tag:blogger.com,1999:blog-15194899027377163862024-02-18T17:38:54.351-08:00SLP Mommy of Apraxialaura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.comBlogger122125tag:blogger.com,1999:blog-1519489902737716386.post-68753317013643485462014-11-09T18:44:00.000-08:002014-11-09T18:44:05.558-08:00I'm moving! Find me at slpmommyofapraxia.com!!When I started blogging, it was an outlet to document all the difficulties with my sweet Ashlynn. Since that time, it turned into so much more. It's still my personal blog, but it has inspired me to do and write so much more. <br />
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My husband is a software developer at Steam Engine Studios, and wanted to update my blog into a webpage. All my old content, and now my new content will be found there at:<br />
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<span style="font-size: x-large;"><a href="http://slpmommyofapraxia.com/">http://slpmommyofapraxia.com</a></span><br />
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<br />laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-8421566855578840092014-11-08T16:17:00.000-08:002014-11-09T09:29:06.547-08:00I Know an Old Lady Book Who Swallowed a Pie Book Companion Pack.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVF2MAl75wYZUvOa95zAkAPqZgzii4iBMd0lo3xD14ABBPYP-0gWmWrb-hvfinRVbV7M0nzwhZUPvX1SyuM1JqCi6DJ2aDbI1j7FTWVxJza3U7k4F4LZmBKT137NPiRFfrVO6_6DgXTf9r/s1600/Swallowed+a+Pie+book+companion.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVF2MAl75wYZUvOa95zAkAPqZgzii4iBMd0lo3xD14ABBPYP-0gWmWrb-hvfinRVbV7M0nzwhZUPvX1SyuM1JqCi6DJ2aDbI1j7FTWVxJza3U7k4F4LZmBKT137NPiRFfrVO6_6DgXTf9r/s1600/Swallowed+a+Pie+book+companion.jpg" height="180" width="320" /></a></div>
Two years ago, I wrote a post entitled <a href="http://slpmommyofapraxia.blogspot.com/2012/11/novermber-book-of-month.html" target="_blank">November book of the month</a>. At that time Ashlynn was just starting to imitate really well, and I used this repetitive book with her to have her work on the CV shape "pie."<br />
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Fast forward two years and here we are. Ashlynn can now say most of the Thanksgiving items in this book, she just has a hard time with word recall and has expressive language needs now at this time. <br />
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I created <a href="http://www.teacherspayteachers.com/Product/I-Know-an-Old-Lady-Who-Swallowed-a-Pie-Book-Companion-activity-pack-1543854" target="_blank">this companion pack for her</a>, but for also my kiddos with a variety of speech/language needs. The first part contains all the pictures in the story with a sequencing board for the kids to sequence their pictures. <br />
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The next part has a following directions activity incorporating a variety of spatial concepts with the vocabulary (i.e. "put the squash between the lady and the table)."<br />
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Part three contains a 9 page mini book with the pictures for the kids to practice a sentence, "She ate a ..." <br />
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The last page contains an enlarged version of the old lady's head with her mouth open, that you can cut out and glue to a manilla envelope and cut out the mouth. You can then have the kids "feed" the old lady all the vocabulary items using whatever speech or language target you choose! <br />
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<span style="font-size: large;"><a href="http://www.teacherspayteachers.com/Product/I-Know-an-Old-Lady-Who-Swallowed-a-Pie-Book-Companion-activity-pack-1543854" target="_blank">Get it here in my TpT store! </a></span><br />
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Happy Thanksgiving!laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-12203492481335951662014-11-02T20:31:00.000-08:002014-11-02T20:33:40.121-08:00Wait...is she the ....R word?Oh apraxia is a sneaky devil. For so long I prayed to just hear her sweet voice say what she wanted to say. At some point she started imitating really well. She didn't really call out to me "mama" and she didn't really offer up "I love you" but she could say it in imitation, and this was good. This was very good...because NOT hearing those words was devastating. <br />
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I still hear my husband putting her to bed at night.<br />
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Husband: "I love you Ashlynn."<br />
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Giggles<br />
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Husband: Say, "I...love....you."<br />
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The progression was slow, but she would do it, in her own way using word approximations. Never spontaneously though.<br />
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The last two years are a blur of therapy appointments, speech practice, working toward the next goal. Despite what I would see at home, she would never show her skills to others so anytime she did something new at school or in therapy and they were so proud, I was just left giving a small thanks that at least she's showing what she does at home. <br />
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Family who knew her began understanding her more and more. However, those who didn't still questioned what she was saying. Disappointing to say the least, but the honest feedback was a necessary reality check. I know what she's saying 99% of the time, so it sucks when even her school SLP rates her at about a 60%. Oh well. I need honesty, and that's honest.<br />
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On her fifth birthday though, it all started to change. I posted a video of her, and the feedback was incredible. Everyone could understand her!! Other people were validating what I have seen for so long!! <br />
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A progress note from school only lists a few artic errors: inconsistent 'l' and 'l' blends, a frontal lisp 's' pattern, and occasional errors with multi-syllabic words and consonant clusters. Of more concern now are expressive language delays including: grammar, sentence formulation, and word finding.<br />
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That's when it hit me. Ashlynn is almost "resolved" from CAS. Her motor plan (I'm tearing up), has caught up.<br />
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What? Could it be true? Can I actually start to even consider my daughter might be working toward resolved CAS?<br />
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How could that be? It's only been two years, but then I remember the struggle has been so much longer. Is this really the girl who could only say "hi" and "a dah" for everything? The girl who said "nah" for "bus" and "dada" for "iPad?"<br />
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I read something once that said,<br />
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The days are long but the years are short.<br />
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Yes. Yes. Perhaps this is true. At some point I stopped praying my nightly prayer that she would overcome apraxia. When did that happen?? <br />
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I'm always looking toward the next problem. The next goal. She has an expressive language disorder now, and the future for a reading disability is still unknown.<br />
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Maybe I need to stop for a minute. Smell the roses Laura. There was a time you yearned to hear that sweet voice. That very voice today that told you, "I like you mama. I like you. I like daddy and I like Jace. You're my family." <br />
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What I would have traded or given to her those words two years ago. <br />
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So yes, I'm going to pause. I'm going to freeze time. I'm going to think, if only for a moment, how sweet it is to hear my daughter's voice. A voice that is her own and able to express her own thoughts.<br />
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I'm going to reflect on the fact, that in just two short years, I met the head of CASANA and went on to now have advanced training and expertise in CAS. I literally have national apraxia experts a keystroke away via email. <br />
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Say what? How did that happen? How did any of this happen?<br />
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I just asked to join the facebook group for resolved apraxia but with new issues. Yes. That's us. We now fit into that category. My daughter talks so much I now know she needs help with expressive language. How amazing is that?<br />
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Even though I was late to the game in my opinion because I so wanted to believe Ashlynn was just a late talker, none of this would have been possible without early intervention.....wait...let me clarify...appropriate early intervention. <br />
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For reasons I will probably address later, I'm so, so, so grateful that Ashlynn's initial evaluating SLP (in the schools) told me it was CAS. I knew then I had to get her private services. I knew then I had to research this disorder. I knew then our life would never be the same. <br />
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I'd seen CAS before. I'm an elementary SLP, and in my 10 years of experience, two kids walked through my door in Kindergarten nonverbal.<br />
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That would have been Ashlynn had not appropriate therapy been initiated. That meant that as an SLP, even I had to pay out of pocket. $365 - $425 a month. Yes. Ouch. Therapy is expensive, but it's worth it. I just had a baby in that time too and was on maternity leave. We didn't have any extra money. You make sacrifices. It's necessary.<br />
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I knew I didn't want Ashlynn walking into a Kindergarten classroom nonverbal, so my husband and bit the bullet and went broke funding her therapy.<br />
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It doesn't matter now. It was all worth it. I'm so proud of her.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6DXK3ZNHUhCPSLYqTP61MVOnfhvclnkgQjqkC-vyLe9bUSU4L1BGfm1avTjljVbIU6butCVktm3JWldAgCUcR1yub2qS4e17YpDc7NtjQDM1I-D90WztgUZqB9RTlNc4v5rfelGduLcrE/s1600/years-are-short-desktop.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6DXK3ZNHUhCPSLYqTP61MVOnfhvclnkgQjqkC-vyLe9bUSU4L1BGfm1avTjljVbIU6butCVktm3JWldAgCUcR1yub2qS4e17YpDc7NtjQDM1I-D90WztgUZqB9RTlNc4v5rfelGduLcrE/s1600/years-are-short-desktop.png" height="213" width="320" /></a></div>
laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com5tag:blogger.com,1999:blog-1519489902737716386.post-56627174116970509352014-10-28T13:18:00.000-07:002014-10-28T13:18:37.488-07:00A tale of two roles: navigating my role on both sides of apraxia.I first met a fellow mommy of apraxia at the Denver Apraxia Walk. She was pleasant with kind eyes, and said she felt her 5 year old son needed a change up in speech therapy services. <br />
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The next week her son was scheduled for therapy at the private clinic in which I work.<br />
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In most cases, I have my parents come with their child into my office. I NEED them to see what I see. I NEED them to do what I do. They are with their child the most, and they are completely capable of carrying over what I am doing, as long as they know WHAT I am doing.<br />
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Normally the child might be somewhat distracted by the parent; however, this day, I was the one distracted. Not by my client, but by his mom. There isn't one word to describe her face, but there were multiple adjectives rolled into one: worry, anxiety, fear, hope. <br />
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These are only a few, and honestly, they killed me.<br />
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I understood more when she said she had successfully home schooled 4 other children, some even in college. I admired her. She not only stayed home and raised her kids, but she taught them school as well. Their entire childhood development rested on her shoulders and she had done a good job. <br />
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But her baby. Her last child. This one was different. <br />
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I felt her pain. I absorbed her worry. I took responsibility for her hope.<br />
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I knew I could help her son. He wasn't receiving the right therapy. That was evident from his first session. <br />
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I was so moved, I came home and told my husband. I described her face and how it was hard for me to take because I kept absorbing all of her emotions. <br />
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It's hard to watch a mother visibly show almost every emotion I went through with Ashlynn's dx, but then be able to turn that off and be the professional SLP I need to be.<br />
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I recently watched an initial video I took when I saw him. Again, though I was trying my hardest to focus on him, I couldn't help but look at his mom in the background. The worry on her face is tangible. I just want to yell out, "I will help him mom." "Slow down." "Stop worrying." "He is going to be okay." <br />
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Unfortunately, I know saying all of those things is like telling the sun not to rise. A mother's worry cannot be extinguished. <br />
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Last week though, something was different about her demeanor. A softness was in her face. Upon further questioning, I discovered her oldest daughter came home from college and told her she saw a difference in her little brother's speech. <br />
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That's all it took. Outside validation from an inside source. <br />
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I'm sure that doesn't mean she's still not worried, but I hope a small weight, even if ever so tiny, was taken off her shoulders. <br />
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<br />laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-77964677967419213192014-10-27T14:39:00.000-07:002014-10-27T14:39:03.935-07:00Costume Character Prosody Game<div class="separator" style="clear: both; text-align: center;">
<img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrntzCYYXNpdHU4ICS73tFDVXp7BW-8dYAwvFwaVL_Z3TUUxeZ1u_LYM1ceeDO4XXwV0uX9knFhxTo3BMUbiKoObmF6F3-NNkzS2gfKfdHoy2iHQRoEoIVVoaIw7o5dOQBctZ77gCl1I7z/s1600/costume+prosody.jpg" height="180" width="320" /></div>
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While working with one of my kiddos with CAS this past week, I improvised a fun way to incorporate prosody into our lesson. Since it's around Halloween, we said his target words in different voices like our ghost voice, monster voice, or vampire voice! </div>
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I decided to make a game that would work really anytime of year to work on prosody. Say it like a Costume Character has 2 sets of 16 different costume characters. Another 8 cards include fun game directions like: "Costume Caper! Take a character from another player."</div>
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Each player has a game board with 8 spots. Whoever fills up their game board first with a different character occupying each space wins!</div>
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Of course, you could always just have your students draw a card and say their targets using their character imitation, or you can play Memory or Go Fish since two sets of cards are included.</div>
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Find it in my TpT store: <a href="http://www.teacherspayteachers.com/Product/Say-it-like-a-Costume-Character-A-game-to-address-prosody-1521820" target="_blank">Say it Like a Costume Character</a></div>
laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-16162713398284002932014-10-20T08:27:00.002-07:002014-10-20T08:27:58.058-07:00"Oh my goodness!!" Ashlynn turns 5!<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfYIKW8HMnkbklbXoMKPrcW7r3tkXnPEjsCdtdxAxfH0IVJcPjsXzRGDrjsVuB2dVmo_t_-8776KoQppL7HBk4mQM8PjTa7TzAx6XsK3VJkNU0g0MqiJh5mmPvdl-rm4n5N2Ul4P9iV4Mq/s1600/10440684_10203567530281441_1567676548862080010_n.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfYIKW8HMnkbklbXoMKPrcW7r3tkXnPEjsCdtdxAxfH0IVJcPjsXzRGDrjsVuB2dVmo_t_-8776KoQppL7HBk4mQM8PjTa7TzAx6XsK3VJkNU0g0MqiJh5mmPvdl-rm4n5N2Ul4P9iV4Mq/s1600/10440684_10203567530281441_1567676548862080010_n.jpg" height="200" width="150" /></a></div>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhh9bhvJFF64hR8VwIL24rb70u0FY58dkNJCz8BVR5Iy-Y_nkmlMPScjTKHtA3K1kNfvGC7u_IS5h71v0m0x31TzyhmUQ7_BowJphhILrSpGJ16fMQIi4Jz9G2CNgOc0P1wltK0RqQj-fZv/s1600/10730169_10203567530481446_8952645511241433698_n.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhh9bhvJFF64hR8VwIL24rb70u0FY58dkNJCz8BVR5Iy-Y_nkmlMPScjTKHtA3K1kNfvGC7u_IS5h71v0m0x31TzyhmUQ7_BowJphhILrSpGJ16fMQIi4Jz9G2CNgOc0P1wltK0RqQj-fZv/s1600/10730169_10203567530481446_8952645511241433698_n.jpg" height="150" width="200" /></a>The day started long before the AM. Preparations were in place to decorate the house after Ashlynn went to bed.<br />
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This year was different though. When I left to leave while Cody was putting her to bed, she asked me where I was going. <br />
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"Mama? Where you going?"<br />
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Though I tried my best to cover, she asked,<br />
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"You going for my birthday?"<br />
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Freeze time. <br />
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My daughter has ALWAYS been astute and observant, but we usually could play it off and nothing more was said. <br />
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SAID. <br />
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That's the thing. Nothing more was said, but Ashlynn has been watching all these years. I think, wait, I KNOW she knew what was going on. <br />
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We celebrated her birthday this morning. My son has been getting up at 3 AM every morning for the past two weeks, so I was sleeping in a chair in his room when I heard noise outside. I walked out and saw Ashlynn gasping for breath. No, she wasn't in trouble, she saw the balloons in the hallway!<br />
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She's seen these before, but today, she could EXPRESS that she really SAW them. I had my phone on me and starting rolling the film.<br />
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Me: Ashlynn, what do you see?<br />
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Ashlynn: Oh...my....GOODness. (dancing through balloons looking at her decorations)<br />
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Ashynn: Whose presents are these?<br />
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Me: Those are YOUR presents!!<br />
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Ashlynn: Who give them to me?<br />
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Me: Mommy and Daddy!<br />
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Ashlynn: Yeah? Look! It's my jerjay Jace (dang assimilation...if you're an SLP, you would find this fascinating, especially since she can say "birthday"<br />
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Jace: It's your birthday today?<br />
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Ashlynn; Yes, it is! <br />
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Me: How old are you Ashlynn?<br />
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Ashlynn showing ten fingers: This many!!!<br />
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Me: Say, "I'm five!"<br />
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Ashlynn in excited fashion: "I'm five!!!<br />
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A little later on,<br />
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Ashlynn: Mama, where's my cake?<br />
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The last two years I made her a cake, but this year I decided to buy her a pretty Minnie ice cream cake that we hadn't picked up yet. I was surprised she asked where it was. <br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: large;">Take that apraxia!</span><br />
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As the morning rolled on, I was folding clothes when my husband came into the room, eyes red. Emotional. But before I explain why, it's important to know the back story.<br />
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A couple weeks ago we were discussing what to get Ashlynn for her birthday. My husband always has it in his head to get our kids a BIG gift. He remembers the BIG gifts from his childhood...and some he even remembers what age he was when he received them.<br />
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I don't remember my big gifts. I remember gifts, usually practical. I love gifts, but for example, on my list for Ashlynn's gifts I had: long sleeve shirts, winter coat, robe, socks....(follow Cody's "really?!?" face). <br />
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Ashlynn just isn't into BIG gifts. For some reason, she loves cards. Any cards. Trading cards, flash cards, alphabet cards, playing cards....cards.<br />
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I told Cody, if he wanted to get her a BIG gift, he should get her cards. Buy her a binder she could decorate and put in pocket protectors. He did...begrudgingly. But it's true. It's what she wants. We took her to the toy store THREE times, and she just wasn't crazy about anything.<br />
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Okay, so back to his red eyed confession. <br />
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Cody: Ashlynn just said "thank you daddy" unprompted.<br />
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Me: Really? For what?<br />
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Cody: Buying her cards. She's never said thank you unprompted before.<br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: large;">Take that apraxia!!</span><br />
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As the guests arrived, her Grandma and Grandpa were two of the first people in the door. She excitedly ushered her grandpa to her swing where she got him to push her. I remember a time my dad came to visit and she wasn't really talking. She said 'hi' but that was about it. He left that day and told my mom he wasn't sure Ashlynn knew he was. <a href="http://slpmommyofapraxia.blogspot.com/2013/06/ashlynn-happy-papas-house.html" target="_blank">You can read about that story here.</a> <br />
