Imitation Games for Toddlers with Apraxia

mom and boy
Today I want to talk about imitation games for toddlers with apraxia.

 

Learning how to imitate is how all of us learn everything…especially how to talk! 

 

We hear somebody say a word and then we say it.

 

Verbal imitation is almost always disrupted in very young children with apraxia. Some kids with apraxia will also have a hard time imitating nonverbally. If you’re working with a child who is not yet consistently trying to imitate words, you may have to back up and teach a child how to imitate nonverbally first.

 

Some apraxia experts disagree with this. Here’s why my opinion differs: When a young child, a toddler, is not imitating any words or sounds, we have to be sure that he understands how to imitate in the first place! Some of our little guys with suspected apraxia do not imitate much at all, even gestures or playing with toys. When this happens, we need to address it by starting at the earliest levels of imitation so that we can walk through the step-by-step, sequential process of learning to imitate, which is an important first step in learning to talk.

 

Some SLPs feel that nonverbal imitation isn’t necessarily connected to verbal imitation, and I agree somewhat because we all have seen children who can imitate everything except words. If that’s the case, then you’ve done your due diligence and eliminated “cannot imitate” as one of the reasons a child isn’t talking.

 

The other reason I believe we should spend time working on the imitation piece with toddlers who have markers for apraxia is because imitation skills are required for the therapy techniques we’ll use to treat apraxia. That’s mostly what happens in speech therapy: the SLP models or cues and the child imitates. Until a child can imitate, or at least try to imitate, the therapy process is s…l…o…w. Working on a child’s core deficit of not understanding how to imitate is time well spent in the beginning phase of therapy.

 

When a child is already pretty verbal, these imitation games will provide additional motor practice and keep a child’s little system “primed” for talking. These kinds of copycat games will help a child learn to imitate more efficiently and more automatically. Beyond that, they’re a whole lot of fun for parents and kids! One of the principles that the research about treating apraxia has taught us is that frequent short bursts of practice are more effective than longer sessions, so using these games throughout the day is a wonderful way for parents to meet that requirement. And they can truly be game-changing.

 

For most kids, even when they’re already talking, we want to begin these little imitation games with nonverbal movements that a child can already do so that he experiences success right away. Usually, I start with something like clapping. Once a child claps with me, I model it again several times so that he can imitate this easy movement for a few times in a row before moving on to another easy motor movement a child can imitate next like waving his arms in the air.

 

If imitating is a brand-new skill for a child or for children who are not developmentally ready to participate in a faster-paced imitation game, then introduce the concept of copying you by imbedding the imitation within another activity. Start with a song like “If You’re Happy and You Know It, Clap Your Hands.” After he’s clapping his hands consistently with you, add a new motion, perhaps “stomp your feet.” When he’s doing that one, add a new motor movement like holding up his arms, kicking, karate chopping, giving high-five, blowing kisses—you name it! Be creative! When a child is reluctant to imitate, I try bigger, more outrageous actions like very enthusiastically shaking my head, or pumping my fist in the air, or jumping up and down, or turning in a circle, or I might just throw myself down on the floor. I don’t know what would be fun for you or your child, but these are some ideas to get you started.

 

Eventually, you’ll sneak in a play sound or simple word as the next turn. For example, you could sing, “If you’re happy and you know it, scream!” If a child can say a few words already, try one of those words. For example, if he says, “Dada,” or even makes a consistent default sound like “duh,” use that. If he likes animal sounds like “moo,” or exclamatory words like “Uh-oh,” add that. If those things are too hard for a child and he’s not attempting an imitation, try coughing or panting or any other easy mouth movement.

 

Over time, drop the song and just begin your imitation game. In sessions, I use clapping as the segue for this activity. After a child has done something—anything that would call for a mini-celebration, like following a request—clap for a child and encourage him to clap too. Once he’s clapped, perform another body movement for him to imitate.

 

That’s how we work on imitation games for toddlers with apraxia. You can use these strategies in sessions and better yet, teach them to parents! That’s how we make a real difference with imitation games for toddlers with apraxia.

 

If you need more treatment ideas for toddlers and preschoolers with apraxia, please check out my therapy manuals The Apraxia Workbooks 1 & 2. Get evidence-based strategies that WORK and make a real difference in a child’s progress!

 

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Laura

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