By Leslie Lindsay
~APRAXA MONDAY|ALWAYS WITH A BOOK~
Spotlight: Sunflower Speech Therapy 2/4
Welcome, Karli Press, CF-SLP to the Apraxia Monday series!
I am delighted to chat with Karli because she is so cool and positive and digs kids speech.
Here, she put together this super-informative infographic about childhood apraxia of speech (CAS), which I shared recently, and it’s been making big waves among the folks who follow my SPEAKING OF APRAXIA Facebook page. I am so grateful for this because it really breaks things down.
CAS is a complex disorder—unless you’re a practicing speech-language pathologist with additional skills and training, it’s a relatively rare speech disorder (typically) only briefly touched on in graduate programs. Still, there are researchers who are studying it and others, too who continue to learn about this sometimes baffling and rare motor-speech disorder. That’s why I love this graphic so much. It really breaks it down.
Karli lives and works as a teletherapist in south Florida and the name of her speech clinic, SUNFLOWER SPEECH—I just love. Her tagline:
“Never stop growing.”
Please join me in welcoming the lovely and generously talented Karli Press to
Karli! Thank you for chatting with us. I know you have an interest in CAS—and this graphic is so well-done and so important. When someone asks, “What is childhood apraxia of speech/verbal apraxia?” What are the key take-aways?
Karli Press, CF-SLP:
Hi Leslie! Thank you so much for having me here. I am so excited to share my knowledge on CAS with you all. Great question! When someone asks me, “What is Childhood Apraxia of Speech?” I always make sure to give them the definition in layman terms because I want them to have a true understanding of this speech disorder. That said, CAS is a speech sound disorder where there is a disconnect between the brain telling the articulators how to say a word with the correct MOVEMENT. This is a MOVEMENT disorder. The child has difficulties coordinating the precise movements for speech and can predominantly be noticed when a child attempts to produce one sound to the next sound (e.g., /S/ to /P/ as in ‘spoon’).
Some may say, “Well, my kid must have CAS because he/she has difficulties producing sounds during connected speech also!”
That is not true.
Another key take-away about CAS, is that speech sounds are inconsistent.
For example, when a child attempts to say /P/, it may come out as a /B/ during one production, and the next time, maybe /M/.
This is a result of the disconnect between the brain signaling the articulators to produce the sound. The child usually knows they want to produce the /P/ sound, that they must seal their lips together to make the sound; but there’s a disconnect and the child produces the wrong sounds, consistently. With CAS, it’s consistently inconsistent. It’s all pretty confusing. Take a peek at this graphic from Karli, which helps break down the speech communication process.
Since you work as a teletherapist, what might you want parents to know about this mode of therapy delivery? Is it more difficult than in-person? Is it better to have parent-as-a-partner? In what ways can parents assist? Or should they?
Karli Press, CF-SLP:
Tele-therapy was always on my mind. I mean, how incredible is it to be able to provide therapy to anyone and anywhere! As a Speech-Language Pathologist (SLP) my goal is always to help as many children as I can. Being in South Florida, there is a large population to provide services for, but I wanted to provide to an even larger population.
Tele-therapy is incredible!
It has provided the world with the opportunity to find a professional that they feel will be the most helpful for their child regardless of living close or far away from them. Many families are hesitant at first when it comes to speech tele-therapy. I wouldn’t be lying if I wasn’t nervous myself the first few sessions! The constant words went through my mind, “I hope I will see progress. I hope I don’t see regression. I hope. I hope. I hope.” Guess what? For some of my patients, I have seen even MORE progress seeing them through tele-therapy than in- person! I have many reasons for this:
1) Children feel most comfortable to express themselves in their natural setting and comforting environment.
2) Functional language is so important and what better way to assist with teaching functional language than being in your own household with the common objects that you are wanting to convey you wants/needs about.
3) The child is not right next to you and can no longer point/gesture instead of using their words. Now that they can’t see where your fingers are going, they are forced to use their words to communicate with you and practice their speech even more!
4) The internet is flooded with tons of interactive games! It never gets boring!
5) The whole family is usually in the house and able to listen to the way the speech therapist is prompting/cueing the child. This allows for the parent to truly understand the proper way to assist their child with their speech. During speech tele-therapy sessions, I highly recommend sitting close to your child and taking a few notes on some of the things your speech therapist is doing to help your child’s speech. Most importantly, ASK. Don’t assume you know what the SLP is doing because if you mess up and start practicing incorrectly with your child, it can really harm the child and make it even more difficult to get your child to create strong motor plans of saying sounds correctly.
Your work focuses on early intervention and play, too. What types of things can parents do at home—in addition to the speech-language therapy—to enhance speech development? What types of play or toys would you recommend?
Karli Press, CF-SLP:
Early intervention is KEY. The sooner you start speaking to your child– interacting with your child, playing with your child and noticing/addressing any delays that they may have–the better the outcome.
Play is SO important!
Some of my favorite toys for speech-language development are cause/effect toys and pretend play toys.
Cause/effect toys are awesome and so important because a child must realize that their actions will have an effect on their environment. For example, once a child realizes when they press on a button music will start playing, they begin to understand the foundations of conversation and understanding that if they make a sound, someone will respond to them.
