Monday, June 1, 2015

Apraxia: ideas to help speech

In January 2015 at age 3 1/2, Presley was given the diagnosis of "severe apraxia".  WedMd says this about it:  "Developmental apraxia of speech is also known as childhood apraxia of speech. This condition is present from birth, and it affects a child's ability to form sounds and words."  In other words, they may know what they want to say, but the words do not come out.  Up to 40% of children with Down syndrome are diagnosed with it.  The therapist said she wasn't sure though, because the few words Presley did say came out consistently the same way and same tone. The therapist said apraxia of speech typically says the same word a little different each time.  Presley could communicate her needs, but there had been very little actual speech from her.  After her evaluation, her speech therapist quit, and we began trying  a few different interventions.  By June 2015 (less than six months later and just a month before her 4th birthday), Presley went from silent gestures to babbling, reading her word cards out loud, imitating us, and trying to make her big sister laugh. Here is a current video of Presley and her sister Payton working on word cards: https://www.youtube.com/watch?v=dmImQzFf9Jc What made Presley begin talking?  She did.  When the time was right, she began talking.  The articulation needs work, but it is coming along great and I am thrilled to have words to work with.  Presley was recently evaluated and is reading on a 2nd grade level, so I knew cognitively she was well prepared, but getting her to form words was completely out of my control. So, we continued the course of laying a solid foundation for good speech. We still have a long way to go, but hearing her sweet voice is a true blessing.  I hope this list of our interventions helps someone else.

1.  Geminii - http://gemiini.org/ - we began this in January 2015 when our SLP bailed on us.  It seems to really give Presley the confidence to sound words out.  They use repetition and lots of close up videos of someone saying the words. Great program with great results. 


2.  Neurodevelopmental program - we use NACD (http://www.nacd.org/) but there are others like ICAN (http://www.senc.us/3.html) so find a reputable evaluator close to you.  NACD has guided me every step of the way.  They believe it is all about INPUT, INPUT, INPUT!  Keep expanding the receptive language and the expressive will follow.  Most of the ideas on this list are from them.


3.  Homemade speech videos using family.  Here are two of ours:
      * https://www.youtube.com/watch?v=FS5d4hPB-64
      * https://www.youtube.com/watch?v=DrtStLk02oE
      * here is a post about making videos:  http://www.3of21.com/2014/03/homemade-videos-to-teach-everything.html


4.  Oral Motor therapy techniques:  we use NACD and talk tools equipment such as bite blocks, horns, straws, etc..  Have an evaluation to ensure everything is strong enough with proper placement for speech.


5.  Sequential Processing:  we will always continue to pursue the next higher level of processing.  See Bob Doman's video about how processing affects language development: https://www.youtube.com/watch?v=QXE9QwjwFJE&app=desktop  or read this article I wrote explaining all about it:  http://www.3of21.com/2015/09/auditory-processing-what-when-how.html


6.  Brillkids:  wonderful reading program that is kind enough to offer large (or free) discounts to children with special needs.  It says the word, shows a photograph of the word, and then shows a video of the object or action. Very easy program to use.  We began this program at 6 months old. http://www.brillkids.com/ 


7.  Diet and supplements:  we began using biokids Shine (http://bioraykids.com/ ) just one week before Presley's increase in words. We also use fermented CLO (Radiant Life) and include lots of healthy fats to feed the brain such as avocados, almond butter, coconut oil, etc..).  We are gluten free and dairy light with only yogurt and raw cheeses.  The gut is known as the second brain and has a direct influence on cognition and "brain fog".


8.  Reading books - this was very important to me as I wanted to create as love of reading for both of our girls.  We even made some videos of my 5 year old reading to Presley and play it over and over.


9.  Music - Presley loves music, so we used different sources:
      *  Talk it, Rock it CD's - (https://www.talkitrockit.com/shop/)  fun,    
          interactive with a good beat to sing to
      *  Readeez -  http://www.readeez.com/ videos with words and singing
      *  Mother goose club Presley's favorite to sing and dance to on youtube
          https://www.youtube.com/watch?v=iwgfEQk4p4U


10.  Speech cards and word flip books - http://www.superduperinc.com/default.aspx


11.  Exercise:  there are so many studies that link exercise with increased cognition.  Here is one article:  http://www.disabilityscoop.com/2013/03/07/can-exercise-down-syndrome/17448/  NACD also encourages encouraging learning while the intensity is high (while they are having fun).  We would go for nature walks and draw alphabet letters in the dirt as we walked and name everything we saw. 


12.  Speech apps:  NACD has a good collection for the ipad: http://nacd.org/speech_sound/apps.php  We also used articulation station, Tiga talk, and Speech 4 Kids.


13.  Ears:  Stay on top of hearing, watch out for fluid and ear infections with any congestion.  Have hearing tested regularly.  They can not repeat sounds they can not hear.


14.  The Listening Program: addresses auditory tonal processing http://nacd.org/speech_sound/the_listening_program.php


15.  Stay informed: Read this great article on Andi Durkin's blog for more information: http://dsdaytoday.blogspot.com/2014/03/treating-apraxia-in-children-with-down.html


16.  Time:  you can do everything on this list, but ultimately they will decide when the time is right.  This is difficult when you know all the pieces are in their proper place, but nothing comes out.  Stay strong and consistent, the end justifies the means.


17.  UPDATE October 2016, we had a very positive output of speech from using the QRI laser.  Read more here:  http://www.3of21.com/2016/10/information-about-cold-laser-low-level.html

Many blessings in your journey,
Robin

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