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The thing is, Ashlynn always knew who he was. She knew he's the guy who plays ball and boats with her. She <i>knew, </i>but because she couldn't say, he left feeling the way he did. <br />
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All those are distant memories now. She asked him "you push me on the swing?" and they were gone.<br />
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As she was opening gifts, she was telling everyone "thank you" in a big loud voice. She opened up a box that had a hoodie in it that she saw in the store shopping with me and told me it was pretty. This was her face opening it up. I think she liked it ;)<br />
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Another shirt she opened had the word Princess written on it. I asked her who calls her princess. As she looked up and scanned the crowd, her eyes stopped on her other grandpa that was there. She smiled and pointed at him, saying his name. He later reported what a cool moment that was. Verbal confirmation that Ashlynn has always known all along just what has been going on.</div>
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This year, singing Happy Birthday and blowing out candles all came easy. That milestone was met <a href="http://slpmommyofapraxia.blogspot.com/2013/10/happy-birthday-song-ashlynn-turns-four.html" target="_blank">last year. </a></div>
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The best came at bedtime. I read her a bedtime story, prayed, and then kissed her goodnight. She was holding the card book Cody gave her. She told me, "Mommy! These are my decorations." (She was pointing out her room decorations that have been on her wall since basically she was born). Yes, honey, those are you room decorations. "Yep, just like my decorations for my birthday." </div>
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She is starting to retain, recall, and generalize higher vocabulary. I smiled. Then she pointed to her card book. </div>
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Ashlynn: Daddy gave this to me</div>
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Me: Yes, he did</div>
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Ashlynn: That was nice of him. You get him so I say thank you?</div>
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Me: You bet Ashlynn.</div>
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<span style="font-size: large;">And that's how we are kicking apraxia's butt!</span></div>
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Happy 5th Birthday Ashlynn! May you continue to find your voice and voice your thoughts, hopes, and dreams.</div>
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Love,</div>
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Mommy</div>
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<br />laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-68223613119063122682014-10-17T20:25:00.002-07:002014-10-18T09:09:45.834-07:00Spooky Spider Web Game For ApraxiaSince Childhood Apraxia of Speech requires a different approach to treatment, principles of motor learning theory need to be driving therapy. You can read more about this in my two interviews: <a href="http://slpmommyofapraxia.blogspot.com/2014/09/september-specialty-series-interview.html" target="_blank">Sharon Gretz interview</a> and <a href="http://slpmommyofapraxia.blogspot.com/2014/09/today-i-am-honored-to-introduce-ruth.html" target="_blank">Ruth Stoeckel Interview</a><br />
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Since getting 100-200 reps per session can be tedious and difficult to keep new and fresh, I came up with this fun Halloween game to play while you work on the child's target sounds.</div>
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Download it at my TpT store: <a href="http://www.teacherspayteachers.com/Product/Spooky-Spiderweb-game-for-Apraxia-of-Speech-1504720" target="_blank">Spooky Spiderweb game</a></div>
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Happy Halloween!</div>
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-67995896423373889872014-10-15T06:23:00.001-07:002014-10-15T06:23:11.642-07:00Kids say the darndest things....unless of course they don't because they have apraxia.What was it that Bill Cosby always said? Kids say the darndest things or something like that. Unless of course, you know, they don't because they have apraxia of speech and can't even say the most basic things. Or this that I just ran across:<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghdz8M90TrtqV0Bq92m94v2MF6Kc11RP7AT8cq2rPhRUGMJI1F1pnBKm89Fhzppq7qWqu70Cpkazrp9Ox-9bEoL3JNJnRZN8xB6rGSRS8L7AsWmtF31dUkba9agCiRFpUUf9hLbt60FOEx/s1600/03890afcf56ad6cd33d0a0c56bb324ec.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghdz8M90TrtqV0Bq92m94v2MF6Kc11RP7AT8cq2rPhRUGMJI1F1pnBKm89Fhzppq7qWqu70Cpkazrp9Ox-9bEoL3JNJnRZN8xB6rGSRS8L7AsWmtF31dUkba9agCiRFpUUf9hLbt60FOEx/s1600/03890afcf56ad6cd33d0a0c56bb324ec.jpg" height="200" width="190" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Unless of course, they don't because they have Apraxia </td></tr>
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When Ashlynn was born, I wondered what her personality would be, the funny things she would do and say. I just expected it to happen. She would be so witty. She has two smart parents, and one in particular who is quite funny (I won't name names but it's not the SLP). <br />
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As time marched on, I did see her personality, and she did do funny things, but it was all so limited. It's pretty hard to say or do basic things, much less funny things when you have motor planning issues affect your entire body.<br />
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Seeing other kids her age or younger on social media or worse in person, usually broke my heart. It got to the point I didn't want to take her around other kids her age and I had to hide friends on social media because I couldn't bear another kids say the darndest things" moment, or really any moment that a typical developing child would have:<br />
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Scenario:<br />
My crazy kid is doing back flips off our couch<br />
What I saw:<br />
Ashlynn can't even jump yet<br />
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Look at our precious baby wearing her mom's high heels. We're in trouble!<br />
What I saw:<br />
My precious baby still falls wearing her own sturdy tennis shoes<br />
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Scenario:<br />
My son just imagined this carrot looked like an alien<br />
What I saw:<br />
Can my daughter even say carrot, and does she even know what an alien is?<br />
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Look at our big boy riding his two wheeler!<br />
What I saw:<br />
My big girl still can't pedal a big wheel.<br />
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Little girl just said she wants to be a princess for Halloween. She sure is daddy's little princess!<br />
What I saw:<br />
My little princess has yet to say her name.<br />
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The list goes on. Not that I wasn't proud of all of these other kids, I was. I was also happy for the parents, and maybe a little jealous. How easy everything came. All these cute little milestones taken for granted.<br />
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Worse yet, the posts about their child's annoying incessant talking. If only there was some peace and quiet.<br />
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Really?<br />
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The quiet is our own little hell. You can't even to begin to understand how painful that is to hear as a mother who has a nonverbal child, when every quiet moment is spent praying that they will talk.<br />
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That's why my last post was so special I guess about <a href="http://slpmommyofapraxia.blogspot.com/2014/10/working-our-way-out-of-apraxia-tunnel.html" target="_blank">Ashlynn confusing "coworkers" with "construction workers." </a> She always comes along, just in her own time,<br />
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and your kids will too. laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com2tag:blogger.com,1999:blog-1519489902737716386.post-44190530659571352342014-10-13T15:00:00.000-07:002014-10-13T17:01:01.139-07:00The Little Old Lady Who Was Not Afraid of Anything: SLP activity pack<div class="separator" style="clear: both; text-align: center;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZsaOJHvF_6zyOIlVl2rl0mGluh_MbKT1XgtzOLAbWFVP6yHZIWhdr0wD9ILpgrgq0S-ZPUzDep5X9ky-rpgEZ1XWFyThrFmEu-vJpbnXZfYp578KFI8qjjEiho_dZKxzKZ9RNF87h8UTB/s1600/the+little+old+lady.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZsaOJHvF_6zyOIlVl2rl0mGluh_MbKT1XgtzOLAbWFVP6yHZIWhdr0wD9ILpgrgq0S-ZPUzDep5X9ky-rpgEZ1XWFyThrFmEu-vJpbnXZfYp578KFI8qjjEiho_dZKxzKZ9RNF87h8UTB/s1600/the+little+old+lady.jpg" height="180" width="320" /></a><span style="font-size: large;">I made my first <a href="http://www.teacherspayteachers.com/Product/The-Little-Old-Lady-Who-Was-Not-Afraid-of-Anything-SLP-activity-pack-1497470" target="_blank">companion pack</a> today</span> to go along with the book, The Little Old Lady Who Was Not Afraid of Anything, by Linda Williams. This book is awesome for speech. I use it for elementary school children, but also read it to my young kids and they are spellbound. The pack includes a sequencing, describing and following directions activity related to the book. </div>
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The book is a repetitive book that builds on the page before. This little old lady goes for a walk in the forest and runs into various articles of clothing and each item makes a certain sound: shoes (clomp), pants (wiggle), shirt (shake), gloves (clap), hat (nod), and a big pumpkin head (boo) at the end. As you will learn from me, <a href="http://slpmommyofapraxia.blogspot.com/p/repetitive-books-that-are-great-for.html" target="_blank">repetitive books</a> are excellent books to use to promote language and practice speech since the children can catch on after a few repetitions. You can read more about how to use repetitive books for apraxia in my <a href="http://www.teacherspayteachers.com/Product/25-Repetitive-books-to-promote-speech-and-language-FREE-1355481" target="_blank">free handout </a>.<br />
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I always make sure to get out props as it engages the children to pay attention and participate in the book even more. If you have my <a href="http://www.teacherspayteachers.com/Product/The-Little-Old-Lady-Who-Was-Not-Afraid-of-Anything-SLP-activity-pack-1497470" target="_blank">companion pack though,</a> there are printable pictures you can also use. For my verbal students, they have to say the sound that goes with their item each time it comes up in the book. For my nonverbal students, I might record the sound on an assistive technology device of some sort that they must press when it is their turn. <br />
I usually choose which items to give the kids depending on their level of speech or language development. Since Ashlynn has apraxia, I gave her the pumpkin head that said, "boo" when she was younger, since she was working on bilabials (b,p,m) in CV combos. As she got older, I have her saying the more complex syllable CCVC 'l' blend shapes (i.e. <strong><u>cl</u></strong>omp, <strong><u>cl</u></strong>ap). <br />
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Once the kids catch on to their word or phrase, as I read the book I stop at their part to have them say it. Lots of participation and lots of fun! <br />
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To get my <a href="http://www.teacherspayteachers.com/Product/The-Little-Old-Lady-Who-Was-Not-Afraid-of-Anything-SLP-activity-pack-1497470" target="_blank">activity pack</a> that includes a sequencing and following directions activity: go to my teachers <a href="http://www.teacherspayteachers.com/Store/Slpmommyofapraxia" target="_blank">pay teachers store. </a><br />
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Happy Halloween!laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com1tag:blogger.com,1999:blog-1519489902737716386.post-76460539991754646782014-10-10T06:48:00.001-07:002014-10-10T06:48:26.678-07:00Working our way out of the apraxia tunnelAshlynn has been saying things lately that are really showing higher level thinking. You'd think this would be glaringly apparent to me, but it really IS crazy how much language gives us an idea of what is going on in their brain.<div>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOwGnsEnGYyyYix49qa_I9H2A30ALX5sgmBMyxJb-whR3Gedz8e-i7R44PpNJ7S6-xA6fKstY9RCkCC-3gWs1GKzDt3Gg8HYc-w6pl_te6p_AYUZ8Fl-D9ZzcaDLO8-nQLw6IA3oTTxxXm/s1600/10649699_10205068830984532_3499164479057535759_n.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOwGnsEnGYyyYix49qa_I9H2A30ALX5sgmBMyxJb-whR3Gedz8e-i7R44PpNJ7S6-xA6fKstY9RCkCC-3gWs1GKzDt3Gg8HYc-w6pl_te6p_AYUZ8Fl-D9ZzcaDLO8-nQLw6IA3oTTxxXm/s1600/10649699_10205068830984532_3499164479057535759_n.jpg" height="320" width="213" /></a>She's been VERY interested in her schedule, and where she is going the next day. I still haven't made our visual schedule, but it's on my to do list. She usually asks me though while she's laying in bed to go to sleep,</div>
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"Mama, what are we doing today?"</div>
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"you mean tomorrow?</div>
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"yes"</div>
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"Tell me that. What are we doing <i>tomorrow?"</i></div>
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<i>"</i>What are we doing, tomahyo?"</div>
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And then we talk about it. She loves it when her grandma drops her off at school and I get to take her to her class. This happens on Tuesday and Wednesdays. She used to just keep asking </div>
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"you takin me to school?"</div>
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I would reply, "Grandma will take you to school and I'll take you to <i>class."</i></div>
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I've been telling her that since she started school. This week she finally said, </div>
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"What are we doing today mama?"</div>
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"you mean<i> tomorrow</i>?"</div>
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"yes"</div>
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"Say that, What are we doing <i>tomorrow</i>?"</div>
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Instead of repeating it back to me, she asked, "Grandma take me to school and you take me to class?" </div>
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This may seem small, but I was sooo proud!</div>
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She also asks me who I work with almost everyday and I usually tell her my coworkers or colleagues.</div>
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Well the other night, she said, "who you go to work with, mama? Construction workers?" </div>
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LOL </div>
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I love it. It makes my heart smile, and in those moments, I know everything is going to be okay.</div>
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My last update has to do with school. This is her third year of preschool.</div>
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The first year she came home singing (with 1-2 sounds) the melody to the baby bumblebee song. By the end of that year, she was also telling me who her friends were in school.</div>
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The second year, she would tell me who she played with for that day, but that was usually the extent of her school reporting.</div>
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This year, her third year, she's identifying the letters of her name all over the place. She also told me the other day when we were talking about arctic animals and that polar bears live there, </div>
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"I live in Colorado." </div>
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Me: "Did you just say you live in Colorado?"</div>
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Ashlynn: "Yes, my teacher tell me that." </div>
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I sat their in awe. This is the first time she's ever told me something she's learned at the school. Heck, this was the first time she said something that she<i> hadn't </i>learned from me or that I hadn't heard her say before. </div>
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I see the light at the end of this tunnel that is apraxia. To be honest, I've seen it for some time now, but I feel we're getting closer to making it completely out.</div>
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com5tag:blogger.com,1999:blog-1519489902737716386.post-44126951762874198762014-10-08T12:11:00.000-07:002014-10-08T12:24:17.978-07:00Back and forth book for nonverbal studentsWhen a child starts school, a range of emotions can be present in BOTH the parent and the child. When Ashlynn started preschool at three years old, she had only ever been watched by family. This was fortunate for us because since she was essentially nonverbal for her first three years of life, my husband and I knew we wouldn't know if someone hurt her or abused her. <br />
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Conversely, we also wouldn't know anything about her day if we relied on her to tell us. I wouldn't know what songs she sang, what friends she made, what activity she enjoyed, what she learned, or even what she ate for snack. Basically, it can be heartbreaking and a little terrifying.<br />
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Currently I'm working in a program in the schools for many kids with severe communication needs. Just because they are elementary level, it doesn't mean the parents still don't have those range of emotions, worries, and desire to hear about their child's day.<br />
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I came up with this cute <a href="http://www.teacherspayteachers.com/Product/Back-and-forth-book-1488348" target="_blank">back and forth book</a> we've been using with some of the kids. We printed the sheets out and laminated them. We then put velcro on and the kids can pick the pictures and put them in the circles for that day.<br />
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For example, in the picture below, our little friend said today he liked the jungle gym, played on the slide at recess, and went to PE. <br />
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You can also get pictures or have names of the child's classmates that can be put on with velcro or written in with dry erase marker on the bottom circle, "I played with ____." <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfn6kH8m4iHDOkX_CGUEB2qGFmw9-8tYwdlqOjo7uypy5DlSt4vjmVZK7N5wDpWdTzKsLmuD-pF2z9Q9TYQRPi5R1C0-VHF8VrrKkieykV9dmvLlHWD9-6N_fl0EpIlBneXVKj7H3ykHII/s640/blogger-image-1413193799.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfn6kH8m4iHDOkX_CGUEB2qGFmw9-8tYwdlqOjo7uypy5DlSt4vjmVZK7N5wDpWdTzKsLmuD-pF2z9Q9TYQRPi5R1C0-VHF8VrrKkieykV9dmvLlHWD9-6N_fl0EpIlBneXVKj7H3ykHII/s320/blogger-image-1413193799.jpg" width="240" /></a><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQxgkcLCXEedGWIcvmo_oBRGry7i93R8NqR_zBv5gIGeLbsIMCKLJLoYIhcW_xGBxC8rFRpxy7c3zq3GtpJ58WZICx3vUE_bmT8I3l8VGwqgiaEByyVVjhVOU1RbonacvORsk9gi1h1fXz/s320/blogger-image-1065254429.jpg" width="240" /> </div>
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<a href="http://www.teacherspayteachers.com/Product/Back-and-forth-book-1488348" target="_blank">Back and Forth book</a></div>
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<br />laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-24186829472454518712014-10-06T06:48:00.000-07:002014-10-15T06:48:17.253-07:00What to do when you can't say "Trick or Treat"<a href="http://slpmommyofapraxia.blogspot.com/2013/11/ashlynn-trick-or-treat.html" target="_blank">Ashlynn said her first "trick or treat" on command at the age of four. </a> At three...she had an approximation, but then she froze when we went trick or treating. <br />
<br />
Many people were polite and kind, not demanding she say something for her candy. Others though, sat indignantly at the door waiting for "the magic words." Because Ashlynn's strengths lie in social skills, she was always able to charmingly muster up the word "hi" instead, and most of them would give her the candy. <br />
<br />
However, many of my clients report anxiety around this time of year for them and for their child with apraxia. I've heard of some creative ways around this.<br />
<br />
One client I had said she took her daughter with older cousins who all went in a group and spoke for her, if you will.<br />
<br />
Another client had a sign that said "Trick or Treat"<br />
<br />
A mom I've met through the fb group, made these cute and wonderful cards that not only say "trick or treat" for the child, but also spread awareness!! I asked if I could share and she was happy to pass them along. <br />
<br />
So here they are!! Thanks Shelley for your generosity! <br />
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If you are finding these hard to print, feel free to email me at lauraslpmommy@gmail.com and I will be happy to send you along the PDF. <br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh2oIIpf1Sil5VGqeTCebAsWqCt44fSWF8qWRGnkyueJu0SagNlczl2H39TLAM7n6uurjr0k2vq-o37TL-bfZZfh0Vex_6FqB68tYjuFOsYGTP9JxSl9MdHzDL_BsHtEX-8i7pNv2PZrE_F/s1600/trick+or+treat+cards.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh2oIIpf1Sil5VGqeTCebAsWqCt44fSWF8qWRGnkyueJu0SagNlczl2H39TLAM7n6uurjr0k2vq-o37TL-bfZZfh0Vex_6FqB68tYjuFOsYGTP9JxSl9MdHzDL_BsHtEX-8i7pNv2PZrE_F/s1600/trick+or+treat+cards.jpg" height="320" width="247" /></a></div>
laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-27157420317757795652014-09-28T18:32:00.000-07:002014-10-06T12:06:41.018-07:00DTTC: Evidence Based Practice in Childhood Apraxia of Speech. An interview with Dr. Ruth Stoeckel<div class="MsoNormal">
Today I am honored to introduce Ruth Stoeckel, nationally
recognized expert and published researcher on Childhood Apraxia of Speech. I first saw Ruth Stoeckel speak back in 2005
when she presented in Colorado. The
packet she handed out during that talk helped me greatly in those early years
when I was first learning about how therapy for apraxia is very different than
therapy I had been doing for other speech sound disorders; and helped me treat
the kids I did see with apraxia after that time.<o:p></o:p></div>
<div class="MsoNormal">
Since then, I was honored to be selected as part of CASANA’s
intensive apraxia training institute in 2014, where Ruth was my mentor for four
days. I can say that during that time I
was able to get to know Ruth better and I can tell you that she is absolutely
passionate about CAS. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Hi Ruth! Thank you so much for
guest blogging today. To start, can you
please talk a little about your background, where you work, and how you found
yourself specializing in CAS. <o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">Thanks for opportunity, Laura.