Here are some great cause-effect toys:
- Wind-Up Toys
- Any toy with a button that produces a sound once pressed
Pretend play is imperative for functional communication.
We always want to teach children language that will be useful for them throughout their life and there is no better way to teach that then being hands on and pretending to perform certain tasks.
Here are some great pretend play toys:
- Kitchen Sets
- Doctor/Medical Sets
- Play Food (make it even more realistic and give them real food to play with!)
- Building Toys
When my daughter, Kate—now fifteen, was younger and we were in the thick of her apraxia treatment, we did a lot of work with sequencing. We had these spiral flip cards that sort of went through beginning-middle-end of a certain scene, say, a child getting ready to go outside: shoes, coat, mittens, that kind of thing. Why is sequencing so important for kids with CAS? Or any kids, really?
Karli Press, CF-SLP:
Sequencing and Childhood Apraxia of Speech (CAS) go hand-in-hand. When we think about CAS, we know that it is a motor speech disorder that affects the ability to precisely sequence the movements for speech production. A child with CAS needs to have a solid understanding that there is a beginning, middle and end to a story, just like there is a beginning, middle and end to a word or conversation. By practicing sequencing cards, this helps bring awareness to the child’s mind that there are bits and pieces that make up a whole picture; Similarly, there are individual sounds that make up a word/phrase/sentence. It’s important to bring awareness to the broken-down form of speech so that the child focuses on producing each sound precisely without any substitutions, omissions, distortions, etc.
I love the name of your speech clinic—SUNFLOWER SPEECH—and how it’s all about growing, not being afraid to stand out, yearning, reaching. Can you talk about how you decided on that theme? It’s so warm and comforting.
Karli Press, CF-SLP:
Ever since I was a little girl, I always loved sunflowers. Whenever I look at a sunflower, I think of happiness, standing tall, being proud of who you are, brightness and positivity. It’s hard to look at a sunflower and feel upset. When I knew I wanted to open up my own private practice, I knew that incorporating the bright and uplifting sunflower into my theme would be necessary! Many times, children with speech and language delays/disorders struggle with confidence and self-esteem. As an SLP, I want my patients to know that they have my support to help them
just like a sunflower.
I like to call my students my little seeds that I get to watch grow into a tall, beautiful sunflower.
Karli, I so appreciate this and would happily ask questions all day, alas, we have other things to do! Before we go, what’s one last piece of speech advice for the road?
Karli Press, CF-SLP:
NEVER GIVE UP and just like my tagline says, NEVER STOP GROWING. Regardless if you have a speech and/or language delay/disorder, you can be anyone you want to be! Chase after your dreams and don’t let anyone or anything stop you from doing that.
Got questions or comments about the process? Give me a shout! Leave a comment. We’ll do what we can to help.
Join us every Monday throughout February right here!
featuring Sunflower Speech Therapy Dr. T’s Lola Koala Adventure Activity Kits, The Sensory Studio and TalkYoga.
Join the SPEAKING OF APRAXIA Facebook Community.
For more resources, Q&As, podcasts, more, see the SPEAKING OF APRAXIA page on this website.
ABOUT THE SPEECH-LANGUAGE PATHOGIST:
Karli Press is a Speech-Language Pathologist in South Florida specializing in Childhood Apraxia of Speech. She attended the University of Central Florida for her bachelor’s degree and Florida International University for her master’s degree in Speech-Language Pathology. She grew up in sunny South Florida her whole life; However, as a tele-therapist, she has the opportunity to help children surpass their speech and language goals regardless of where they are located! Feel free to keep in touch with her by following her social media pages.
ABOUT YOUR HOST/AUTHOR:
Leslie Lindsay is the creator and host of the award-winning author interview series,“Always with a Book.” Since 2013, Leslie, named “one of the most influential book reviewers” by Jane Friedman, ranks in the top 1% of all GoodReads reviewers and has conducted over 700 warm, inquisitive conversations with authors as wide-ranging as Robert Kolker and Mary Kubica to Helen Phillips and Mary Beth Keane, making her website a go-to for book lovers world-wide. Her writing & photography have appeared in various print journals and online. She is the award-winning author of SPEAKING OF APRAXIA: A Parents’ Guide to Childhood Apraxia of Speech. A former psychiatric R.N. at the Mayo Clinic, Leslie’s memoir, MODEL HOME: Motherhood, Madness, & Memory, is currently on submission with Catalyst Literary Management. Leslie resides in the Chicago area with her family.
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Follow us every Monday right here for more great tips, insights, interviews, more featuring Sunflower Speech Therapy/a fab infographic of CAS, Dr. T’s Lola Koala Adventure Activity Kits, tips for integrating sensory work and yoga with The Sensory Studio and TalkYoga.
[Special thanks to Karli Press, CF-SLP for the generous use of several of her graphics. “Every child deserves a voice” sunflower image retrieved from her FB page on 1.30.21. Others from Karli Press’s personal archives. Artistic image of SPEAKING OF APRAXIA designed and photographed by A. Fors, CCC-SLP and used with permission. Image of K. Press courtesy of K.Press. All other images as credited by WordPress.]