For those of you who are following the apparently very controversial article “Oral Motor Exercises” and all of the comments, here’s a follow-up I received today from Dr. Lof. Here are his comments specifically related to oral motor exercises as they are used with children who have been diagnosed with apraxia, and of course, a few of my own comments.
Hope this helps.
So? What does this mean for you if your child has been diagnosed with apraxia? Children have to practice SPEECH, not movements without any sound or movements with just a sound (such as “p” for /p/) to be able to learn to talk.
Dr. Lof’s mention of working at the syllable level means that sounds aren’t practiced alone, or in isolation, as your SLP might say. Most early interventionists and pediatric SLPs use this approach since we work on WORDS in the context of daily activities or play. Sometimes SLPs (myself included) will cue the sound in isolation, or by itself, to be sure the child is capable of producing the sound as well as to heighten a child’s awareness of the sound.
Your SLP might also use verbal, visual, or tactile sound cues such saying “Use your popper sound” for /p/ while pointing to her lips, or your “throaty” sound for /k/ while touching under your child’s neck. Again, this kind of practice should be very limited (no more than a couple of repetitions) and shouldn’t be the focus of the session since we’re talking about toddlers and young preschoolers here! Individual speech sounds should be placed in words pretty quickly so that the sounds make sense AND so that you don’t lose a child’s attention in this process. Cognitively, most children aren’t ready for intensely focused sound production practice until after 3.
Sound practice for children with apraxia isn’t recommended since it’s the SEQUENCING of sounds that usually causes the problems with intelligibility. He or she may be able to say the sound alone perfectly, but then it falls apart in the word or phrase. Practicing the individual sound over and over is often pointless since this is not the real problem.
Let me also reiterate one more HUGE principle that I’ll emphasize yet again. If your child is really young and his LANGUAGE skills (vocabulary size, phrase length, using words to ask for things and respond to you, etc…) are NOT age-appropriate, all of these speech or sound issues should take a back seat to helping him learn to be an effective communicator. The time to address all of the specific sound errors is AFTER his language skills are well on their way to matching those of his same-age peers. Focus on WORDS and COMMUNICATION. Intelligibility will come, but it won’t matter anyway if he has nothing to say! Laura