. Isolated exercises designed to "strengthen" the oral muscles will not help with speech. CAS is a disorder of speech coordination, not strength.

To improve speech, the child must practice speech. However, getting feedback from a number of senses, such as tactile "touch" cues and visual cues (e.g., watching him/herself in the mirror) as well as auditory feedback, is often helpful. With this multi-sensory feedback, the child can more readily repeat syllables, words, sentences and longer utterances to improve muscle coordination and sequencing for speech." 1
It is no coincidence that the Phoneme Touch & Say hand cues are highly effective in helping children develop speech. PTS hand cues provide explicit visual information to show which sound should be in which order in a word. However, the Phoneme Touch & Say hand cues also provide touch cues the child can use on him/herself to cue correct articulation.

As a child become familiar with more and more of the PTS hand cues, they can be used quite naturally throughout the day to cue speech. The hand cues should also be used during regular individual practice sessions.
Most of the materials on this website use Phoneme Touch & Say hand cues to support learning specific skills such as saying sounds, words and sentences. For example, Touch & Say Sounds Starter 1 DVD, the Saying Sounds DVDs, and the Dog is Barking DVD all use PTS hand cues to highlight speech sounds. If you wish to learn the whole system of hand cues, the Phoneme Touch & Say program is designed to teach the adult (parent, educator, SLP, etc) how to make and use the hand cues to develop numerous speech, language and literacy skills.

1. http://www.asha.org/public/speech/disorders/childhoodapraxia.htm