When I first posted Sheridan's diagnosis, many people sent me private questions about Apraxia or simply asked that I provide as much information as possible. So, for this post I'll include some information about what Sheridan's speech intervention looks like, show you some of the materials we're using, etc.
Some Basics to Lay the Foundation
Sheridan's SLP is allowing me to record and post portions of Sheridan's sessions. Although she uses a number of strategies with Sheridan (e.g., oral motor therapy, facilitating speech through play), the two things you'll see in the video below are Jane's use of PROMPT and Kaufman cards. Most speech sessions look like this:
1. Oral Motor (usually about 20 minutes)
2. Kaufmann cards using PROMPT
3. Play (during which Jane works to help Sheridan generalize the speech production beyond the cards, often using PROMPT when necessary)
Here's an online description of the Kaufman cards: The Kaufman K-SLP Treatment Kit 1 (basic level) employs a systematic treatment approach that controls the level of motor-speech difficulty by simplifying word pronunciation patterns. Each card displays a series of “successive approximations” of the target word based on least physiological effort. This “word shell” approach is highly effective for quickly building motor-speech coordination and allows children to begin progressing immediately from a simple core vocabulary toward becoming effective vocal/verbal communicators.
The 5x7 cards are organized from the "easiest" words (from a motor planning, speech production perspective) and then build on those sounds to form progressively more advanced/difficult words (I'll show you what I mean in a second). Bonus: Nancy Kaufman is a woman after my own heart... look at those color-coded dividers. *swoon*
I was a little hesitant at first because all the cards use cartoon drawings. For example, the "daddy" does not, ah-hem, look like daddy. At. All.
So I was worried about whether or not these would make sense for Sheridan, and his ability to generalize from the specific drawing to real objects/people. I didn't need to worry. He totally gets it - calls that card "daddy" every time he sees it, calls Gary "daddy," and doesn't call random up-tight white guys "daddy." So we're good.
An example of an early card (from the CVCV group (by the way, C = consonant; V = vowel) would be dada, mama, moo moo.
The next level is VC (e.g., on, out, in, eat, ouch, arm). Here's an example:
|Sheridan has difficulties with /r/ (as do many 3-year-old children), so he still approximates arm as "ahm."|
|Sheridan does well with this card and says pie (though he does drag out the /i/ and /e/ at times).|
|Sheridan still struggles with /m/ versus /b/. Most often he says "be" or "m-be" here.|
|Notice that as words get more difficult, one might use a longer progression of approximations to get to the target word. Sheridan is doing really well with this particular word, and nearly always says "a-po"|
|One of Sheridan's favorite words... he immediately says "bubbos" when he sees this card.|
|Sheridan says "pee-po" - but occasionally needs prompting to get the "pee" on the front (he has a tendency to say the last syllable of a word; this is somewhat common in people with apraxia).|
|Sheridan says "noo-do" with prompting (he doesn't know all the words in this set yet by sight). Notice that this word is a combination of the sounds he learned in earlier sets (new & dough).|
- Sheridan is working only on sets 1 (CVCV) and 2 (VC) at this point in time.
- You'll see Jane using PROMPT when she uses physical cues to help Sheridan remember/feel how to make specific sounds.
- You'll see Sheridan get really frustrated a couple times because some sounds were really hard for him (for example, /e/ as in eat). Many vowels were really difficult for him.
- But know this... Sheridan LOVES (seriously loves) these cards. So much so that we bought a set so he could practice whenever he wants (sometimes he asks every day, sometimes he asks once a week... we follow his lead).
- Notice that Sheridan often leans into Jane so he can be prompted.
- He often prompts himself, as well.
- I provide the sound he's working on, and the target word so you can get a feel for how this works.
- It's worth watching to the very end so you can see that, despite his frustration at times, he truly loves Jane (and he's a little obsessed and extra excited for some of the cards... we often have to hide the up card).