Wednesday, July 6, 2011

Emergently Vocal

To a parent with a child who has autism, the beginning of speech seems a lot like this - the mythical Phoenix rising from the ashes of past dreams.  We have spent a lot of time and money having Alanna work with a speech-language pathologist, with follow-up from her IBI team to get her to speak.  She has speech apraxia, so despite her best attempts to imitate vocally (despite effort, intention and desire), she cannot make many sounds without a lot of help.  It is incredibly frustrating for her.  I am convinced without this additional impediment she would be very vocal (perhaps not communicating functionally, but have no trouble with vocal imitation).

We have been using PROMPT, a technique that gives Alanna some physical cues about lip, jaw and tongue placement to make sounds.  Once she has a sound, she also has difficulty isolating it and combining it with new sounds to make words.  For example, trying to get her to imitate \o\ (as in go) can be tough because she learned this sound as go, and so the "g" has to be in front to get to the "o", and if you want to combine "o" with something else, we have to get her to drop the "g".

However, she is now "emergently" verbal.  We have several words that are consistent and have meaning:
  • Go
  • More
  • Up
  • Help
  • Open
And we have a word list of perhaps 26 words she can sometimes say, but needs physical prompting or she is inconsistent or we can't understand the speech production.

Of course all of this is very expensive but it is also worth it.  Every word she can say is like gold because it makes it easier for her to communicate and be understood.


  1. How fantastic! It must be so amazing for all of you to see the fruits of your labor like this. I hope that this is just the beginning of a language explosion for her.

  2. My son has apraxia as well. We live in Durham and he sees an SLP but they don't do a whole lot of prompting. Now I am wondering why they aren't doing this. Who comes to your house to do this with your daughter? Any help is much appreciated :)

  3. @ kal - We have an SLP in private practice who used to work at the Toronto Preschool Service doing mostly oral-motor difficulties. She used to work at the Hanen Centre. Apraxia requires intensive treatment but the public system will not give you nearly the hours you need. Good luck!

  4. Wow...really glad I read this post. I never considered Apraxia before. Our son will be 4 in December and is non-verbal autism. We are now looking into the PROMPT therapy to present to our speech therapist. SHe is from Ontario so hopefully she will have heard of it. If we could just get out a few words we would be so happy. thanks for your blog, when i read it i feel like we are writing it...our stories are very similar. Thanks.