He is seven and almost a year out from his severe TBI. He can say mom, dad, and hi. He tries so hard but it's not coming easily for him.
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Answer transcribed from the Brightway Answers interview with speech-language pathologist Amber Kloess:
This is really difficult, especially with a seven-year-old because he probably wants to communicate and talk and say all the things that are going on in his world. Very frustrating for you as a parent because you might not always know what your child is trying to communicate.
I would definitely consult his speech-language pathologist first. I don't know the background of your son’s case - apraxia has different levels of severities and treatment. But as a speech-language pathologist, my goal for treatment typically is to help someone achieve their highest level of independent functioning, whether it's communication or language or swallowing. We want to make someone as independent as possible to participate in conversation and communication with others.
My thought, without the background information, would be has your child trialed any AAC devices (augmentative and alternative communication)? Is he able to gesture or sign? You can train using a communication board or a low-tech or high-tech communication device - those are all options that don't necessarily replace verbal communication, but can help to support communication. You may also find that he can verbalize more when he hears that model first from a high-tech communication device - to be able to repeat it.
Low-tech can be pretty much anything. It might be a piece of paper with a yes and a no on it - so being able to point to yes or no to answer a question. For high-tech, there are a variety of companies that produce communication devices. Usually an iPad or a tablet that has built-in software for communication.
Apraxia is a careful diagnosis. I am certain that they were diagnosed correctly. As a speech-language pathologist, I would want to know what kind of damage was sustained, I would need to know if it was a hemorrhagic event or anoxic event. What kind of damage was there? What hemisphere? Was it diffused or is it focal?
For example, if the imaging shows you that it's a left frontal lobe damage, that would go hand in hand with the diagnosis of apraxia. If they exhibit behaviors like groping or inconsistent errors or importantly, if they’re able to imitate. The number one most important thing is if your child is able to imitate the sound that family members are giving them. If they can repeat, that's a really good positive prognosis. That's something that I would say might not be of an apraxia type of origin. So number one is to get the right diagnosis.
Let's say we know it is apraxia. We’d start with visual sounds - they're called bilabial - so that would be sounds like “ba”, “pa”, “ma” - something that you're producing with the front of your mouth.
After the individual masters the bilabial sounds, we go into the alveolar sounds. That means t's and d's and s's and z’s - so we're going back in the mouth where it's less visual. So you could say “tie”, “tee”, “top”, “door”, things like that.
After the individual masters alveolar sounds, you go further back in your mouth and start with the velars. which is “kuh”, “the”, etc.
Everything that speech language pathologists do to treat apraxia is really structured, and consistency is key. It can feel very robotic in nature, but it’s effective because you're retraining by taking the sound classes and building and applying to the other words.
Thank you so much for answering. My son was kicked by a horse on the left side of his cheek right where you feel the cheek bone, across to his ear. It was a diffused injury. He was left handed before the accident and they said that might be beneficial but that his speech woul most likely be the last thing to return. He has made a remarkable recovery per his neurosurgeon but he still has a long way to go. We know for sure that his speech problems are motor related but everything points to apraxia from what I've researched as well. His cognitive skills are great, right side hemiplegia/weakness. He is only making vowel sounds and N,M and G sounds usually but cannot imitate the same sounds that we say. He tries so hard but you can see that the conn is lost. Thank you agai!
Great to hear he is making steady gains! Try to start with bilabials, then move the sounds to alveolArs, then velars. Singing helps:) I'm sure you already know that. Best of luck, and it was a pleasure.