Apraxia Practice Principles

Apraxia is a motor speech problem where the is a disruption between what the brain is telling the mouth to do and what actually happens.  Children with apraxia have trouble controlling their muscles to make speech sounds.  Often what the way they say sounds and words is not consistent.  When working with children with apraxia it is important to follow the principles of motor learning: 

  • Do as many repetitions of the words you are working on as possible.

  • More frequent shorter sessions are better than longer ones.

  • Provide feedback that tells what exactly he needs to do with his tongue, lips, etc. to make the sound correctly.  Don’t say “I heard a W instead of an R”.  Say “Bite your back teeth together and pull your tongue back.”

  • Once he is able to make a sound fairly well (can do it 5 times in a row without much help or can do it in short sentences with just a bit of focus you can start to change practice to develop Carryover. 

  •  Not providing feedback every time, doing it about 50 to  70% of the time, can help children to evaluate for themselves how they are doing.  Try having him flip a coin or roll a dice as a way to decide if feedback will be given.

  • Waiting a few second before providing feedback can help children self-evaluate – it can help them to think about how they did.
    • When you do provide feed back ask how it sounded? Help your child to listen to what they are producing.

  • Work on multiple sounds and word shapes at the same time.  Don’t work on one sound or word shape until it is “fixed”.  

  • Provide variability.  Practice saying words different ways – soft, loud, sarcastic, joyful, angry, etc. When practicing sentences place emphasis on different words in the sentence, make some questions, exclamations, etc.  

  • If possible don’t break sounds apart to make them easier to say.  If you are working on R don’t say “R…ed”.  Instead stretch it out and slow it down to make it easier “Rrrrrreeed”.

  • In addition to working on other practice words, work on a small list of “Core” words – words that you practice every day.  Watch for these words when you see him outside of therapy.  Send this list home.  See separate sheet for more information on Core Words.

 

I hope these ideas help.  For more information on Apraxia I would suggest visiting Apraxia Kids.  This is a wonderful site with therapy guides for parents as well as for speech therapists along with tons of great information to help with this difficult problem. Let me know if you have any questions. Garth Schindel SLPatHome