On Aug 5, 2010, at 11:36 AM, Brooke Fescenmeyer wrote:
>
> Does anyone know of any brochures to give to parents about the use
> of AAC
> methods with children? I know someone mentioned a publication in
> Britian, but
> are there any published in the states or anything specifically on AAC?
>
> Thanks,
> Brooke
>
Hi Brooke,
I am not sure it is relevant to all of your cases, but here is an
article for parent consumers that I wrote regarding using sign for
kids with CAS. Please know that this article does not cite the
literature. It is written for parents and as a "lay" piece, however,
was reviewed by members of CASANA's Professional Advisory Board prior
to publishing. Hope it might help a bit?
Sharon Gretz
Exec. Director/Founder
Childhood Apraxia of Speech Assoc. of North America
Link to article here: http://tinyurl.com/aqr2u3
Using Sign Language With Children Who Have Apraxia of Speech
by Sharon Gretz, M.Ed.
Often when someone raises the idea of using sign language for a child
with apraxia, parents may experience confusion and even fear. After
all, "The child can hear just fine! Why would we use sign language
for a hearing child?" Or "But won't using the sign mean my child
won't need to talk? Won't it keep him/her from speaking?"
Conversely, some parents report that their child's speech language
pathologist has told them that the child will rely on sign and thus
not learn to speak. This article attempts to address many of these
myths about signing.
First of all, in our mainstream culture it is true that we most often
see images of sign language associated with people who are deaf or
hard of hearing. However, that doesn't mean that for some children -
those with apraxia - that sign cannot help! For children with
apraxia the sign can be used to assist and augment their verbal
communication, sort of as a bridge to communication while they are
learning to speak clearly. The use of signing with children who have
apraxia has nothing to do with their ability to hear or understand the
spoken word. Most children with apraxia have very good receptive
language skills.
Secondly, it is rare that a child's speech output is diminished by
using sign language. To the contrary, therapists and parents alike
nearly always report a heightened willingness to try new words and say
more. Nearly all parents are actually quite relieved when their child
starts to use some signs to help with communication. It makes life
easier for the child and the parent!
For just a few children with apraxia of speech, sign may not be
indicated. These children have additional severe motor planning
difficulties with their arms and hands, making it extremely difficult
for the child to use a fairly consistent manual sign to represent a
word. However, it is possible that even these children can benefit
from sign if the adult uses the sign as a form of visual cueing
(explained in more detail below). And it is not necessary that the
child's sign is "perfect," just that they can be fairly consistent
with whatever approximation of a sign they can achieve.
Below are some reasons why you might want to consider using sign and
verbal attempts for a child with apraxia:
1. Reduce Frustration: Reduce frustration and have basic needs
understood. Children who have access to sign language are at least
able to communicate at some level, which usually results in decreased
frustration on their part and yours.
2. Symbolic Communication: Sign can be important to young children
with little or no speech because it is symbolic communication. They
are learning that they can label things and use the signs to
communicate. This is important for all children. Those with
typically developing speech are doing so with speech attempts -
words. Our children with speech apraxia also need a way to do this so
that this part of the process of acquiring language is not further
delayed.
3. Expansion of Expressive Speech: For children who have apraxia and
who are really struggling to sequence sounds into words, sign can be a
mechanism to insure that their expressive language development isn't
further impeded. Speech production is just that: producing speech.
Expressive language is the ability to understand and properly use the
rules of the language to construct sentences. So a child with apraxia
is at risk, due to the speech production struggle, of also falling
seriously behind in expressive language since they have no means to
try out and practice how words go together to create meaningful and
proper messages. Using sign assists children to keep expanding their
expressive language. While they may not be able to speak a word or
put two words together, they can still, by using sign, be doing this
same thing in a different way.
4. Successful Communication: Children with apraxia who use sign, may
also use it as an assist for the listener when accompanied by their
vocal attempts. They may be capable of, for example, three word
sentences in which each word is an approximation, not properly
articulated, and thus the listener may not understand their message.
When the child uses sign, along with the vocal attempt, the listener
(if they know the signs) can have a better chance of understanding the
message and thus, the child is successful at communication. Our
children very much need to feel successful in their attempts to use
their voice to communicate. If when attempting to use their voice to
communicate, no one ever understands, it is not uncommon for them to
just stop trying to use their voice. When they are understood
(perhaps because they also used sign) they are delighted to realize
they were successful and are more likely to keep on trying.
5. Controls Rate of Speech: You will notice that when the adult uses
sign, and even when the child uses sign, it has the tendency of
slowing down the rate of speech for most people (obviously not for
interpreters perhaps!). For some children with apraxia, this is very
helpful for them to have the additional time to allow for motoric
transitions between words, etc. It gives them a better chance, in
many cases, of also being able to imitate you. Many adults speak fast
and that can have a negative effect on a child with apraxia's ability
to imitate you.
6. Serves as Visual Cues: It is pretty much universally agreed that
multi-sensory input is helpful to children with apraxia of speech.
The literature is full of examples of "cues" from various modalities
that, when consistently paired with verbal attempts, can trigger for
the child access to the motor plan they need to produce the word,
sound, or sound sequence correctly. One very powerful modality for
many children with apraxia is visual (thus the term "visual cues").
When the adult is also using sign to "cue" the child, and an
association between the visual cue and the word or sound has been made
over time, just the sight of the "cue" can help the child produce the
correct word. Sometimes a sign for an alphabet letter may be used in
conjunction with a location to cue a sound (sign for "K" being held at
the throat). As a child's speech becomes more intelligible, they
almost always drop their use of the signs. However, many parents and
therapists will continue to use a sign themselves for the purpose of
providing a visual cue for sound or word production when the child is
struggling.
7. Kinesthetic Reinforcement: Some people believe that the use of
manual sign provides the kinesthetic reinforcement of volitional
movements and sequencing when accompanying the verbal attempt.
Speech-language pathologists who successfully use sign language with
children who have apraxia do not have the child using the signs in
isolation. Instead, they are encouraging the child to use signs
along with verbal attempts. Therapists and parents need to work
together in partnership on all aspects of a child's therapy, including
the use of manual sign language to augment speech attempts.
www.apraxia-kids.org
© Apraxia-KIDSSM - A program of The Childhood Apraxia of Speech
Association (CASANA).
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