I’ve met a lot of great SLPs and parents through CASANA and I’m glad you
are out there spreading the word to increase awareness. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">How did I find my way to special interest in apraxia? Lots of things seemed to push me in this
direction. I did undergraduate work at University of Iowa at a time when Penelope Meyers was there and talking with
students about apraxia several years before she and Donald Robin co- wrote the
book <i>Developmental Apraxia of Speech:
Theory and Clinical Practice</i>. When I
moved to Minnesota, my clinical supervisor in the local school system was none
other than Kathe Yoss, who together with Fred Darley had published an early
study (1974) of a cohort of children who had a unique set of characteristics
that they described as similar to adults with apraxia. Kathe was a wonderful mentor and encouraged
me to develop expertise in low incidence disorders like childhood apraxia. A number of years later, I left the school
system to work at Mayo Clinic. I have
had the opportunity to work with and
learn from two exceptional leaders in the field of motor speech disorders, Joe Duffy and Edythe Strand. Finally, I happened upon the Apraxia-Kids
listserv one night early in the
evolution of what would become CASANA and was drawn in by the passion of the
parents and SLPs who contributed there.
The combination of my work experiences and relationship with CASANA has allowed
me to have great opportunities to develop my expertise and learn from both
parents and colleagues!<o:p></o:p></span></div>
<div class="MsoNormal">
<b><br /></b></div>
<div class="MsoNormal">
<b>Almost weekly I get asked, “What is the BEST approach for CAS.” I know that you are a proponent of DTTC. Can you explain what this is, and do you feel
this is the BEST approach? Why or Why not?
<o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">There is so much we still need to learn about how to treat
CAS. I have to say that, based on what
we know right now, there is NO single “best” approach for treatment. The greatest amount of empirical evidence is
for Integral Stimulation/DTTC, but positive results are being seen in studies
using other techniques, including PROMPT, ReST, and ultrasound in
treatment. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">I do use Dynamic Temporal and Tactile Cuing (DTTC) to guide my
treatment. DTTC is a flexible framework
for dynamic decision-making in treatment – changing what you do moment to
moment based on the child’s responses.
It was developed by Edythe Strand based on the adult 8-step continuum
proposed for adults by Rosenbeck and colleagues. </span><span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">This framework emphasizes the shaping of movement gestures for
speech production using a systematic hierarchy of cues, with continued practice
of those gestures in the context of speech. The focus of treatment is not on
sounds – but on the movement gestures, or movement transitions for sound
combinations. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-right: .5in;">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">DTTC is primarily an integral
stimulation method that can incorporate whatever types of cues facilitate a
child’s production, including visual, tactile and gestural. Prosody is incorporated early on as
well. There is a temporal hierarchy
(i.e. simultaneous production, immediate repetition, repetition after delay) in
addition to the different types of cues.
The dynamic adjustments in temporal characteristics and level of cuing
allow opportunities for the child to take increasing responsibility for
assembling, retrieving and habituating motor plans. </span><span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">This approach is
individualized to the child by using a functional core vocabulary of words
meaningful to them. The principles of
motor learning are integrated into this framework as well. These principles are thought to be an
important element for any treatment of motor speech disorder.<o:p></o:p></span></div>
<div class="MsoNormal">
<b><br /></b></div>
<div class="MsoNormal">
<b>What <i>does</i>
the research say about DTTC? <o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">Based on recent review studies, DTTC has the largest base of empirical
research to suggest effectiveness for treatment of children with CAS. However, the studies have been done with a
small number of children, and further studies are needed to identify which
elements of the framework may be key ingredients, and which may be less
important. As I said above, there is
emerging evidence to support other
approaches as well.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Since you mentioned
principles of motor learning, can you provide a *brief* overview? What do SLP’s really need to be doing
differently from traditional articulation or phonological based therapy? <o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">Edwin Maas and colleagues wrote a great tutorial in 2008 that I
recommend to anyone interested in motor speech disorders. There have been a few small studies since
then that have looked at these principles on a more individual basis, but there
is still much to learn about how they apply to speech therapy. </span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><span style="font-size: large;">Key aspects of treatment that are different
for apraxia versus phonological disorder</span>
are that apraxia therapy focuses on <i>movement</i>
sequences rather than sound sequences and that it emphasizes working on movement
<i>sequences</i> (coarticulation) within and
between syllables. Repetition is another
key difference. Based on just a couple
of studies, there is evidence that we need a large number of repetitions per
sessions to help a child establish the needed level of skill for producing a
target. It may take some time to build
up to, but I try to get<span style="font-size: large;"> 100-200 repetitions of targets within a 20-30 minute
session. </span> How those repetitions are
organized is decided using the principles of motor learning. As they are laid
out in the Maas article, we consider these principles as a way to influence how
a child acquires a skill and then transfers or generalizes the skill. They include the following:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><span style="font-size: large;">*Massed versus Distributed practice,</span> which is many trials in a
short period of time compared to practice of a given number of trials or
sessions over a longer period of time.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><span style="font-size: large;">*Variable versus Constant practice,</span> which is working on the same
target in the same context as compared to practice on different targets in
different contexts<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><span style="font-size: large;">*Blocked versus Random practice</span>, which is working on different
targets in predictable blocks or treatment phases compared to mixing practice
on various targets in less predictable ways.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><span style="font-size: large;">*Simple versus Complex task, </span>which is a focus on “easier” sounds
and sequences (what the child can say, or what is presumed easier or earlier
developing) compared to more complex sounds and sound sequences.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><span style="font-size: large;">*Feedback on performance versus feedback on results,</span> which is
telling the child what behavior was produced accurately (e.g., you got your
lips closed before you started”) need to do differently as compared to telling
them “you got 3 out of 5 right.”</span> <o:p></o:p></div>
<div class="MsoNormal">
<b><br /></b></div>
<div class="MsoNormal">
<b>Many SLP’s want to
know how to pick therapy targets. Where
do you start when picking targets?<o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">I start by: 1) identifying
the child’s phonetic repertoire; 2) their phonotactic (syllable) repertoire; and
3) finding out from the child and their caregivers what words are important and
potentially motivating for that child.
In my motor speech exam, I probe the words that I might consider
including as therapy targets by exploring what sequences the child can produce
with different levels of help. I want to
try to expand their sound repertoire and their ability to sequence syllables,
looking for how I can do that using a core functional vocabulary</span>.<o:p></o:p></div>
<div class="MsoNormal">
<b><br /></b></div>
<div class="MsoNormal">
<b>What if the child has
a later developing sound in their repertoire?
Would you include this in a potential target word? <o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">This comes up a lot. Many
SLPs are trained in their graduate programs to think of a “sequence” of sound
development and to focus efforts on sounds thought to be earlier
developing. It seems that among the
folks who have been doing this a while (it’s not validated in a study as of
yet), <span style="font-size: large;">the kids with apraxia “didn’t read the book” on speech sound
development.</span> It’s possible they will have
an “sh” or /r/ in several words before they have a consistent /b/or /m/. That is why I think it is so important in
assessment to survey the child’s phonetic and phonemic repertoire and to build
the targets used in intervention on sounds that the child can produce either on
their own or with help, regardless of where it is on a chart. So, for example, the /s/ sound is very
important in English for intelligibility and as a linguistic marker. If a child is stimulable for it at all, I go
for it in vocabulary targets, even though it’s considered later-developing.<o:p></o:p></span></div>
<div class="MsoNormal">
<b><br /></b></div>
<div class="MsoNormal">
<b>Do you ever use oral
motor exercises in the treatment of CAS?
Why or why not?<o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">I want to be very clear in my response to this question. Because speech is accomplished by moving the
mouth, pretty much everything we do in speech therapy can be considered “oral
motor” work. The key distinction seems
to be doing “exercises” vs “speech work.”
I do use some physical materials
to assist with placement, like suckers or tongue depressors, and I do sometimes
have a child practice a speech movement a number of times without speaking as a
way to simplify the task at first. But I
always move the child as quickly as possible from that type of practice to
using the movement in the context of a spoken target. I don’t presume that practicing nonspeech
tasks (e.g., chewing, blowing, etc. ) will result in improved speech movements
and never ask a child to practice repetitions of isolated nonspeech movements
or exercises to “strengthen” or “increase awareness of movement.” Based
on what we know of speech physiology, muscle movements are task-specific rather
than muscle-specific. That is, the
activation pattern for a given muscle is different depending on the task that
it is doing. So we need to teach a movement
in the context in which it will be used.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>What advice would you
give for a beginning clinician who has minimal background on apraxia and
apraxia therapy? Do you have any
webinars available for viewing, or good articles they could use as a start
guide?<o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">I’d advise a clinician with minimal knowledge of background to do 2
things: </span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">1) to find a colleague who has
expertise and can provide mentoring; and 2) take advantage of the wealth of
information available at the Apraxia-Kids website. Next, they could attend workshops or webinars
sponsored by CASANA. I think it’s
usually more meaningful when seeking information to be pursuing it for a
particular student – as it was for you, when deciding you needed to learn about
apraxia because of Ashlynn. I think the information will be more relevant and perhaps
“stick” better when it is being sought for an immediate purpose. Then that learning can be transferred to how
one thinks about additional students who come along later with apraxia or
severe speech sound disorder.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Thank you SO much
Ruth for being here today! I am honored
and thrilled that you agreed to guest blog.
I continue to admire your work in the field, your dedication to the
children and their families affected by CAS, as well as your contribution to
the field with your research.<o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;"><br /></span></div>
<div class="MsoNormal">
<span style="color: #2e75b6; mso-style-textfill-fill-alpha: 100.0%; mso-style-textfill-fill-color: #2E75B6; mso-style-textfill-fill-colortransforms: lumm=75000; mso-style-textfill-fill-themecolor: accent1; mso-themecolor: accent1; mso-themeshade: 191;">Thanks so much for having me!<o:p></o:p></span></div>
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<i><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Arial;">Ruth Stoeckel, Ph.D.,
CCC-SLP is a speech-language pathologist at the Mayo Clinic in Rochester,
Minnesota. She has experience working as
a clinician and independent consultant in schools, private practice, private
rehabilitation agency and clinical settings.
She specializes in assessment and treatment of children with severe
speech sound disorders and developmental challenges. Dr. Stoeckel has participated in research
studies on apraxia treatment and on the relationship of speech sound disorders
to later learning disorders. She has presented workshops and advanced trainings
nationally and is known for presenting practical, evidence-based information
that participants can put to immediate use in their day-to-day practice. Dr.
