Jake's Journey with Apraxia

And the Friends We Met Along the Way

“Jake! Jake! Say it! Say it!” My neighbor’s teenage son, Jackson, and his friends were enthusiastically shouting to my Little Man when I walked in their front door. We had been back from Arizona for about a week and my neighbor, the Pre-K 4 teacher, had volunteered to watch Jake for about an hour while I attended a meeting.

Jake greeted me with a big grin and said, “I am A boss! I am A boss!”

Jackson had a smile on his face, but looked a little disappointed. His mom spoke up to explain, “They’ve been trying to get him to say, ‘I am THE boss!’ for about an hour, but he just can’t seem to say ‘the.’ No matter how many times he repeats it after them, he keeps saying ‘a’ instead.”

Jake continued to peer up at me with a mischievous smirk because he and I both knew without a shadow of a doubt that he could say it correctly. After all, he’d just spent a week saying that word repeatedly at Foundations Developmental House.

Instead of shrugging it off or breaking the sentence down into parts like I did pre-FDH-intensive, now I knew how to combat this problem … and win. I could do one of three types of “feedback” that Lynn Carahaly taught me in order to help Jake say the entire sentence the correct way.

  1. Minimal Cue – I could say, “Jake, can you fix it?” (i.e.- Fix the sentence and say it the correct way).
  2. Minimal Cue – I could give him the hand cue for /th/ without verbally saying anything.
  3. Maximum Cue – I could repeat the sentence to him, just as the boys had done, but use the hand cue for /th/ when I got to the word “the.”

According to the Speech-EZ Parent Manual, the type of feedback is very important in treating apraxia: Having the child process, search for, accurately retrieve and execute motor plans as independently as possible is believed to accelerate progress and strengthen the neurological pathways associated with motor planning and accurate speech productions.

Because Jake’s speech is so far along now, typically I would start with a minimum cue and build up to a maximum cue if needed. But in this particular instance, I gave him the maximum cue just to make sure that he could definitely get it because he had already been working with the boys for a while.

After I said the sentence, along with the hand cue, Jake recited each and every word perfectly. I then completed the feedback by saying, “Good job using your hands!”

Jackson just looked at me a little stunned and said, “How’d you do that?”

I said something to the effect of, “It’s a brain thing. If Jake uses his hands for sounds, a different part of his brain is used, so it’s easier for him to get the words out. The hand cue also helps cement the sound into his memory.”

Isn’t the brain remarkable? I have really been awed at how the brain can transition into a stronger machine just by being worked in a different and consistent way.

It’s also interesting to me how we all have our own weaknesses that we have had to compensate for over the years. For instance, my sense of direction is so bad that I consider it a handicap. But, I’ve learn how to survive. I have to get from Point A to Point B. I can’t just give up and accept my deficiencies or else I’d spend a heck of a lot of time at home in my safe haven.

How do I defeat my weakness? Here’s my most recent example …

Even though I’ve been to Jake’s Integrative MD’s office in the city several times, each visit I was still having to refer to my written directions. However, lately we have been going more often, so I made mental notes to help me remember how to get there better.

Turn left at the red “Check Cashing” sign. Go past the Center for Disease Control on the right. Turn right at the yellow Shell Gas Station.

Now that I have done this a couple of times by incorporating visual cues, my brain now knows the route without having to be reminded with written directions. I choose to find a work-around for my shortcoming and therefore, I am able to get to Point B using a skill other than my innate ability. Doesn’t this sound a lot like what it takes to beat apraxia?

For more information on Foundations Developmental House and the Speech-EZ Apraxia Program, please visit their website by clicking here.

4 thoughts on “I Am The Boss: Speech-EZ Feedback Techniques

  1. Rowan McLeod says:

    Hi there,
    Lovely to read all about Jake’s progress – I am often checking in here for inspiration! I’m just wondering if you wouldn’t mind taking a moment to explain how or what helped you to script sentences for Jake? Piper is imitating single words well right now and we are moving onto Kaufman kit 2, but I am not sure how to enforce and cue for the accurate formation of basic beginners phrases. She tends to put all the words in any order without any functional words to connect them such as ‘ I, it, and, the, etc etc’
    Any thoughts would be much appreciated!!
    Thanks again

  2. tstarmom says:

    Rowan, Yes! While Jake’s sentences are now longer in length, he is still leaving out many of the little connecting words. I am going to try and include a video in this week’s blog post, either of Jake & his breakdowns & how I correct him or a You Tube video of Speech-EZ in action. So, please check back. I didn’t “officially” understand how/when to cue until I took Lynn’s webinar through CASANA back in October, so I totally *get* where you’re coming from. Seeing it in action is really the best way to learn I think. While I wish we would have started cueing earlier, we did not start until Jake was also beginning the second Kaufman set. I felt like the hand cues were a great way to push him forward to the next level. Do you have an iPad? The Speech-EZ app does a great job showing all of the hand cues and at our intensive session, I learned that knowing these cues, along with the sounds they make is key. If you don’t have an iPad, you could also look at getting the Parent Manuel, which would also explain the method in greater detail.

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