SPEECH-SOUND ERRORS:
APRAXIA & PHONOLOGICAL DEFICITS:


What is Apraxia?

Apraxia (otherwise known as Childhood Apraxia of Speech — CAS) is a motor planning deficit, specifically with producing speech, that makes it difficult to understand a child’s speech. The child is unable to coordinate the complex movements required for the mouth to form each sound as well as the movements between sounds to produce words, sentences, and phrases.

What are the signs of apraxia?

The child attempts to communicate; however, his/her speech is very difficult to understand and he/she appears to have extreme difficulty sequencing between speech sounds. An example of this is a child who might only produce a consonant as an approximation for a word (e.g., “p” for “please” or “t” for “want”).

What are Phonological Deficits?

Phonological deficits are characterized as errors in patterns of sounds. A child’s sound errors can include patterns such as consonant cluster reduction (e.g., deleting the “s” from “star”), substitutions (e.g., pronouncing “cup” as “tup”), and syllable deletions (e.g., pronouncing “bubble” as “buh”).

What are the signs of phonological deficits?

The child communicates; however, his/her speech is difficult to understand. Frequently, these children are not aware that they are making any speech errors.

What causes speech sound deficits?

Some speech sound deficits are a result of a phonological processing problem, where a child is not hearing the speech sounds he/she is producing and recognizing the difference between his/her own speech and the speech of others around him/her.

Speech sound deficits can also be the result of oral-motor weakness or coordination problems where a child is unable to move his/her mouth to shape his/her articulators to produce speech sounds accurately.

How can apraxia, phonology, and other speech sound deficits be treated?

A comprehensive approach tends to be the most efficient and effective method for treating CAS and other speech sound deficits, incorporating elements of oral motor therapy, tactile-kinesthetic cueing, and cycling through individual speech sounds. It is also important to encourage functional communication through verbalizations, signs, gestures, word approximations, and Augmentative Alternative Communication such as the Picture Exchange Communication System or speech generating devices, depending on what is appropriate for each child.

How can apraxia, phonology, and other speech-sound deficits influence school success?

If children are not able to process and produce speech sounds accurately, they are likely to have difficulties learning to read. This is primarily because children who have speech sound deficits may not be able to isolate individual sounds in words, which enables them to learn the sound-letter pairs. In other words, a child who understands that the word “spot” can be segmented into 4 sounds: “s - p - o - t”, can also learn that the sound “s” is represented by the letter “S” and the sound “p” is associated with the letter “P”, etc. A child who cannot do this is at risk for having problems with the acquisition of phonics and may eventually be diagnosed as dyslexic.

How are we trained to help?

We are trained to use the TalkTools approach to oral motor therapy, the Cycles approach to phonology, PECS, ASL, and augmentative and alternative communication (AAC) systems including voice output devices. We are also experienced with techniques including PROMPT, the Kaufman Method, and oro-facial myology.
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