Stoeckel is on the Professional Advisory Board of CASANA and has been a faculty
member of the Intensive Training Institute sponsored by CASANA.<o:p></o:p></span></i><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkABYBc-H_RrZoG2e9nHnMQ4D7IvK8cBG1YVtlAngi-gRz-1TOoo1bhTCj_fW01rm3B0U0i4FZkOqQbch-le_I6FveyVzaR8CoW8Kpw5LKQXt3CFHxkxM70e_Mcv3Z87rAnGAyPfc_n12a/s1600/DTTC.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkABYBc-H_RrZoG2e9nHnMQ4D7IvK8cBG1YVtlAngi-gRz-1TOoo1bhTCj_fW01rm3B0U0i4FZkOqQbch-le_I6FveyVzaR8CoW8Kpw5LKQXt3CFHxkxM70e_Mcv3Z87rAnGAyPfc_n12a/s1600/DTTC.jpg" height="320" width="209" /></a></div>
<i><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Arial;"><br /></span></i></div>laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-85431022605721166772014-09-27T19:45:00.001-07:002014-10-06T12:06:41.118-07:00Annual IEP - year 3It's been two years since Ashlynn was first identified as having CAS. She is now almost 5. At her first IEP meeting, I remember praying that she would talk. If she would just talk, everything would be okay. <br />
<br />
Last year, she was talking, but they explained she had a hard time fitting in with her peer group. She would tend to just repeat what others said, but she was at least "staying in the game" with this strategy. At that meeting, I remember they also said they were concerned with her attention. At one of the parent teacher conferences last year, they told me she couldn't identify the letters of her name. I worked on it every night. I bought letter puzzles, alphabet cards, and we practiced identifying the letters of her name and sequencing them. <br />
<br />
This year, she can identify ALL the letters of her name. She notices them on billboards and store signs. She has this down....it's just she has 20 more letters to learn before she goes to Kindergarten next year. Sweet Jesus, why do babies need to know so much so early now!! <br />
<br />
They remain concerned with her attention. It doesn't really look like ADHD, but maybe it's something we need to look at later. Oh, and then there is the cognitive test. They want one of those in the Spring too. I don't want a cognitive test. My immediate reaction is "no." However, Deb, her private SLP and my friend pointed out that I should find out the reason they want the test. If they want it to determine a label....no. If they want it to find out other information to help her programming, maybe.<br />
<br />
I'm just worried because with her difficulties with fine motor skills, speech and language, and visual motor.....I know the score is going to come out low, and quite frankly, I can't look at that right now. Maybe I'm in denial, but I just don't see how they can get an accurate score when she has so many difficulties that could influence it right now.<br />
<br />
Another issue I was flabbergasted to learn, was that Ashlylnn can't categorize. This is where children identify items based on similarities. They sort items. I clarified if they tested her receptively so she didn't have to name them. They did. The school SLP said she had three categories: clothing, toys, and food and she didn't categorize them correctly. They did say attention could have been a factor, but then I took her to private SLP and she confirmed it. Seriously?? I just did an activity this summer that she <a href="http://slpmommyofapraxia.blogspot.com/2014/07/speech-language-with-puzzles.html" target="_blank">rocked it.</a> Sigh. I don't know why she's not transferring it, but I can't believe I have another basic skill that we need to work on.<br />
<br />
Her goal to sequence pictures was not met. I knew this though. She simply doesn't look at the pictures and their details to realize what comes first, second, or third. I need to work on that.<br />
<br />
And this folks is why even after attending probably hundreds of IEP meetings in my career, I absolutely LOATHE them when it's my own kid. Despite all of the positives ( oh did I mention she's asking questions and socializing with peers), I have to hear all of the problems. All of the things I need to work on and my shoulders feel so heavy. Despite this though, I have to pull on my big girl panties and attack it. I have to put aside my fears and just step one foot in front of the other.<br />
<br />
I'm choosing to think about ALL the gains she's made in PT and OT recently. The PT said she could navigate ALL the playground equipment now like any other kid, and even shows beginning swinging skills of pumping her legs that other kids her age don't have yet. My husband beamed. This is his area. This is his hard work paying off.<br />
<br />
Her legs and core are getting stronger. In private OT she just pedaled her Big Wheel for 14 consecutive rotations!! She fatigues, but she's getting stronger.<br />
<br />
Her power wheel that was too much to motor plan pushing the throttle AND steering.....well she's doing both now on our <i>sidewalk.</i><br />
<br />
In private swim lessons she's now holding her breath for 5 seconds while she kicks her legs for two laps straight before she tires. When I watch it, I cry because this girl <a href="http://slpmommyofapraxia.blogspot.com/2014/07/i-saw-light-go-out-in-her-eyes.html" target="_blank">almost drowned </a>and she got right back up and attacks it. Every time. She attacks it.<br />
<br />
If she attacks it, what excuse do I have? My husband says every goal we've made she meets. She does, it's just so much work and it stresses me out. I'm terrified she'll have dyslexia on top of all of her learning difficulties. I hate to see her struggle. She's struggled all of her short life. When will she get a break?<br />
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<br />laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-39455364407245412592014-09-21T17:51:00.003-07:002014-10-06T12:06:41.038-07:00September Specialty Series: Using AAC (Alternative and Augmentative
Communication). A mother's story.<div class="MsoNormal">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwkjEY7uKQjcNC9G7wCd08RKeiGIPn1K8yzwi5PVAWNAgnH1s3Dx9BMkGwLx23Z9mZ5QRcvsudW3fsdEnYR3kMWA-OOZUbm9lP8Mfka1FtxuxCEyZBZ3IvAO7DC1RZjduz-y2xkKodijWE/s1600/AAC+cover.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwkjEY7uKQjcNC9G7wCd08RKeiGIPn1K8yzwi5PVAWNAgnH1s3Dx9BMkGwLx23Z9mZ5QRcvsudW3fsdEnYR3kMWA-OOZUbm9lP8Mfka1FtxuxCEyZBZ3IvAO7DC1RZjduz-y2xkKodijWE/s1600/AAC+cover.jpg" height="320" width="209"></a></div>
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<br>
To continue my September Specialty series, I want to introduce Merry. Merry is an amazing mom, and I wanted to feature a mother because in my opinion, parents are the experts on their child. I think it's important professionals keep this in mind, so I'll say it again.</div>
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<br></div>
<div class="MsoNormal">
<span style="font-size: large;">Parents are the experts on their child.</span></div>
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<br></div>
<div class="MsoNormal">
Her daughter is using an AAC (Assistive &
Augmentative Communication) device at the age of 2 ½!! I thought she was the PERFECT guest to talk
about AAC because many parents aren’t even told it’s an option, or they are
told their child is too young. I’m a big
believer that mothers know their child better than any professional and are
their biggest advocate. Merry is proof
of this! Thanks Merry for guest
blogging!</div>
<div class="MsoNormal">
<b><br></b></div>
<div class="MsoNormal">
<b><o:p></o:p></b></div>
<div class="MsoNormal">
<b>Tell us a little bit about yourself and your child with
apraxia.<o:p></o:p></b></div>
<div class="MsoNormal">
<br></div>
<div class="MsoNormal">
<span style="color: #0070c0;">I am a young stay-at-home mom
with no background or experience with speech or medicine. I’m actually a
funeral director by trade and education. However, I consider myself very
science-minded and I try to do things in an evidence-based manner whenever possible.
I think that’s been very helpful to me in my journey as a special needs parent.
<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">My daughter, Elanor, is my only
child. She is 2 ½ and absolutely loves music, dancing, animals, and most
children’s television programming. She is especially fond of Blue’s Clues. She
has a lot of trouble learning to speak due to childhood apraxia of speech. She
also has dyspraxia, which is basically a full-body apraxia. This makes a lot of
other things hard for her, including things like running, jumping, or putting
on shoes. She has had her communication device for about a year now. It is an
iPad mini with a communication app called Speak for Yourself and an amplified
case called an iAdapter. We call it her talker. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Image: <a href="http://imgur.com/RppfuAn">http://imgur.com/RppfuAn</a><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><br></span></div>
<div class="MsoNormal">
<b>When and how did you discover your daughter would benefit
from a device?<o:p></o:p></b></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><br></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">I remember being at a friend’s
daughter’s birthday party when Elanor was about a year old. There were several
parents all bunched into a corner talking about their children’s speech
problems. Most of their kids were older, and some were already in speech
therapy. My husband and I looked at each other kind of pridefully, because that
was one problem we knew for sure that Elanor didn’t have. At one year Elanor
may not have been walking (or anywhere near walking) but she had a good number
of words, probably about 10. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">At 15 months when Elanor <u>still</u>
wasn’t walking, we followed a random tip and pursued ear tubes for her. We had
heard that fluid in the ears could mess with a child’s balance, and that seemed
to be Elanor’s problem. We had about a month of many many doctor’s appointments
to look at her ears and talk about tubes. It was during this time that my
husband and I kind of looked around and realized she hadn’t said anything in a
while. Sometime between 12 and 15 months she lost all of her words and most of
her sounds and we had barely noticed. It was assumed at this point that the ear
tubes would fix everything. She had ear tube surgery at 16 months and walked
two days later, but she remained nearly silent. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">At that point we were already in
the process of getting early intervention from the county due to the walking
issue. At the first assessment they were no longer concerned about her walking
but shared our concern over her speech. We were told to come back in a month if
she still had no words. It was during this nearly silent month that I happened
to read something in a mommy forum about apraxia of speech. A lot of it really
seemed to fit. Elanor couldn’t stick out her tongue, she couldn’t pucker to
kiss. She had a lot of trouble eating. Her speech had progressed backwards
instead of forwards. The symptoms really seemed to match. Of course, I couldn’t
be sure about any of the main symptoms of apraxia (like inconsistent errors in
speech) because in order to see those symptoms she would have to be able to
speak, which she really couldn’t. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">During one of my many googling
sessions I came across a video on YouTube of a child with apraxia using a
communication device. He was using Proloquo2go (a communication app on the
iPad) to ask his mother for a snack. I remember how incredibly happy he was to
be able to tell his mom exactly what he wanted. I knew then that I wanted that
for Elanor. I made an appointment for a speech evaluation with a private
clinic. We discussed a communication device at the very first appointment and
things went from there. Elanor was 18 months old when she started using her
device. Here is a video of the first time she ever used it: <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Video:
<a href="https://www.youtube.com/watch?v=WnxEEy_9i4I">https://www.youtube.com/watch?v=WnxEEy_9i4I</a><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><b><br></b></span></div>
<div class="MsoNormal">
<b>What advice would you give to other parents who have been
told their child is not a candidate for AAC.</b><o:p></o:p></div>
<div class="MsoNormal">
<b><br></b></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Here is what I have to say to
them: your child deserves an opportunity to communicate their thoughts and
needs without having to wait to learn to speak and they CAN do it. This recent
blog post from a Speak for Yourself creator basically blows away the entire
concept of needing certain skills to be able to use a device:
<a href="http://www.speakforyourself.org/2014/07/22/myth-augmentative-alternative-communication-aac-pre-requisite-skills/">http://www.speakforyourself.org/2014/07/22/myth-augmentative-alternative-communication-aac-pre-requisite-skills/<o:p></o:p></a></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">I know that Elanor continues to
be one of the youngest AAC users that many speech pathologists have ever seen.
This isn’t because toddlers can’t do it, it’s because they haven’t been given
an opportunity to do it because people think they aren’t ready. They are. Your
child is too. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><b><br></b></span></div>
<div class="MsoNormal">
<b>A big myth regarding AAC is that the child will “give up”
trying to talk if they are given a device.
However, research refutes this.
As a mother though, how do you respond to this?<o:p></o:p></b></div>
<div class="MsoNormal">
<b><br></b></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Using a communication device is
hard. It’s slow. It is so much easier for me to say things out loud than to say
them on the Elanor’s device. For Elanor that’s not true because speaking is so
difficult for her, but the moment she can speak a word intelligibly she will
always choose to speak it because it is faster and easier. Not only that, but
not everyone has a device. Everyone around her is speaking aloud all the time.
She would obviously prefer to be doing that. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">I also think this worry about
your kid “giving up” on speech is really misguided because the device helps
with speech so much. There are a lot of theories I’ve heard about why this is
the case. What I know for sure is that it works. The more we push Elanor to use
the device the more her speech blossoms. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Here she is a couple of weeks
ago telling her Daddy “I don’t know”, her first real sentence. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Video:
<a href="https://www.youtube.com/watch?v=30Ygjgp-4Mk">https://www.youtube.com/watch?v=30Ygjgp-4Mk<o:p></o:p></a></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><br></span></div>
<div class="MsoNormal">
<b>Who programs the device and who teaches your child how to
use it?</b><o:p></o:p></div>
<div class="MsoNormal">
<b><br></b></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Me and me. I know this is
different for some people who get their device through their child’s school,
but since we bought it ourselves we are in charge of it. Programming Speak for
Yourself is actually really easy. That’s one of the reasons I chose it over
some other communication apps. There’s also a Speak for Yourself User’s Group
on Facebook that is incredibly helpful with any questions about programming or
anything else. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">I am able to quickly add words
and pictures to Elanor’s device to make it more personal. She has all her
family members and friends names and pictures in there, every cartoon
character, every cartoon. Her device is really very specialized for her. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Here she is asking to watch
Blue’s Clues: <br>
Video: <a href="https://www.youtube.com/watch?v=rZAPrJu89VU">https://www.youtube.com/watch?v=rZAPrJu89VU</a><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">As far as teaching her how to
use it, I mostly do that through modeling. This means that I speak through the
device just like she does. If you think about it, children learn to speak by
hearing us do it. It doesn’t make sense for them to learn to use a
communication device without seeing someone do that too. I get guidance on how
to do this from Elanor’s speech therapists and also from the creators of Speak
for Yourself, who are incredibly involved and helpful. Sometimes it seems
tedious, especially if it doesn’t seem like Elanor is paying attention. I
learned pretty quickly that she is always paying attention, even if it doesn’t
seem like it. It is incredibly rewarding to see her use a word or sentence I
showed her days before when she seemed entirely uninterested. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><br></span></div>
<div class="MsoNormal">
<b>Many parents of children with apraxia report increased
frustration and tantrums due in part to their inability to speak or communicate
in some way. Did you have a similar
experience and find that the device reduced your child’s frustration?<o:p></o:p></b></div>
<div class="MsoNormal">
<b><br></b></div>
<div class="MsoNormal">
<span style="color: #0070c0;">I didn’t have that problem
before we got the device because she was so young when we got it. She has had
some means of communication, whether it be ASL or her device, for a long time.
However, now that she has become more verbal I have noticed some frustration
when I don’t understand what she is trying to tell me verbally. I usually have
to redirect her to the device, where she can usually tell me what she was
trying to say. That’s why it’s so important for me to keep modeling and using
the device with her even though she is able to talk more now. It is an amazing
source of relief for both of us!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">This video shows her right after
I spent about 5 minutes trying to figure out what she was asking for:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Video:
<a href="https://www.youtube.com/watch?v=VL1hiF3aKu4">https://www.youtube.com/watch?v=VL1hiF3aKu4<o:p></o:p></a></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><br></span></div>
<div class="MsoNormal">
<b>How did you pay for the device? Are there funding sources?</b><o:p></o:p></div>
<div class="MsoNormal">
<b><br></b></div>
<div class="MsoNormal">
<span style="color: #0070c0;">The first device we had was an
iPad 2. My parents bought the iPad (around $500) and my husband’s parents
bought the Speak for Yourself communication app ($200). We later replaced the
iPad 2 with an iPad Mini, which we paid for ($300), and we used GoFundMe to
crowdsource funds for the amplified iAdapter Case ($400). <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Compared to dedicated devices
like a Dynavox, it’s pretty inexpensive to purchase an iPad mini and
communication app. We’re talking the difference between $500 and $5000-$10,000.
That being said, $500 is still a lot to come up with out of nowhere. For funding
sources I suggest family members, churches, and local charities. I know most
churches would love to fund something like this for a child in their
congregation. CASANA also gives away
iPads once a year to kids with apraxia, so that’s something to look into as
well. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #0070c0;"><b><br></b></span></div>
<div class="MsoNormal">
<b><a href="https://www.blogger.com/null" name="h.i1nzo33jvchj"></a>Do you have any additional
comments/recommendations/or final thoughts that you want to tell parents who
are experiencing the pain of having a child who struggles to speak?<o:p></o:p></b></div>
<div class="MsoNormal">
<b><br></b></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="h.fy5rka129rt3"></a><span style="color: #0070c0;">I
just want to say that having this device has helped my daughter immensely in
ways I never knew it could. I am a part of many groups of parents with children
using AAC, and all of these children are doing better than they would be
without a device. Their speech isn’t hindered, it’s helped, and their parents
have been given a chance to really know them. <o:p></o:p></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="h.da0azxautdaf"></a><span style="color: #0070c0;">Almost
every day on online apraxia groups I see parents complaining that their child
can’t tell them things. They don’t know their child’s favorite things. They
don’t know what their child did at school that day, etc. I sympathize with
these parents, but I can’t empathize with them because I honestly don’t know
what that’s like. Elanor can tell me all those things and more with her
communication device. <o:p></o:p></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="h.gjdgxs"></a><span style="color: #0070c0;">I guess in
the end what I want to tell all the apraxia parents out there is that you can
know your child, and they can have a voice <i>now.</i>
There’s no need to wait until they can speak. This technology is available and
it is amazing. It can change both of your lives forever. <o:p></o:p></span></div>
<div class="MsoNormal">
<br></div>
<div class="MsoNormal">
<span style="color: windowtext;">Incredible Merry! Elanor is
so lucky to have a mama like you! <o:p></o:p></span></div>
<br>
<div class="MsoNormal">
<span style="color: windowtext;">To read more about Merry and
Elanor visit her blog: <o:p></o:p></span><a href="http://aacabc.blogspot.com/">http://aacabc.blogspot.com/</a></div>
laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-61163264811361516332014-09-19T20:26:00.000-07:002014-10-06T12:06:41.076-07:00Turning Pain into a Purpose<span style="font-size: x-large;">Two years ago,</span><br />
I found out my almost three year old first born had Childhood Apraxia of Speech (CAS). Despite being an SLP and treating CAS at the elementary level, I failed to recognize it in my baby. <br />
It was a VERY difficult time filled with overwhelming sadness for my daughter and guilt as her mother...an SLP who didn't realize she had CAS. <br />
<span style="font-size: x-large;"><br /></span>
<span style="font-size: x-large;">It rocked my world. </span><br />
Not only did the dx devastate me, but her silence and struggle to speak was truly heartbreaking. You CANNOT appreciate how complex speech is until you watch a child struggle to speak.<br />
I was sad and I was angry. I had a master's degree in Speech/Language Pathology, but my education about CAS consisted of 20 short pages. Every time I think about this, write this, or say this, I can't help but shake my head. This isn't right. <br />
<br />
<span style="font-size: x-large;">I decided soon after I would become an expert in CAS</span> and I would help not only my daughter, but other children who were the same. I had NO idea how I was going to do this. I researched like crazy. I found out a national Apraxia conference was coming to Denver the next year. I took it as a sign. I signed up for webinars. I created a binder full of CAS treatment and research. I watched a three hour Kaufman video at my private practice. I talked to my cousin who is also an SLP, and she said she had two videos from David Hammer and Ruth Stoeckel I could borrow. I devoured them. I expressed my desire to specialize in CAS to my clinical director. She didn't blink. I had her full support 100%.<br />
<br />
After attending the Apraxia National Convention, I found out about an apraxia bootcamp. I wanted in. I talked to the founder of CASANA, and she explained it was highly competitive. The wind kinda went out of my sails. She still encouraged me to apply, but I didn't feel confident. The clinical director at my private practice started filtering the kids with apraxia to me. Her faith in me was affirming, and I was more determined than ever.<br />
<br />
<span style="font-size: x-large;">Then, I found out I got in.</span> I was a mix of emotions. This is what I wanted, but it also meant leaving my family for FOUR days. Being without my babies, my heart, would be hard.....but I absolutely believed in this cause. I was going to go, but.... I had never flown alone. I had never been to the East Coast. I had never left my babies for this long. I read a quote, "if it's both terrifying and amazing, then you should definitely pursue it." Check and check. Its "go time" as my daughter would say.<br />
<br />
Then today, a little over two years after my affirmation, I received this.<br />
<span class="userContent" data-ft="{"tn":"K"}" style="background-color: color: #37404e; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;"><br /></span>
<span class="userContent" data-ft="{"tn":"K"}" style="background-color: color: #37404e; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;">CONGRATULATIONS go to Laura Smith for successfully completing her case study and now being:<br /><br /><b>CASANA Recognized for Advanced Training and Expertise in Childhood Apraxia of Speech.</b>"</span><span class="userContentSecondary fcg" style="background-color: color: #9197a3; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 20px;"> </span><br />
<br />
<br />
I AM an apraxia expert, recognized by CASANA for advanced expertise. I am elated. The road here was difficult, but amazing. I once read that the definition of happiness is "the feeling we feel when striving toward our potential."<br />
<br />
When <i>striving toward our potential. </i> NOT when we achieve it. So here I am. What is my next goal? What is my NEXT potential? What am I striving toward? I have some ideas. Some small and some REALLY big. <br />
<br />
<span style="font-size: x-large;">One thing I've learned from Ashlynn though</span>...a positive attitude, perseverance, and a willingness to fail and try again = <b><span style="font-size: large;">success. </span></b><br />
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<br />laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com3tag:blogger.com,1999:blog-1519489902737716386.post-87417042556714195802014-09-17T12:39:00.000-07:002014-10-06T12:06:41.123-07:00September Speciality Series with Mama OT: Sensory Processing DisorderPart II<div style="background: margin-bottom: .0001pt; margin: 0in;">
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<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i><br /></i></span></span></b>
<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i><br /></i></span></span></b>
<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i>Today I welcome back Christie from <a href="http://mamaot.com/" target="_blank">MamaOT</a> for Part II in our Q & A about sensory processing disorder! If you missed Part I, you can read about it <a href="http://slpmommyofapraxia.blogspot.com/2014/09/september-specialty-series-with-mama-ot.html" target="_blank">here. </a> </i></span></span></b></div>
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<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i><br /></i></span></span></b></div>
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<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i>Hi Christie! So now that we know WHAT it is, let's talk about what we can DO about it. My first question is what should parents do if they
suspect their child has any warning signs?
