A is a 6 ½ year old boy who has been coming to the Allen Hall Speech Clinic since summer of 2006. He had been diagnosed with severe Childhood Apraxia of Speech, and was provided with an AAC device called the Vantage. His general diagnosis is Delayed Speech and Language. Over the summer of 2007, he was also diagnosed with Selective Mutism.
We have been working on many, many goals. Several are related to language, both expressive and receptive, also on producing function words and some pre-literacy and basic literacy skills. We are also working on using the Vantage for communication, and learning the language of Unity that the Vantage uses.
Paul (1997) suggests that if a child is using some vocalizations, then it is appropriate to shape these into words meeting a variety of social functions, such as greetings, acknowledgements, and attention getting. This reinforces my attempts to teach A to say such words as “hi” and to shape his attempts at “dad, uh-huh, huh-uh, look, more” into more standard productions. As communication is a multimodal event, this is a fitting addition to A’s communicative abilities.
It is also important that AAC users become literate, as this is the most efficient and common method of communication that may be available to them. Literacy socialization is one of the basic components to building literacy. This involves understanding words as being made up of letters and having meaning, page turning and left to right progression of words and sentences, and different types of language found in books. I am trying to foster some of these skills in A by attempting to read a story to him at least once a week, often pointing to the words as I read and having him turn the pages.
I think A has a very tough road ahead of him, and try very hard to support his attempts at and abilities for communication. We are working hard, and although progress is slow, it is occurring. A is a challenging and enjoyable boy to work with, and with the support of my supervisor, I am learning a lot from him.
Paul, R (1997).Facilitating transitions in language development for children using AAC. Augmentative and Alternative Communication. 13, 141-8.
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Hey Paula,
It was interesting to hear about what you and A. are working on in therapy. The two of you have a great bond together.
I found another article that highlighted the difficulties that children with childhood apraxia of speech may have with phonological awareness and reading. Gillian and Moriarty (2007) found that children with apraxia aged 6-7 were at risk for reading and phonological awareness problems. These researchers also noted the importance of concentrating on an overall phonological approach, pairing written and spoken words, much like you are doing with A.
I thought it was interesting that this study focused on kids aged 6 and 7, as literacy really now begins at age 4 and 5. The study focused on young kids who are struggling with literacy but who have great potential to become literate because of their young age. The children they worked with showed a significant improvement in "simultaneuos speech, phonologial awareness, and deoding ability (51). Their study also supports an emphasis on literacy, as well as a phonological approach to spoken language.
Thank you for posting info on your therapy techniques and focus with A.
References:
Gillon, G. T. Moriarty, B. C. (2007). Childhood Apraxia of Speech: Children at Risk for Persistent Reading and Spelling Disorder. Seminars in Speech and Language. 28, 48-57.
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