Apraxia Monday on Tuesday: Part 2 of 2 with Donna Lederman, SLP

Ever feel like everyday is the same day over and over?  Sort of like that movie, “Groundhog Day?”  Well, no need to be confused–it’s Tuesday and I am still summarizing what I learned in Donna Lederman, SLP’s presentation on CAS (orignial presentation was held on October 14th in Wheaton, IL). Feel free to look back to yesterday’s post for some additional background information if you are just catching up on your blog reading.   

Not only did Ms. Lederman talk about general concerns related to CAS, she also discussed related areas of deficit in children with apraxia.  I know you’re curious, so here they are:

  • Sensory Processing Disorder (also sometimes called Sensory Integration Disorder) in which kids have diffilculty synthesizing all of that environmental stimulation into their nervous systems…those things you and I may take for granted like sighs, sounds, tastes, textures, etc are challenging for these kids to absorb and understand.  They may have a hyper-awareness to sounds or scratchy clothing for example.
  • Language impairment–this kiddos may have greater difficulty learning to read and write (spell)…work with them on rhyming and sound segmentation.  Even once kids with CAS are considered “resolved” these challenges with reading and spelling can persist.

What’s a parent to do?

I all sounds a bit daunting, I know.  But don’t give up hope, and please don’t think you aren’t doing anything for your child–you are doing way more than you realize! 

  • For starters, make sure you have a good SLP who works well with children and meshes with your style as a parent.  
  • Keep in mind that kids with CAS need to have frequent, intense therapy to make the appropropriate gains.  That may mean two sessions a week at 60 minutes each.  It may mean 30-minute sesssions four times a week.  You know best how your child absorbs information (attention span, motivation, trust,  time and financial resources). 
  • Therapy should incorporate high levels of motor practice (doing/saying the same sounds/phrases over and over), but in a fun, engaging manner
  • Therapy should enhance sensory feedback; a “good” therapist will make sure your child is receiving motivational feedback–like “Good job–I like the way you made the “Ba” sound!” (knowledge of performance) or “Not quite.  I need you to try is again like this__” (knowledge of results). 
  • Finally, as a parent you’ll want to make sure you pause periodically to determine the benefits of therapy.  How do you do that?    1) Question whether or no your child received the correct diagnosis 2) Ask if it’s possible that your child may have some other co-occuring disorder that requires some addtional intervention (auditory processing d/o, cognitive delay, dysarthria, or sensory processing d/o, ADHD), 3) Ask if speech therapy is provided with enough intensity and frequency 4) Ask if the approach to therapy used by your child’s SLP is appropriate and effective (sit in on a session or two) and 5) Make sure you are aware of what your child’s speech goals are (IEP)…are they written clearly and can you see some tangible progress on them? 

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