</i><o:p></o:p></span></span></b></div>
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<br /></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>If you are a parent and you suspect
your child may be demonstrating sensory processing difficulties, mention it to
your child’s primary care provider (usually the pediatrician) and be an
advocate for your child.</b> It is not uncommon for pediatricians
to brush off parental concerns regarding sensory processing difficulties. I
have heard many examples from parents where the pediatrician either disregarded
the concern altogether (saying something to the effect of, “He’ll grow out it,
he’s just active because he’s a boy”, or, “She’ll grow out of it, all toddlers
and preschoolers are picky eaters.”), or completely overlooked the sensory
issues and labeled them as something else entirely (such as Oppositional
Defiance Disorder or ADHD). So, as both a parent and a professional, I strongly
feel that parents need to be advocates for their kids. I’m not saying you need
to be hostile toward your child’s doctor. But you know your child best. You
know how they have been since the day they were born (and before), and you know
how significantly their daily life is impacted by their difficulties. <o:p></o:p></span></div>
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<br /></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>If you do talk to the pediatrician
about your concerns, emphasize how these sensory processing difficulties are
impacting your child’s ability to perform activities of daily living</b>
such as bathing, grooming, dressing, eating, self-feeding, sleeping, or
playing. You can also emphasize any safety concerns you have, such as your
4-year-old unsafely seeking movement by climbing onto countertops or fences and
then jumping off, or becoming so overstimulated in noisy environments that she
begins crashing her body into walls or banging her head. Once you have shared
your concerns with the pediatrician, he or she can then put in a referral for
an occupational therapy evaluation and, depending on the results, OT treatment
sessions can then begin in order to address the areas of concern and goals that
are written as part of the evaluation process.
<o:p></o:p></span></div>
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<br /></div>
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<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i>Sensory bins and activities seem to
bombard social media, but from a professional perspective, why are they
important? <o:p></o:p></i></span></span></b></div>
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<br /></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">Sensory
bins and “messy play” activities allow children to learn and explore through
the sense of touch. For children with typically functioning tactile systems,
this is good because it provides sensory information to the tactile system that
actually helps develop a more refined sense of touch (discrimination) and,
subsequently, supports the development of fine motor skills such as using eating
utensils, writing implements, scissors, and handheld sports equipment such as a
basketball, baseball bat, or tennis racquet. For kiddos who demonstrate any of
the three previously mentioned patterns of disordered sensory processing,
sensory bins and activities are even MORE important and helpful. For those with
over-responsive tactile sensory systems, sensory bins and messy play activities
give kids the chance to explore tactile materials in a gradual,
non-threatening, fun way. This can help them become more comfortable engaging
with textures and substances their body perceives as threatening and can even
help decrease picky eating. For kids with under-responsive tactile systems,
sensory bins and activities provide the additional sensory input needed to sort
of “wake up” their tactile system and give it the extra input it has been
missing, which is so important for the development of those fine motor skills.
And kids who seek/crave tactile input? They have more fun than anyone! For
these kiddos – the touchers, the fidgeters, the grabbers – sensory bins and
messy play activities are like a breath of fresh air to their tactile system!
It gives them a chance to stimulate that sensory system in a fun, creative,
safe, and age-appropriate way. Learn tons of fun ideas for sensory bins, plus
find out lots of different ways to play with sensory bins <a href="http://www.yourkidstable.com/2012/06/ultimate-list-of-sensory-bin-ideas.html">HERE</a>.<o:p></o:p></span></div>
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<br /></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i>What are some easy ways to
incorporate sensory activities in the home? <o:p></o:p></i></span></span></b></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="color: blue; font-family: Georgia, Times New Roman, serif;">First
of all, don’t go crazy trying to do every creative and crazy sensory activity
you find on the internet! There are many ways to incorporate and embed sensory
activities into your child’s daily routine. Here are a few ideas:<o:p></o:p></span></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<br /></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->If
you have a baby or toddler, let them get messy when they eat. Read more about
why this is good <a href="http://mamaot.com/2014/02/02/let-baby-play-peas-eat/">HERE</a>.<o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->Allow
kids to eat with their hands (when appropriate) so they can be exposed to a
variety of textures during meal time. <o:p></o:p></span></div>
<div style="background: margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->Give
your kids the chance to help with meal preparation and “play” with their food
at the end of their meal. Your Kids Table has a great post <a href="http://www.playingwithwords365.com/2012/08/getting-your-picky-eater-to-explore-new-foods/">HERE</a> about
why and how to do this.<o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->Use
a water table to promote outdoor sensory play and exploration. Learn more about
how to use a water table for sensory play <a href="http://mamaot.com/2013/09/24/10-ways-to-play-with-a-water-sensory-table/">HERE</a>. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->Many
household chores provide natural opportunities for movement and “heavy work”,
which is great for all kids but especially those who seek out proprioceptive
input (to the joints and muscles). Some examples include taking out the trash,
sweeping, mopping, vacuuming, raking leaves, loading or emptying the
dishwasher, loading the washing machine with wet clothes, washing mirrors or
windows, or mowing the lawn. So if it’s chores time, give your sensory seeker
the choice of “heavy work” chores that are appropriate for their age and level
of responsibility.<o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->Let
your child push the shopping cart at the grocery store. <o:p></o:p></span></div>
<div style="background: margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->Start
a habit of taking your child (or the whole family) on a walk after dinner. It
can be a walk to the park, around the block, or down a favorite path. Your
kiddo can push their sibling’s stroller, pull a wagon, or even ride their trike
or bike. <o:p></o:p></span></div>
<div style="background: margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]-->Challenge
your child to “animal walk” to different parts of the house during their
routine activities, such as getting dressed in the morning or getting ready for
bed at night. Some good animal walks include walking like a bear (hands and
feet on floor, booty in the air), walking like a crab (hands and feet on floor,
belly up to the ceiling, booty up off the floor), and crawling like a snake or
lizard (belly crawling with arms and legs pulling the body along). <o:p></o:p></span></div>
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<br /></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="color: blue; font-family: Georgia, Times New Roman, serif;">Surviving
and navigating Sensory Processing Disorder is no small task. It can be
frustrating, confusing, and downright maddening. But remember that there is a
community of occupational therapists who are trained to help, intervene, listen,
and celebrate successes with you and your child as they work to develop the
skills needed to more fully participate in and enjoy life!<o:p></o:p></span></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i>Thanks so much Christie! Tell us a little about your blog,
MamaOT.com. </i><o:p></o:p></span></span></b></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="color: blue; font-family: Georgia, Times New Roman, serif;">MamaOT.com
is a place where I share tips and tricks for those who care for children,
particularly babies, toddlers, and school-age kids. I started Mama OT in 2012
and love that I am able to use my experience as both a mom and an OT to help
other parents, caregivers, therapists, and teachers as they support the
development of the children in their lives. <o:p></o:p></span></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: blue;">There
are many ways you can follow and connect with me!</span><span style="color: #333333;"><o:p></o:p></span></span></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: #333333;">Blog:
</span><a href="http://mamaot.com/">http://MamaOT.com</a><span style="color: #333333;"><o:p></o:p></span></span></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: #333333;">Facebook:
</span><a href="http://facebook.com/MamaOTblog">http://Facebook.com/MamaOTblog</a><span style="color: #333333;"><o:p></o:p></span></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: #333333;">Pinterest:
</span><a href="http://pinterest.com/ckiley">http://Pinterest.com/ckiley</a></span></div>
<div style="background: margin-bottom: .0001pt; margin: 0in;">
<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: #333333;">Twitter:
</span><a href="https://twitter.com/mamaotblog">https://Twitter.com/mamaotblog</a></span><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"> </span><span style="font-family: Helvetica, sans-serif; font-size: 11pt;"><o:p></o:p></span></span><br />
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-41640289570587684182014-09-15T13:21:00.000-07:002014-10-06T12:06:41.043-07:00September Specialty Series with Mama OT: All about Sensory Processing
Disorder Part I<span style="font-family: Georgia, Times New Roman, serif;"><i><b>Today I'm thrilled to introduce Christie from <a href="http://mamaot.com/" target="_blank">MamaOT</a>! Hi Christie! I'm a faithful follower of your blog and find your activities so easy, fun and practical to do at home! For my readers who don't know you though, tell us a little bit about yourself, your background as an OT, and your family.</b></i></span><br>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">I’m
a pediatric occupational therapist who works with children and their families
to help <span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial;">improve their ability to participate in daily living
activities (known as “occupations”) such as eating, sleeping, self-care,
playing, socializing, and learning. This is done by addressing underlying
difficulties such as fine motor, hand-eye coordination, problem solving,
attention, and sensory processing skills (to name a few), while also taking
into account the effect of a task’s difficulty on the child’s performance, as
well as the impact the physical and social environment has on their ability to
participate.</span> OT's get to do such amazing work! I have worked as a pediatric
OT in a variety of settings, including in-home early intervention, clinic-based
therapy, and school-based therapy. I have loved working with kids ever since I
myself was a kid and, once I discovered the field of occupational therapy after
I graduated college, I realized I was born to be an OT. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">I
am a wife and a mom to two sweet boys, currently ages 3 and 1. The thing I love
about being both a mama and an OT is that nearly everything I learn in one role
teaches me how to do a better job in the other. The things I learn from being
an OT make me a better parent. And the things I learn from being a parent make
me a better pediatric therapist. It’s awesome!<o:p></o:p></span></div>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><i><b>So today I wanted to talk about Sensory Processing Processing Disorder. SPD gets a lot of buzz lately, but was is it really?</b></i></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">In
order to talk about Sensory Processing Disorder, we need to first understand
what typical sensory processing is. <o:p></o:p></span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: blue;">“Sensory
processing” refers to the nervous system’s ability to take in sensory input
from all the different sensory systems, organize it in the brain for functional
use, and then send out signals to activate the appropriate motor, behavior, or
emotional responses (known as an “adaptive response”). In individuals with
intact sensory processing, this happens automatically, unconsciously, and
nearly instantaneously.</span><span style="color: #333333;"><o:p></o:p></span></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>When occupational therapists talk about
sensory processing (also referred to as “sensory integration”), we are
typically referencing seven sensory systems.</b> </span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">Most people have
heard of the classic five senses but never knew there are two additional
“hidden” sensory systems that play a powerful role in our body’s ability to
function on a day-to-day basis. Without going into too much detail (I don’t
want to bore you!), the seven sensory systems OT's typically refer to are:<o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]--><b>Vestibular</b>:
Sense of balance and motion, located in the middle ear, tells us where we are
in space. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b> Proprioception</b>:
Sense of body awareness, located in sensory receptors in our muscles and joints,
activated any time we push or pull on objects, as well as any time the joints
are compressed together or stretched apart (such as jumping up and down or
hanging on monkey bars). Proprioceptive input tends to have a calming and
organizing effect on the body. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <b>Tactile</b>:
Sense of touch, located in sensory receptors in our skin and mouth. Tells us <i>when</i> we’ve touched something (sensation)
and <i>what it is</i> we’ve touched
(discrimination, such as texture, size, temperature). <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]--><b>Visual</b>:
Sense of vision, but it’s more than just about being able to see clearly. Our
visual system also helps us see what we need to see and filter out what we
don’t need to focus on. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]--><b>Auditory</b>:
Sense of hearing but, again, it’s more than just able to hear accurately. When
we process auditory information, our brain has to be able to determine what
sounds are important and what sounds can be “tuned out”. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"> <!--[endif]--><b>Olfactory</b>:
Sense of smell, influences sense of taste, and is the only sense that is
directly tied to the part of the brain responsible for emotional memories
(think of the emotions you feel when you smell a familiar smell, whether a
positive one like grandma’s cookies baking in the oven, or a negative one like
the smell of cologne/perfume that a previous boyfriend/girlfriend used to
wear). <o:p></o:p></span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: blue;"> <!--[endif]--><b>Gustatory</b></span><span style="color: blue;">:
Sense of taste, responsible for detecting all the different flavors that come
in the mouth. </span><span style="color: #333333;"><o:p></o:p></span></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>Sensory Processing Disorder occurs when
the nervous system struggles to adequately process the incoming sensory
information and organize it (or “integrate” it) in order to produce the
expected motor, behavioral, or emotional responses.</b> </span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">While
all of us struggle with processing certain types of sensory input to some
degree on occasion, <i>disordered</i>
sensory processing occurs in approximately 1 out of every 20 individuals, and
it significantly impacts individuals’ ability to participate and succeed in the
important tasks, activities, and roles of daily life (aka – “occupations”). I
want to be clear that SPD is more than just being sensitive to certain types of
textures, scents, movements, or sounds. As occupational therapist Dr. Lucy Jane
Miller describes in her book “<a href="http://www.amazon.com/Sensational-Kids-Revised-Children-Processing-ebook/dp/B00DMCW1V4/ref=sr_1_1?ie=UTF8&qid=1410548220&sr=8-1&keywords=sensational+kids">Sensational Kids</a>”,
the difficulties resulting from Sensory Processing Disorder are <i>chronic</i> and they <i>disrupt</i> everyday life. It doesn’t matter how hard you try to
positively reinforce good behavior, or how firmly you set your behavioral
expectations for wearing certain clothing textures, eating certain foods, not
wiggling or fidgeting while seated, or keeping hands to self. It just doesn’t
work, because those kiddos’ brains are just wired differently than those
without SPD. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>Thinking of the brain as a “traffic
cop” for sensory input can be helpful when trying to understand SPD.</b> In
those with intact sensory processing, the brain acts as a traffic cop and is
able to take the incoming sensory information from all the senses, process it,
and then send it to the appropriate location in an orderly and accurate
fashion; this allows people to respond to all of the information in an
accurate, efficient, and functional manner. In individuals with SPD, however,
the sensory information is not processed and sent off to the appropriate
location in that expected orderly fashion, causing what you could say is a
“neurological traffic jam” (a term pioneered by OT, educational psychologist,
and neuroscientist Dr. A. Jean Ayres). This means certain parts of the brain do
not receive the correct information needed in order to interpret and respond to
the sensory input, making it difficult to process and act upon the information
received from the senses in an accurate, efficient, and functional manner. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>Sensory Processing Disorder can (and
often does) occur in relation to more than one sensory system.</b> So
a child (or grown-up) with SPD may be <i>over-responsive</i>
in one or more senses while simultaneously being <i>under-responsive</i> or <i>sensory
seeking</i> in other senses. Additionally, a person’s ability to process and
respond to particular types of sensory input can vary from day to day, hour to
hour, even minute to minute. This can be extremely frustrating for parents,
teachers, therapists, medical professionals, and even the children themselves.
One day (or one minute) they may be fine with the hum of the air conditioning
or the fluorescent lights in the room, and then the next…it is unbearable to
them. One day they may be okay eating a food of a certain texture or wearing a
particular pair of socks, and then the next…the sight or thought of them makes
them scream and cry. The body is constantly working to filter out what is unnecessary</span><span style="color: blue; font-family: Georgia, 'Times New Roman', serif;"> and focus on what is important, and then trying to respond to all of
that input in a functional way. For a person with disordered sensory
processing, the brain and body need extra help to be able to balance all of
this incoming sensory input and appropriately respond to it (often referred to
as “modulation”).</span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><span style="color: blue;">As
you can probably tell, Sensory Processing Disorder is very complex, and very tricky! </span><span style="color: #333333;"><o:p></o:p></span></span></div>
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<span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><br></span></span></div>
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<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i>So do we know what causes Sensory Processing
Disorder? </i><o:p></o:p></span></span></b></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">At
this point in time, the exact cause of Sensory Processing Disorder is unknown.
