Easton’s Journey

EASTON’S JOURNEY: “A parent perspective on their son’s experience with childhood apraxia of speech”

Easton sits on his mother’s lap, smiling at the camera.  He is happy, engaged, and confident. Just a little over a year ago, he was a quiet little boy, unsure of his surroundings and frustrated by his communication difficulties.

“Easton started his journey with Urban Speech Therapy at the age of two and a half. As his parents, we were concerned that he had vocabulary of less than five words and appeared to get frustrated with his inability to express himself. After an assessment, he was diagnosed with Childhood Apraxia of Speech (CAS). We were not familiar with CAS, but Urban Speech Therapy provided us with education around the diagnosis and the importance of individual speech therapy, along with family involvement.”

Childhood Apraxia of Speech is a motor speech disorder in which children have difficulty planning and programming the movements needed to speak.  In other words, children know what they want to say, but they have difficulty saying it.  It is estimated that one in 1000 children has been diagnosed with childhood apraxia of speech. Common characteristics of children with apraxia of speech include vowel and voicing errors, inconsistent errors and production, difficulty with multi-syllabic words, decreased speech intelligibility, limited sound repertoire, disturbances in prosody (“choppy” or “monotone” speech), slower rate of speech, delayed onset of speech, and possible groping (visibly searching for a sound). Children with CAS have difficulty sequencing and timing the movements needed for speech.

Therapy for CAS should look different than traditional articulation or phonological therapy. Instead of specific sounds targeted in isolation, words, phrases, and sentences, therapy for CAS involves the actual movement patterns associated with speech. It is a motor learning approach much like learning to play the piano. The more we practice, the more our fingers know which keys to hit to produce an intended sound – the more likely our motor skills will become automatic.

A speech therapist targeting CAS should incorporate the principles of motor learning, a set of processes that help an individual acquire and retain motor skills.  Children with apraxia should receive more frequent, consistent speech therapy with goals that are meaningful and functional for the child. Oftentimes, it is helpful for parents and speech therapists to create target word lists using words that are important to the child and sound and consonant-vowel forms that are successful for the child. Therapy should be individual, intensive, and primarily focused on motor learning. This means that verbal, visual, and tactile cues should be used frequently at first and then fade over time and with progress. The level and kind of feedback provided by the speech pathologist during a session should also be considered.  Children should be given descriptive and immediate feedback (specific information on how sounds are formed) and then feedback should also be reduced as needed.  Treatment for CAS should also focus on rhythm, intonation, and pitch.

Easton’s therapy sessions focused on consonant-vowel and vowel-consonant movements with sounds in his inventory and words in his vocabulary.  (For instance, “hi”, “bye”, “ma”, “pa”, “no”, “in”, “up”, “on”) He also worked on CVCV combinations such as “mama” and “papa”.  Initially, Easton displayed some frustration when trying to communicate.  Once he began to work on attainable goals, his confidence increased, and his negative behaviors decreased.

“Between Easton’s therapy sessions and practicing at home, we started to hear subtle changes in his communication. He was adding words to his vocabulary and learning ways to communicate his needs with us. Over time, his progress continued, and he started to string words into sentences, had the ability to add sounds to the end of his words and had a newly found confidence. “

Easton received consistent and frequent speech therapy at Urban Speech Therapy. Goals changed as he made progress.  Soon, Easton was speaking in three- and four-word phrases, mostly intelligible to familiar listeners! There are still times when he becomes frustrated, but he has learned some words that can help him express that frustration.  For some children with apraxia, establishing and maintaining friendships can be difficult.  Talking is harder.  Conversation is harder. It is important that children with CAS be set up for success.  Teachers can be made aware of a child’s diagnosis before school begins.  Children with CAS can be paired with other children who have similar interests. They can be given verbal choices rather than being asked open-ended questions. Additionally, the term “childhood apraxia of speech” should not be avoided.  Advocating for children with CAS and educating others helps spread awareness, which in turn, can help others on their communication journey.  Easton has an excellent team of teachers, speech therapists, and most importantly, family members.   They have been integral in his speech development and success as well!

Easton’s mother smiles as she thinks about his progress. 

“Fast forward one year, we are amazed at how far he has come in his communication. We value sitting around the dinner table each night with Easton sharing his favorite part of his day with us. Hearing a new word or phrase is now a regular occurrence, which brings us so much joy. We can say with confidence, without Urban Speech Therapy, Easton would not be as far in his speech journey without them. We are incredibly grateful for them giving Easton the gift of communication!”

She looks at her son.  “Right, Easton?”

He smiles and looks at her and says clearly, “Right, mom!!”