But we do know from research that SPD is neurologically based; the brains of
individuals with SPD are actually different than those of individuals who do
not have SPD. In Chapter 13 of “Sensational Kids”, Dr. Lucy Jane Miller notes
that current research suggests three “leading contenders” that contribute to
Sensory Processing Disorder – heredity, prenatal and birth complications (such
as prematurity or labor and delivery difficulties), and environmental factors
(such as sensory deprivation, trauma, or abuse). However, like many conditions,
more research is needed to in order to truly be able to identify the causes of
SPD. <o:p></o:p></span></div>
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<b><span style="color: #333333;"><i><span style="font-family: Georgia, Times New Roman, serif;">Who diagnoses Sensory Processing
Disorder? <o:p></o:p></span></i></span></b></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">At
this point in time, Sensory Processing Disorder is not an “official” medical
diagnosis. That is, it is not listed as its own category in the most current
version of the handbook used for diagnosing neurologically-based disorders such
as Autism, ADHD, OCD, and Depression. However, as any parent of a child with
SPD will tell you, this does not mean Sensory Processing Disorder is not real.
It just means there is still millions of dollars of research that needs to be
done in order to demonstrate that SPD is a condition that is separate from the
other neurological disorders. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">As
pediatric occupational therapists, we do not treat the diagnosis; we treat the
whole child. So, to be honest, it doesn’t really matter what “diagnosis” a
child has when they are referred to OT. We look at what the child’s strengths
are, what occupations they are struggling with, what skills or abilities are
needed to be able to perform those occupations, and then we set goals and
create a treatment plan to help them be able to more fully engage, participate
in, and enjoy life. This can include addressing sensory processing difficulties
and their impact on daily life.<o:p></o:p></span></div>
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<span style="color: #333333;"><b><i><span style="font-family: Georgia, Times New Roman, serif;">Can SPD occur in isolation or only with
other disorders? What other disorders does it occur with? <o:p></o:p></span></i></b></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">Research
has already shown that the brains of children with SPD are different (and
respond differently to sensory input) than those diagnosed with disorders such
as Autism and ADHD. Yes, Sensory Processing Disorder can and does absolutely
occur on its own, but it also can and does occur alongside many other diagnoses
such as Autism (over half of individuals with Autism also have SPD), ADHD
(approximately half of those with ADHD also have SPD),CAS (Childhood Apraxia of Speech), OCD, Depression, PTSD,
Prematurity, Developmental Delays, Learning Disorders, and more.<o:p></o:p></span></div>
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<b><span style="color: #333333;"><span style="font-family: Georgia, Times New Roman, serif;"><i>How early can SPD be diagnosed, and
what are some early warning signs? </i><o:p></o:p></span></span></b></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">Sensory
processing difficulties can be identified from birth, though it is not usually
until later in the child’s first year or beyond that parents or medical
professionals suspect that a child’s behavioral or developmental difficulties
might be related to sensory processing. <o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;">As
I mentioned previously, kids may either over-respond, under-respond, or
seek/crave certain types of sensory input. Dr. Lucy Jane Miller’s book, “<a href="http://www.amazon.com/Sensational-Kids-Revised-Children-Processing-ebook/dp/B00DMCW1V4/ref=sr_1_1?ie=UTF8&qid=1410548220&sr=8-1&keywords=sensational+kids">Sensational Kids</a>”,
has some great checklists in Chapter 2 to help parents identify whether their
child might be exhibiting signs of SPD. Below are some examples from those checklists,
all of which are commonly known to OTs who are trained to work with children
with SPD.<o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>Some red flags related to
over-responsive sensory systems</b> can include avoiding or
being extremely bothered by or avoidant of certain textures, fabrics, messy
substances on hands or face, grooming tasks (tooth or hair brushing, nail
clipping), smells, sounds, lights, or movements (particularly not wanting to be
laid down for diaper changes as a baby or not wanting to be out of an upright
position as a child). Children with over-responsive sensory systems may appear
to be irritable (babies often express an over-responsive tactile system by
arching), aggressive, impulsive, overly cautious, or overly rigid in their
desire for structure and predictability.<o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>Some red flags related to
under-responsive sensory systems</b> can include appearing to
not “register” the sensation or pain caused by minor injuries (such as
splinters or sprains), seeming to not sense typical body sensations such as
hunger/temperature/full bladder or bowel, preferring sedentary activities over
physical play, seeming oblivious to what’s going on in the environment, and
generally demonstrating a lack of body and spatial awareness. Children with
under-responsive sensory systems may appear passive, lethargic, slow,
unmotivated, uncoordinated, or disinterested in social interactions.<o:p></o:p></span></div>
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<span style="color: blue; font-family: Georgia, Times New Roman, serif;"><b>Some red flags related to sensory seeking/craving</b>
can include excessive movement, fidgeting, wiggling,
spinning/jumping/rolling/climbing, touching everything, non-stop talking,
seeking out vibration (such as washing machine, dishwasher, vibrating
toothbrush or toys), licking/mouthing/chewing non-food objects, consistently
smelling objects, seeking out certain noises, seeking out visual input, and
preferring strong foods and textures (lemons, hot sauce, pickles, ice cubes,
crunchy foods, etc.). This can cause children to behave as if they are
impulsive, angry, difficult to calm down, disobedient, or difficult to control.<o:p></o:p></span></div>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><i><b>Wow Christie! Thank you so much! </b></i></span></div>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><i><b>Stay tuned for Part II when Christie discusses treatments, what parents can do, and why sensory play isn't just a Pinterest trend! </b></i></span></div>
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-83725684735303087562014-09-13T20:26:00.000-07:002014-10-06T12:06:41.114-07:00My apraxia star sparkled at her first Walk for Children's Apraxia of Speech<span style="font-size: x-large;">Apraxia Stars</span><br />
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That is what we as the CAS community have come to refer to our children with apraxia. I was able to attend my first Walk for Apraxia in Denver today as a mother first supporting my daughter, but also as an SLP walking for my clients, two of which came today. <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjdUVRYdQZxPEwiCMZZPo89xWkNWNZSJB5jyk_p6Z2jKyrFH14Qe34Mq5fGHqUyIs0ykxG3yYC_NOowf7ZGCnXwAV4g2CDxb_r9BXU-vj-h9OYSYaN4nn1YnI9rJRyuYQ6QUWrHehmRaGQ/s1600/sign+ashlynn.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjdUVRYdQZxPEwiCMZZPo89xWkNWNZSJB5jyk_p6Z2jKyrFH14Qe34Mq5fGHqUyIs0ykxG3yYC_NOowf7ZGCnXwAV4g2CDxb_r9BXU-vj-h9OYSYaN4nn1YnI9rJRyuYQ6QUWrHehmRaGQ/s1600/sign+ashlynn.jpg" height="320" width="240" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmOKGpTCNxDb3tDTt8TR7_oe9sdG-_TMY81MPFQb-4GjTpuo61EVW-1Syf1XJ1mSp0I7OP7sCKBW-IliGn2lcG1iiENMrdjOzifD57U2k_NmmaucFfWv2gZH5bhbi0k57_9houMXkhSaGb/s1600/dayanara.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmOKGpTCNxDb3tDTt8TR7_oe9sdG-_TMY81MPFQb-4GjTpuo61EVW-1Syf1XJ1mSp0I7OP7sCKBW-IliGn2lcG1iiENMrdjOzifD57U2k_NmmaucFfWv2gZH5bhbi0k57_9houMXkhSaGb/s1600/dayanara.jpg" height="320" width="240" /></a></div>
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Aren't they cute? Ashlynn started to get the idea this day was all about her when she recognized her name on a sign. She's smiling from ear to ear! She didn't yet know what the day was really about, but she was starting to realize it was all about her.</div>
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Then team members began to arrive! Ashlynn's Aunt and fiancee were the first to show up. Then came another Aunt and cousin, and holding up the rear was her Grandma. It was hard to know if she realized they were all there for her, but I think she started to get the message.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRDpvSPxHX6uR9KoX03mzm_GPRX7Y-BkA9JTGOj7gIEt-vx6G2Mw2XjULszaPDor6PK3bHYus2g2rZejFpYGAK7WMylO-WlnT6ZBLo5tBsS59INbwd1hyphenhyphenXiMF_XcmAb6p6fb-k91Z2aNzD/s1600/grandma+b.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRDpvSPxHX6uR9KoX03mzm_GPRX7Y-BkA9JTGOj7gIEt-vx6G2Mw2XjULszaPDor6PK3bHYus2g2rZejFpYGAK7WMylO-WlnT6ZBLo5tBsS59INbwd1hyphenhyphenXiMF_XcmAb6p6fb-k91Z2aNzD/s1600/grandma+b.jpg" height="320" width="240" /></a><br />
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Then the medal ceremony began. All the kids with apraxia were called up one by one, and given a medal to go around their neck. Each name brought cheers from the crowd. My mom didn't hear the announcement, and asked innocently, "What is the medal for?" As we thought about it, the medal was for them being exactly who they are. </div>
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<span style="font-size: x-large;">What a gift. </span></div>
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To be given a medal for simply being <b>who you are</b>. </div>
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I got to thinking about stars again today. Stars aren't as bright and flashy as the sun. They don't command one's immediate attention like the moon. However, when one focuses on the sky, the stars are what's written about in poetry, gazed upon in stories. </div>
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The stars, beautiful in their simplicity. Shining brighter than ever in their subtle ubiquity. </div>
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Yes the stars are the metaphor for our children, and they sure shone bright today!</div>
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-38890186294946847372014-09-07T15:38:00.000-07:002014-10-06T12:06:41.033-07:00September Specialty Series: Ask an Occupational Therapist<div class="separator" style="clear: both; text-align: center;">
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Today I am excited to introduce Tonya from
<a href="http://therapyfunzone.net/" target="_blank">TherapyFunZone</a>! Thank you for agreeing
to guest blog today Tonya! Please tell
us a little bit about yourself!<o:p></o:p></div>
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<span style="color: #2e74b5;">I am Tonya, and have been a
pediatric Occupational Therapist for 23 years.
I have worked with a huge variety of kids and diagnoses in my career as
an OT, and have worked in a clinic setting, inpatient acute, inpatient rehab,
early intervention, and school district.
I have treated kids with spinal cord injuries, cerebral palsy, spina
bifida, coordination problems, feeding problems, and autism.<o:p></o:p></span></div>
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<span style="color: #333333;">I have seen a few acronyms for
occupational therapy. What's the difference
between an OT and a COTA?</span><span style="color: #2e74b5;"><o:p></o:p></span></div>
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<span style="color: #2e74b5;">I am an OTR (Occupational
Therapist, Registered), and also work with several COTAs, which are Certified
Occupational Therapy Assistants. They go
through OT school and have specific training in treatment techniques. They do not have training in evaluations,
which OTRs do, but COTAs have lots of experience and training in activities and
treatment techniques. We work together
to get the best treatment for the kids that we see.</span></div>
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<span style="color: #333333;">The field of OT seems to cover so many areas. What areas do you diagnose and treat in the
pediatric population?</span><o:p></o:p></div>
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<span style="color: #2e74b5;">In essence, as an OT, we treat
the problem areas and it isn’t as important what the underlying diagnosis
is. When I evaluate a child, I look at
what activities and movements they can and can’t do, and why they can’t do
it. Occupational Therapy treats and
helps modify tasks in order for you to be able to do and participate in the “occupations”
of life. These occupations in your day
consist of being able to get dressed in the morning, feeding yourself, taking
care of your needs such as grooming and hygiene, and for a child, they include
playing and participating in school.</span><span style="color: #2e74b5;"> </span></div>
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<span style="color: #333333;">Will you define apraxia as it relates to gross and fine
motor skills and tell us, what is the appropriate term when describing gross
and fine motor planning issues? I’ve
heard apraxia, dyspraxia, limb dyspraxia, DCD (developmental coordination
disorder). Are these the same thing, or
are there differences? </span><span style="background-color: transparent; color: #2e74b5;"> </span></div>
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<span style="color: #2e74b5;">One area that can limit kids is
the area of Praxis. Praxis is the
ability to organize your movements to complete a specific task. When using medical terminology, you add an A
in front of a term to mean not there, and a dys in front of the word to mean
difficulty with, so the word apraxia means the inability to organize those
movements, and the word dyspraxia means difficulty organizing movements. Many times when talking about praxia, these
words are used in the same way, although they technically don’t mean exactly
the same thing, but really, they are close enough in meaning that it is not a
problem. <o:p></o:p></span></div>
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<span style="color: #2e74b5;">Many people also use these terms
to relate to the specific activity that the child has trouble with, such as
speech apraxia, dressing apraxia, etc.
In my reports, I tend to just talk about motor planning as it is a more
easily understood term rather than a medical term, and the definition is the
same.<o:p></o:p></span></div>
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<span style="color: #2e74b5;">Another term out there is
Developmental Coordination Disorder.
This is an actual medical diagnosis that has to come from a neurologist.
This actual diagnosis was created in the 1990s to be used with kids that had
these coordination problems but didn’t fit into any other established
diagnosis. Before that these kids were
just labeled as clumsy and uncoordinated.
Some may have fallen into a category of mild cerebral palsy, but did not
really fit there either. </span><span style="color: #2e74b5;"> </span></div>
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<span style="color: #333333;">What are some early signs of motor delays in infants and
toddlers and what should parents do if they suspect delays?</span></div>
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<span style="color: #2e74b5;">Motor planning problems is not
an area that you can diagnose very early because all young children have to go
through their developmental stages, and there is a wide range of normal
development. Every child is going to
gain skills at a different pace, so you really do have to wait and see if the
child will just develop a tiny bit later than you had hoped. You also can’t expect a child to be able to
do an activity if they have never had an opportunity to try and practice the
activity. For example, you can not
consider a child delayed with the ability to cut with scissors if they have
never been allowed to touch scissors before.
Here is a developmental guide for fine motor skills, which can give you
an idea of what skills you would expect your child to be able to do next in
their age level. <o:p></o:p></span></div>
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<span style="color: #2e74b5;"><a href="http://therapyfunzone.net/blog/ot/fine-motor-skills/development-guide-for-fine-motor-skills/">http://therapyfunzone.net/blog/ot/fine-motor-skills/development-guide-for-fine-motor-skills/</a></span><span style="color: #2e74b5;"> </span></div>
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<span style="color: #333333;">What would you recommend parents focus on most to
encourage motor skills at home? I get
packets of suggestions from the therapists, but find them so overwhelming at
times. </span><span style="background-color: transparent; color: #2e74b5;"> </span></div>
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<span style="color: #2e74b5;">Many times, kids who have some
coordination problems will benefit the most from individual sports types of
activities such as gymnastics and karate, or lots of active outdoor play at the
playground. These sports let the kids
practice motor movements in a typical kid environment, but the kids are just
working to get better at the sport for themselves and not for a team (although
team sports are great too). Getting
outside and playing in nature and experiencing a large variety of physical
movements is the perfect therapy as well.
Slide down the slide upside down, hang on the monkey bars, crawl through
mazes, climb trees, etc. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="color: #2e74b5;">When working on developing
skills at home, the best thing is to work movement and activities into your
normal day and normal life. Most of the
time, therapists will give you a long list of activities to do, but that is
because not every activity is going to work for everyone, so they give a list
of things that you can pick from or that can trigger an idea of an activity that
you may already do that is the same. For
example, squeezing sponges may be on a list for hand strengthening activities,
so you can think “ah, great idea, I can just throw some sponges into the bath,
and our therapy will be done during bath time”. Our objective as therapists is not to make
life more difficult for you, but to try to make life easier by giving lots of
ideas so that one or two of those may be a perfect fit for your life. <o:p></o:p></span></div>
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<br /></div>
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That’s what I love about your blog and facebook page
Tonya! You give activity ideas that are
practical, and I feel like I can get motor work in every day just by
incorporating your suggestions. For my
readers who don’t know, can you tell us a little bit about your blog?<o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
<span style="color: #2e74b5;">I have a site called Therapy Fun
Zone, where I post activities that target specific skill areas. I think that if the therapy isn’t fun, then
the kids won’t participate to the fullest.
When I first became an OT, I did not realize how much creativity is
involved, which is my favorite part of being a therapist. I enjoy thinking outside the box and problem
solving to make a task easier or harder, depending on what is needed. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
Thank you so much Tonya for being here today! Please visit Tonya’s facebook page and blog
for great tips and ideas!<o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
<a href="http://therapyfunzone.net/blog/">http://therapyfunzone.net/blog/</a><o:p></o:p></div>
<div class="MsoNormal">
<a href="http://therapyfunzone.net/blog/ot/apraxia-or-motor-planning/">http://therapyfunzone.net/blog/ot/apraxia-or-motor-planning/</a><o:p></o:p></div>
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-30604386905676698742014-09-01T05:00:00.000-07:002014-10-06T12:06:41.023-07:00September Specialty Series: Apraxia Q&A. Interview with Sharon Gretz. Founder and Executive Director of CASANA (apraxia-kids.org)<div class="MsoNormal">
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<br />
I am absolutely thrilled to introduce Sharon Gretz as my
first guest in my September Specialty series!
Sharon Gretz is the founder and executive director behind CASANA
(apraxia-kids.org), the largest non-profit dedicated exclusively to Childhood
Apraxia of Speech. <o:p></o:p></div>
<div class="MsoNormal">
Sharon’s dedication to CAS (Childhood Apraxia of Speech)
awareness, support, research, and funding started with her experiences of being
a mother to a child diagnosed with CAS.
When I first met her, I instantly felt that she “got me.” She understood what it was like to walk in my
shoes. She had been there, and I took
incredible comfort in hearing the words “me too.”<o:p></o:p></div>
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Hi Sharon! I hope
you know what an inspiration and comfort you are/were to me, especially around
the time of my daughter’s dx. What I
love about CASANA is that many of the board of directors have a personal
connection to CAS. For those who don’t
know you, will you tell us a little about you and your personal connection to
CAS?<o:p></o:p></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">Laura, it
has been wonderful meeting you and getting to know you a bit this last
year! Thank you for the complement about
CASANA’s Board of Directors. Yes, each person has someone with apraxia of
speech that they love in their family!
Of course, this all started for me when my son Luke was diagnosed with
severe apraxia of speech at age 3. I
can’t believe it, but in just a few weeks it has been 2 decades since his
diagnosis. He had been in speech therapy
for a full year with no verbal progress prior to me taking him to the
evaluation where he received the apraxia diagnosis. Once my son began to
receive intensive, frequent, and appropriate speech therapy for apraxia, his
progress finally began! We were blessed
to be connected to apraxia expert David Hammer who was simply amazing with my
son. It was all so fascinating, watching
this “dance” of therapy between David and Luke, the sheer effort and
determination they both had. I don’t
think I’ll ever forget it. </span><br />
<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">So, I guess the
bottom line is I have traveled this road.
I’ve been a lot of places, seen and heard an awful lot, and most of all,
in these years I have tried to do my best to learn and share about all things
concerning childhood apraxia of speech.
My son speaks very well now and is approaching his final semester of
college. He is a young adult and I
continue to be very, very proud of him.<o:p></o:p></span></div>
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You mentioned that your son had been receiving services
for a year before you found David Hammer. For other parents who currently have
children in those early stages of therapy, what advice would you give
them? How can they know if their SLP is
knowledgeable or has experience with apraxia, and what kind of progress should
they expect to see?<o:p></o:p></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;">Well,
Laura, I know that you are aware that despite the fact that our children with
apraxia all share a speech diagnosis and all that it means, they are also very
different than one another. That said,
the advice that I would give parents of children in the early phases of therapy
is to watch, learn and question. </span><br />
<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">When I
think back about what I saw in speech therapy for my son with his first
therapist, I noted that she played with him. She played quite nicely and he
enjoyed it. She talked a lot. She
described things – the toys, their colors and shapes. She asked him questions (though he did not
respond back). She did reinforce some of
the growing sign language that we were teaching him at home and attempted to
get him to sign back. The first
therapist that my son had was a very lovely person. My son liked her and so did I. The hard lesson is that just because someone
is nice and fun and a child likes them does not mean that therapy is
appropriate or that progress is going to come.
I distinctly remember watching their sessions - start to finish- and not
being able to really understand what the goal was. What was she truly working
on that was about learning to speak? My
son was bright and attentive and it appeared, best I could tell, that she was
reinforcing language and play routines, something that I always did myself. Therapy started one time a week, then bumped
up to two times a week, and over the course of the year he still said almost
nothing.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">So, while
speech therapy for young children is necessarily embedded in play, I think
parents need to know that unproductive therapy cannot go on indefinitely. There should be noticeable progress in a
child’s speech attempts and the refinement of their speech. It was after my son’s diagnosis with very
severe apraxia of speech that I came to understand that the therapy he had been
getting was appropriate for a child with a “simple” speech/language delay. It was a language stimulation approach – not
a horrible thing, just not appropriate if the child’s main issue is speech
motor planning and programming, which is the primary problem of apraxia. I remember the evaluator, Dr. Tom Campbell
told me that I could continue on with the therapy my son had been receiving,
but it was likely I would also continue to see the same results. Or – OR – we could try something different. Speech
therapy should match the child’s particular speech, language, and communication
issues. If it is true that a child’s
main problem (relative to any other language or communication problems) is
apraxia of speech then the therapy must be tailored to a direct focus on speech
production if we want to see meaningful, noticeable progress.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">I learned
how to <b>ask questions</b> and I made learning about childhood apraxia of speech a
priority. I imagine that I was a bit
annoying to David Hammer, my son’s SLP, because the questions just started on
day one and kept on coming! “I noticed
you did x, why did you do that?” But I
will tell you Laura, even from Luke’s first day with David Hammer, I never had to
guess what the goal was again and I never, in my son’s whole life to that point,
had heard him make so many attempts to speak.
By observing their therapy sessions, which included a ton of play, it
was very, very clear what the goal was. </span><br />
<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">So, another tip for parents is to
<b>observe therapy</b>. Observe as much as possible!
Obviously the best scenario is if there is an observation room with a
one way mirror. I know that everyone doesn’t have that feature but there are
many ingenious ways parents have found to observe and watch the therapy
sessions. It was through the watching
that I learned what I must do at home to elicit good speech practice from my
son. I just don’t think I could have
been a great therapy partner had I not actually seen the therapy in action with
my own eyes. I’m not sure I would have
understood my son’s progress either, without the direct observation.<o:p></o:p></span><br />
<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><b>Learn,
observe, and ask questions!</b><o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">As for
progress – if therapy is appropriate to the problem of apraxia… if the therapy
method is appropriate, the frequency is appropriate, and the intensity is
appropriate (child is saying and practicing lots and lots of speech targets
each and every session) – then progress should be notable. If it is not noticeable or progress is slow
to nonexistent, I think that more investigation needs to occur. An impossibly slow rate of progress is
hopefully questioned by the professional first!
While progress in children with CAS may be slower than progress in
children with other types of speech sound disorders, you should still see
noticeable progress! </span><br />
<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">There may be
reasons for progress that is slower than expected. For example, each competing diagnosis added
alongside of CAS is going to challenge the rate of progress. But unproductive
therapy should not go on indefinitely without being questioned, the techniques
changed up, or referral made for more assessment or evaluation. Over the last
two decades I my personal observation has been that with the right therapy,
hopefully early, and enough of it, most kids with apraxia will make amazing
progress in their speech, some to the extent you would never know they once had
a severe speech disorder. Other kids will have good progress but there may be
some noticeable residual errors in their speech. And yet others, despite best
efforts, may not be fully intelligible speakers. <o:p></o:p></span></div>
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Many parents are told by a neurologist, doctor, or other
professional that their child must have a certain therapy approach. Examples include: Kaufman, PROMPT, SpeechEZ,
and DTTC. I’ve noticed that the creators
behind many of those programs are on CASANA’s professional advisory board. Is there an approach you would recommend over
another? <o:p></o:p></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;">This is a
good question Laura. No. CASANA does not
“recommend” specific methods. What we
try to do is, first of all, share what many of these methods have in common
that make them appropriate for a child who has apraxia – ie: speech motor
planning issues. All of the methods you
have mentioned share common features, and some have uniqueness as well.
Research into effective treatment has really just begun a few years ago because
of CASANA’s push and funding for pilot treatment research studies. Many of
those studies are being published now and have added to the body of research
and what we know. CASANA does have an
emphasis on sharing facts as we know them at this time. So, we definitely do share information about
research and various methods and which ones have more research than others, as
well as which have no published research at this time. </span><br />
<span style="color: #4472c4; mso-themecolor: accent5;">I can say that there is not any <u>one</u>
method to date that has been proven to be effective with all ages of kids with
CAS, all levels of severity, etc. etc.
We are learning more, though, through all of the published treatment
research and appreciate that this type of research is incredibly difficult to
do and to get funded! CASANA wants
families and professionals to not just know about a particular method, but to
have some understanding about <u>WHY</u> it may be effective. That understanding, we hope, leads to better
decision-making for the child’s therapy program.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
What then <b>should</b>
parents be looking for to discern if their child is getting good apraxia
therapy?<o:p></o:p></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;">Those
therapies that appear to be most effective focus on a process called <b>speech
motor learning</b>. There is a lot of data published
about how humans learn skilled movements.
Those “principles” of motor learning applied to the speech learning
process are woven into effective methods of treatment for CAS. Some of the principles have to do with
aspects of practice and feedback to the child.
<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">So, in
regard to practice, the SLP is paying attention to getting <b>frequent and
intensive repetition</b> of speech targets.
A child is encouraged to produce words many, many, many times each
therapy session. If a child is basically
silent or says little or attempts to speak rarely in a speech therapy session,
that would be a BIG concern. We know our
kids will need many, many, MANY repetitions of speech targets in order for the
motor plans to become automatic and not so effortful. <o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">The
<b>speech targets</b> need to be carefully considered and planned by the SLP so that
the child is able to have some success & their speech attempts can then be
shaped into closer and closer correct adult forms. Pulling out random word lists and expecting
children to practice them without any consideration of the child’s current
inventory of sounds and syllable shapes would be unproductive. Also, an SLP who
understands apraxia will give consideration to how many speech targets the
child is working on each session and how they are presented. For example, should the child practice the
word “mom” 10 x in a row or should those 10 repetitions of “mom” be woven among
the child’s other speech targets? <o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">Ok, so is
having a child say words many, many times going to do it? Nope, it won’t because the child must also receive
<b>feedback</b> about how they are forming the words and/or about the accuracy of
their attempts. I have seen many videos
of therapy sessions in which the child is making a lot of attempts, saying
target words, but the SLP is not providing any feedback to them or says “good
job!!!” after every attempt, whether or not the child’s attempt was accurate or
even close! There are times that
feedback should be frequent and specific, and times it should be less frequent
and more general, but there must be good feedback and an SLP who has good
apraxia experience is always giving thought to and considering the amount and
type of feedback provided to the child.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">All of
the methods most noted as being appropriate for children with apraxia of speech
incorporate what we call “<b>cues</b>”. Cues
are like reminders to the child about what to do with their mouth and/or how to
position their oral structures during speech production. Some cues are visual in that the child “sees”
something that reminds them of what to do.
Some cues are verbal. And some
cues are even physical or touch cues (tactile) in which a touch creates a
tactile sensation which reminds the child of what to do. Our kids have
difficulty moving from sound to sound, syllable to syllable. Appropriate therapy for CAS is going to
emphasize MOVEMENT – how to MOVE sound to sound and syllable to syllable –
think speech in motion. Some children
will need to be taught individual sounds too, but that is not the emphasis of
therapy for CAS.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">Another
thing that I would remind parents about and that involves the principles of
speech motor learning which I mention above is that the child needs to actually
directly work on the skill they are trying to acquire. It seems like common sense, but yet we do
hear from families in which the bulk of a child’s therapy program is working on
other skills and not on speech directly.
For our kids to learn to speak, they must be working on speech most of
their therapy time! That does not mean, for example, that the child will not
ALSO need to work on language, pragmatic skills, etc., but if we want to
improve speech intelligibility, we need to work on speech.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-themecolor: accent5;"><br /></span>
<span style="color: #4472c4; mso-themecolor: accent5;">Finally,
all the while we are hoping for and working on speech intelligibility, children
still need a way to communicate. I would
encourage parents to not be afraid of alternative or augmentative forms of
communication. These forms can serve as
a real functional bridge for the kids so that they can keep expanding their
language even if their speech production skills are not capable of keeping up
quite yet.</span></div>
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<span style="background-color: line-height: 18.35pt;">On the </span>apraxia<span style="background-color: line-height: 18.35pt;">-kids.org
website, there are five goals </span>CASANA<span style="background-color: line-height: 18.35pt;"> tries to achieve, with the top goal
being:</span><span style="background-color: line-height: 18.35pt;"> “</span><span style="color: #222222; font-family: inherit, serif; font-size: 10.5pt; line-height: 18.35pt;">To provide high quality information
on CAS to families, professionals, policy-makers and other members of the
public.” </span><span style="color: #222222; line-height: 18.35pt;">Why is this a top
priority and what are some things you are doing to meet that goal?</span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">Well,
it is unfortunate, but there is a lot of poor and shallow information out there
on CAS. When we started the organization,
we felt that it was urgently important to assure that the information that we
shared was as up to date and accurate as possible and free from, what I can
only call, sensationalism. Having access
to high quality information makes families much better advocates for their
children and it makes for way more informed professionals who spend their lives
dedicated to helping our kids. Resources
are sometimes quite slim and that situation isn’t changing anytime soon. High quality information hopefully helps
parents ask good questions, scrutinize things closely and make good decisions
about the use of their personal resources and helps decision-makers do better
by kids with apraxia. We continue to strive
for this each and every day. Our
information is always under review and being updated and shared. We read every
piece of research that is published on CAS or related to motor speech
production and related topics. We have a
Professional Advisory Board that includes most of the top experts and
researchers in CAS who help us in that way as well.<o:p></o:p></span></div>
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<br /></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">Anyone who
speaks to you will usually discover your interest in, and pursuit of research. Can you explain why this is important to you?
<o:p></o:p></span></div>
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<br /></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">I
believe that research is important to objectively verify what we observe or
believe and to know the best way forward.
Today, especially on the internet and even as reported by mainstream
media in magazines and books, the objective “facts” are often misconstrued,
misunderstood, and/or minimized.
Researchers, the good ones, are scientists that are seeking to test and
explain phenomena. They may have a
hypothesis of what they think, but at their best they are truth seekers. I have an interest in GOOD research. Believe me, I have seen individuals report
results that they CALL research, but that I sure would not call high quality
research. I also quite frequently read
online about claims regarding research, for example “X product or method is
known to help apraxia”, when in fact there is no research at all or “sketchy”
research to substantiate the claim. I
think that parents are trying so hard to help their children that sometimes
these claims and assertions are not easy to detect for what they are. I want to teach parents to be the skeptic and
to detect and investigate these sorts of false or misleading claims, to uncover
the truth and then to weigh it all and make the best, most fruitful decisions
for their child.<o:p></o:p></span></div>
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<br /></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">For
our children, children with apraxia of speech, high quality research is
enabling us to better understand the disorder, how to best treat it, and
hopefully one day how to possibly even prevent it (at least in some cases). The needs of our children in speech and
communication are so extensive that we need to really be sure that both public
and private resources are being used as wisely as possible because these kids
use a lot of resources. When we continue
to have high rates of misdiagnosis and/or unproductive treatments, resources
are not being used well.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">Research
is not easy to do and it needs a lot of funding to get it done, most
often. But we have to try! Because it is difficult is no reason to not
do it or to not try to move the science forward.<o:p></o:p></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";"> Since we’re on the topic, what
are the current trends in research related to CAS?<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">There
are some really interesting papers sitting in my reading pile! One of the latest that I am excited to dive
into is by one of our CASANA grantees, Dr. Jonathan Preston who has just
recently relocated to Syracuse University.
He and colleagues have just published a paper looking at
neurophysiological differences in speech production for children with CAS. Through measuring aspects of EEG signals they
were able to gather evidence of key differences in neural processing of
children with CAS during speech planning and programming tasks, especially for
more complex words. So, why is this and
other neurobiological evidence important?
Because now, through this study and others using neuroimaging, for
example, we are beginning to have physical evidence of the speech behaviors
that we think we see. While still early,
these sorts of studies eventually could lead to faster ways to determine who
has CAS or is at risk of having it as well as biological evidence of treatment
effectiveness.<br />
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">The
whole area of genetics research is really fascinating as well. For example, a recent paper by Shriberg and
colleagues used whole exome sequencing (WES) for children with what might be
called “idiopathic” CAS (no known cause).
These subjects were tested extensively to be sure they truly did have
speech behaviors fitting the definition of CAS.
Eight of the ten subjects – 80% - had genetic variations in one or two
of six genes of high interest and which were picked up with WES. Will most cases of idiopathic CAS turn out to
actually be genetic? Maybe, but it’s too
early to tell.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">There
has been more treatment research publications published in the last several years,
including the first clinical treatment trial from our wonderful friends in
Australia, which is truly exciting. Just
in 2007 the ASHA AdHOC committee on CAS could only identify 4 treatment studies
in the previous 20+ years. Many of
CASANA funded research grants have focused on pilot studies of speech therapy
treatments and nearly all of them have made it through peer-review and are in
publication in the professional literature.
There are many exciting things in CAS research world!<o:p></o:p></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">I heard you say
once that finding support is one of the most powerful things you can do as a
parent in this situation. I couldn’t
agree more from a personal perspective, and have literally been saved through
the facebook group. Not only can I get
questions answered immediately, I have others who can cheer my daughter’s
success, and can also find experts willing to give their advice. I’ve also met “friends” around the country
who I’ve connected with based on our shared experiences. I said it in the opening, but there is
something so comforting in hearing the words “me too.” <o:p></o:p></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">Maya Angelou once
said, “I’ve learned that you can’t go through life with two catcher’s
mitts. You need to be able to throw
something back once in a while.” This
quote reminds me of you. I’ve now met
many people who have moved on after their child had resolved apraxia. <o:p></o:p></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">Please tell me in your own words why it was
so important to you to literally found a non-profit after your son’s diagnosis,
and why it is that you remain so active on the facebook group supporting
parents and offering your advice?<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">Well,
it is a long story I suppose. The core
of it started with observing, literally observing, through what I call my
“looking glass” (ie: the one way speech therapy room window). It truly stunned me to watch my son, over the
course of the years he had speech therapy with David Hammer, and how deep the
struggle was and how much he very much wanted to learn to speak. It was equally stunning to see the depth at
which Dave worked with my son, how challenging the work was for both of them,
and how much Dave really wanted to be that person who could change Luke’s
life. Well, together they did it. And at some point in that process I realized
that my son was going to be ok. He was
going to be a talker, no doubt. What a
gift to be able to give a child a voice!
Truly, in those years I felt I had learned so much and had already
started communicating online about what I was learning. At the time there was nothing online and yet
the need was still great back then. So..
what does one do? Do you walk away and
say, “my child is going to be just fine”?
I guess I felt a calling. I don’t
know what else to say. Creating CASANA
and working with my wonderful and dedicated colleagues on our staff and board
is my passion because I know in a deeply personal way that what we do matters
and can help to transform the lives of the children. It is especially rewarding, now, to see quite
a few of the older children and youth with wonderful futures unfolding. What a warm feeling to know that our
organization helped to play a role in it all.<o:p></o:p></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">Are there any
closing comments, suggestions, or recommendations you would like to make?<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">I
like the Angelou quote a lot! I hope
that families and professionals out there who have benefited from CASANA can,
in turn, find a way to reach back, whether that be to us as an organization or
to another parent or colleague.<o:p></o:p></span></div>
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<span style="color: #4472c4; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent5;">The
other thing I want to say has to do with our tagline: <i><b>Every child deserves a
voice</b></i>. It’s important to me that parents
remember that having a voice is a much larger enterprise than just learning to
speak clearly. Amidst it all, we want
our children to develop into every bit of who they were meant to be. We want
them to grow in confidence so that they can, indeed, share their inner worlds,
their thoughts, hopes, convictions and dreams as they go out into the
world. We want them to take pride in
themselves and their efforts and accomplishments, whether or not they learn to
speak perfectly. As parents we can’t
lose sight of the whole child.<o:p></o:p></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">Thank you so much
Sharon! Again, on behalf of not only
myself and my family; but also all the professionals, researchers, and more
importantly the children and their families whose lives have been changed for
the better due to your hard work and dedication, thank you. Truly, THANK YOU. I am honored you were willing to guest blog
today. <o:p></o:p></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">To find more
information on apraxia and CASANA, visit apraxia-kids.org.<o:p></o:p></span></div>
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<i><span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">Sharon Gretz
is the founder and Executive Director of the Childhood Apraxia of Speech
Association of North America (CASANA). Officially incorporated in 2000, CASANA
emanated from an online education effort that Sharon led called
“Apraxia-KIDS”. In addition to being the
mother of a now young adult son who grew up with CAS, Sharon has her Master’s
Degree in Counselor Education and has completed all coursework for requirements
of a Ph.D. in Communication Sciences and Disorders (completed after her son’s
diagnosis). Sharon was also a recipient
of </span>the National Distinguished Service Award at the Kennedy Center in
Washington, DC, presented to her by the National Council on Communicative
Disorders for her advocacy and work on behalf of children with apraxia and has
been named a “Community Hero” for her work with apraxia in her home location of
Pittsburgh.</i><span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span><br />
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<tr><td class="tr-caption" style="text-align: center;">With Sharon at the Apraxia of Speech National Conference</td></tr>
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com2tag:blogger.com,1999:blog-1519489902737716386.post-77305258660629915842014-08-26T12:01:00.000-07:002014-10-06T12:06:41.109-07:00Back to school speech folders.I'm in a new district, a new school, and with a new bunch of kids this year! One thing I've always done the first week is have the kids make their own "speech folder." <br />
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Kids love decorating their own folder! I start with a long piece of construction paper that come pretty standard in most schools. <br />
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I then whipped up three template pages the kids can write on and then glue onto their folder.<br />
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The first page starts out with them writing their name, and then they glue it on the front cover.</div>
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Aside from their name, the second page I consider the most important. It has the child think about WHY they come to speech. I think it's important to start the year discussing the child's goals so they can be an active participant in their learning! <br />
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This page also has them tell one fun fact about themselves, which always gets them talking! <br />
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Finally, the last page contains their teacher's name and their favorite subject. If there is time, I let the kids color and decorate it.</div>
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I have always found this activity to be a great first session activity, and works for really all age groups. Hope you all like it too! </div>
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I'm only going to offer it free on my <a href="http://www.teacherspayteachers.com/Product/Speech-folders-1414685" target="_blank">TpT store today</a>, so if you are interested. Snag it now!</div>
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Happy Back to School!</div>
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laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-76036802592245767582014-08-22T07:19:00.000-07:002014-10-06T12:06:41.103-07:00Last year of Pre-K<div class="separator" style="clear: both;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjxPJwUbr94LS6ABqTHdlcSpkhGSwjcAQ2hkd868C3pysH0AasT_QA8dQFUoSHLwZvG4PBjZMTTfzAZLZ3tP5_EfHp-m5YpsIgw0d4co3wVonrwOx9UATSLgp235xs2YCrqFgtFpB3Sr0n/s640/blogger-image--215377715.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjxPJwUbr94LS6ABqTHdlcSpkhGSwjcAQ2hkd868C3pysH0AasT_QA8dQFUoSHLwZvG4PBjZMTTfzAZLZ3tP5_EfHp-m5YpsIgw0d4co3wVonrwOx9UATSLgp235xs2YCrqFgtFpB3Sr0n/s640/blogger-image--215377715.jpg" /></a>Today was Ashlynn's official first day to her last year of preschool. It was also two years ago today I heard the words, "Laura, this is apraxia." I'll never forget that. It was like hearing something for the first time you don't want to believe, but that you instantly know to be true. Apraxia. Apraxia. No. Not my baby. Why apraxia? That one word brought forth all sorts of things in my brain. Speech will be a struggle. Learning to talk will be a struggle. She will have to have a lot of therapy and she will have to work for every sound, every word, and then every sentence. I texted a colleague. "She has apraxia and I'm devastated." I cried. My little social butterfly whose favorite word was "HI" would have to fight to be able to talk. She would have to earn her right to do the ONE thing that brought her joy: To be social and speak to others.</div>
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It was a hard pill to swallow. I remember I put her in her car seat, and as I leaned over to hug her I cried. She smiled and asked me, "hi?" I cried some more. </div>
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Her first week of school though was nothing short of amazing. She qualified for free preschool in a special needs classroom due to her needs. You can read about that here. <a href="http://slpmommyofapraxia.blogspot.com/2012/11/first-week-of-pre-k.html" target="_blank">First week of Pre-K</a></div>
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Her second year of preschool brought even more exciting developments.</div>
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<a href="http://slpmommyofapraxia.blogspot.com/2014/02/her-little-heart-of-gold-this.html" target="_blank">Encouraged!</a></div>
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<a href="http://slpmommyofapraxia.blogspot.com/2014/02/her-first-favorite.html" target="_blank">Her first favorite</a></div>
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<a href="http://slpmommyofapraxia.blogspot.com/2014/05/to-say-your-name.html" target="_blank">To Say your Name</a></div>
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<a href="http://slpmommyofapraxia.blogspot.com/2014/05/for-once-i-went-to-school-and-i-heard.html" target="_blank">Only positives</a></div>
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Today she was sooo excited for school. When she came home, she wasn't able to really tell me WHAT she did, but it typical Ashlynn style, she could tell me WHO she played. with. There was Mia and Carly, her teachers Kubra and Donna. I'm excited, hopeful, and maybe a little nervous. This IS her year to catch up. I'm doing everything I can as her mom. She's in private speech and OT, she's still getting private swim lessons since swimming has been amazing for helping with her bilateral coordination, we're doing sensory and OT/PT activities at home, and of course the speech she always gets from me. </div>
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We sure have come along way from that day in the car that I cried, and from that text message that said I was devastated. Our ENTIRE family is different now, and we're all better for it. </div>
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So bring it on school year 2014/2015! We're going to give it all we got!</div>
laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-47333619152725959982014-08-15T20:55:00.001-07:002014-10-06T12:06:41.063-07:00Initial 'T' tic-tac-toe<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAo_9UI39LgEXTwIy2O6F5WW2Ttz3ACOeQX_uDKW5KcpLRgV0USAoltyXvLc0f0ljechDfb9qrXGJ96IxE_7ArY4xHjYx8Qyq_NvwgEGbyrp3r9yop0wVhdoeJnYYAHH2l2uuLQjUurlwx/s640/blogger-image--797603550.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAo_9UI39LgEXTwIy2O6F5WW2Ttz3ACOeQX_uDKW5KcpLRgV0USAoltyXvLc0f0ljechDfb9qrXGJ96IxE_7ArY4xHjYx8Qyq_NvwgEGbyrp3r9yop0wVhdoeJnYYAHH2l2uuLQjUurlwx/s200/blogger-image--797603550.jpg" width="150" /></a>One thing I've found, is that as an SLP, finding materials for apraxia can be challenging. This is mostly due in part to the fact that syllable shape and complexity matter more for apraxia than they do for other speech sound disorders. <br />
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For example, if you were working on the 'T' sound and opened a typical articulation workbook, it wouldn't be uncommon to see a variety of single syllable and multi-syllabic words mixed in together. As an SLP specializing in apraixa, I need materials and FUN worksheets that my kiddos with apraxia can use without having to say, "Let's skip that word" or "Don't worry about that one." <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixkZ6LEXLEotcXDBErDczG3mE9JtB1_B3pkPHFGM20Y64Z0PZ1-0BVA2Jq4LzRdXv7SvKDDpEUiIaObXqmE6GxJht3PmsllAXcC3Ng7s8ZI6_3fEpXnS-bktKwp0oZ_o5HwG6ued2CdyQk/s640/blogger-image--1767939982.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixkZ6LEXLEotcXDBErDczG3mE9JtB1_B3pkPHFGM20Y64Z0PZ1-0BVA2Jq4LzRdXv7SvKDDpEUiIaObXqmE6GxJht3PmsllAXcC3Ng7s8ZI6_3fEpXnS-bktKwp0oZ_o5HwG6ued2CdyQk/s200/blogger-image--1767939982.jpg" width="150" /></a>Here is a tic-tac-toe game I made for a kiddo right now who needs a review and extra practice for initial 'T.' You will notice the syllable shapes are simple: CV and CVC. <br />
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To get more repetitions in, I also had a basic deck of cards (minus the face cards) sitting by our game. We had to pick a card and whatever number we picked was how many times we had to say our word!<br />
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If you're interested, you can find it on my TpT site here: <a href="http://www.teacherspayteachers.com/Product/Letter-T-Tic-Tac-Toe-1395131" target="_blank">Letter 'T' tic-tac-toe</a>laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0tag:blogger.com,1999:blog-1519489902737716386.post-24104790353607405082014-08-12T19:41:00.001-07:002014-08-12T19:44:03.342-07:00The high of summer! The fear of "back to school."Oh summer, how I love thee. Filled with swimming lessons, play dates; visits to the park and zoo.<br />
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During summer, I get to see my children be children. Their carefree smiles light up a room, and the echoes of their laughter can be heard long after they lay down their head.
Yes, therapy appointments are a way of life for Ashlynn, but even speech and occupational therapy bring positive updates from the session and we can quickly return to our days of play.<br />
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This summer I signed up to a few good facebook pages I found: <a href="https://www.facebook.com/MamaOTblog" target="_blank">MamaOT </a>and <a href="https://www.facebook.com/inspired.treehouse" target="_blank">Inspired Treehouse</a>. I LOVE these pages! Instead of the packet of ideas I would get heaped upon my shoulders during the school year, these pages provide an idea a day to do with your child. Simple, easy, fun! When I just get one idea a day, the load seems MUCH more manageable. I was so inspired, I tried to do the same for speech and language on my <a href="https://www.facebook.com/pages/SLP-mommy-of-Apraxia/275144516000550" target="_blank">SLP Mommy of Apraxia</a> page, since I'm usually doing something related throughout my day with my kids since that at least, comes naturally to me.
I really think they helped Ashlynn, and I felt good about incorporating some sort of speech, sensory, or occupational/physical therapy at home.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPaZHhVgAQrFs7lE95_qIaXG2qZY5kboNTbbZOYkm55eqs9GAVbXpWIV4uHExZig-hGX6-EfqXEe4Z-YL4UB-KT_UvadKcxmbz43UX7eAmG7K8EmwR_U_O6CZRbFoItH5zzhjx48GIlUPl/s1600/climb.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPaZHhVgAQrFs7lE95_qIaXG2qZY5kboNTbbZOYkm55eqs9GAVbXpWIV4uHExZig-hGX6-EfqXEe4Z-YL4UB-KT_UvadKcxmbz43UX7eAmG7K8EmwR_U_O6CZRbFoItH5zzhjx48GIlUPl/s320/climb.jpg" /></a> My husband and I also saw HUGE improvements this summer in the motor realm. Ashlynn climbed a play structure that she had yet to conquer at our nearby park.
Who knew how much core stability, bilateral hand coordination, and crossing midline play a part in climbing a simple play structure!
Well, I'll tell you who know.<br />
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Parents of children who have dyspraxia!<br />
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At the local amusement park, she was riding the tea cups independently. My husband shot a video. During the first two go rounds she was just sitting there, but by the third go round she figured out how to spin the wheel to spin her teacup! You should hear my husband cheer.
Who knew how much core strength, bilateral hand coordination, and crossing midline play a part in being able to operate a simple teacup ride.<br />
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Oh yeah, parents of children who have dyspraxia.<br />
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However, now summer is coming to an end. I see facebook posts ripe with updates along the lines of "I'm so happy school is coming up!" Or memes like this one: <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyy4dNwWe7FMt5wTalsbRahaVASj_w8dsHkxqFtBH50SKRVQVmStwp6Nio6QEfRhUMtU61wvTHwjBguQ0JRTWOSzfSrf21VAaKccTtbw1kj6PVD_f47YVg8Tf0wPk3Ap_hqA4ktjrhR0li/s1600/back+to+school.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyy4dNwWe7FMt5wTalsbRahaVASj_w8dsHkxqFtBH50SKRVQVmStwp6Nio6QEfRhUMtU61wvTHwjBguQ0JRTWOSzfSrf21VAaKccTtbw1kj6PVD_f47YVg8Tf0wPk3Ap_hqA4ktjrhR0li/s1600/back+to+school.jpg" height="236" width="320" /></a></div>
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Not me.
School. Sigh. What can I say? I have a love/hate relationship with school.<br />
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I firmly believe school helps children develop their social skills and gives them important language models, which is especially important for kids with speech and language delays. <a href="http://slpmommyofapraxia.blogspot.com/2012/11/first-week-of-pre-k.html" target="_blank">The first week my daughter went to school shortly after she turned three, she came home singing a tune I actually could decipher, and at that time she was nonverbal</a>! That my friends, is the power of school!<br />
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On the other hand, school brings new fears and new worries. I always thought, once she starts talking, I'll be okay.<br />
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Not true.<br />
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Now I'm worried about her phonemic awareness skills, language lag, slow processing speed, and being able to write.<br />
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My God how much do kids need to do and know now just to be ready for Kindergarten???<br />
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I'm not looking forward to the IEP meeting, the parent/teacher conferences, the comparisons I try not to make when I'm visiting her classroom.<br />
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Quite frankly....
It SUCKS. Apraxia STILL sucks!<br />
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So no. I'm not ready for Ashlynn to go back to school. My SLP friend and mother to two young boys with apraxia who has a blog: <a href="http://landonjourney.blogspot.com/" target="_blank">Landon Journey</a> just posted this song lyric the other day:<br />
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If I could make days last forever<br />
If I could make wishes come true<br />
I'd save every day like a treasure and then,<br />
Again, I would spend them with you.<br />
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As my brother says though, "Life's not fair. Get used to it."<br />
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So farewell summer! I bid you adieu. You have been so kind to us this year. We have made castles in your warm sand, felt the glow of the sun upon our face, cooled off in your waters, and celebrated the milestones and successes at our pace. Though I'm anxious for the coming school year, I have faith you will be waiting on the other side. Welcoming my children to your sunshine, casting light onto their beauty. <br />
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<br />laura smithhttp://www.blogger.com/profile/05006380477369116663noreply@blogger.com0