Lori Riggs photo

Today’s interview is with Lori Riggs, SLP of NACD.  Please visit their website to learn more.

Thank you for participating our interview. Please tell us a little about yourself.

Hi! Thank you for including me. I am a mom of two boys and have been practicing speech therapy for more years than I should admit to. I currently work with the National Association for Child Development (NACD) out of Ogden, Utah, where I assess children and write home programs for parents to implement, addressing issues with speech, language, and feeding, as well as supervising auditory therapies, such as our Targeted Sound Intervention and The Listening Program. Because all of our work is home-based, our model is a little bit different from typical therapy models. I’m a native Texan, residing in the mountains of Utah with two kids and one Labradoodle.


May 14th is the 3rd Annual Apraxia Awareness Day so I’d like to take this opportunity to ask some questions about Childhood Apraxia of Speech (Apraxia).

What is Childhood Apraxia of Speech?

Since anyone can Google it and find the official definition, I’ll give my take on CAS. It’s a motor planning problem. In short, this means that it’s a difficulty making the mouth move and sequence movements the way the brain wants it to for the purpose of producing speech. Apraxia is NOT a disease. I see it more as a description.


What are the signs of Apraxia? What should a parent do if they are concerned about their child’s speech?

Obviously what CAS looks like varies widely with developmental level, age, etc. For a young child just developing speech, or a non-verbal older child, a hallmark of CAS is groping-type behaviors, such as a child watching you say “mama” and moving their mouth, but looking like they can’t figure out how to put their lips together to do what you’re doing. Intentional productions tend to be more difficult.  For this reason, “pop-out” words tend to be common in this group, where you may hear a unique, clear word produced out of the blue, and then never hear it again. Or just after the child said that pop-out word, you try to get them to repeat it, and they can’t. In verbal children, CAS may manifest as: inconsistent articulation errors, voicing errors, and prosody problems (such as poor inflection or incorrect syllable/word stress). It is not uncommon to see language delays and/or dysarthria (actual muscle weakness) in conjunction with CAS. But these are not actually part of the diagnosis. If a parent is concerned about their child’s speech for any reason, they should visit their local speech pathologist.


When can Apraxia be diagnosed and who can diagnose it?

This is where my response will vary a bit from others. I will talk around the question a little because I prefer to address in a child all of the pieces that need to be addressed, not just one thing dictated by a diagnosis. At NACD we don’t “put kids in a box” because of a diagnosis. We look at all aspects of development and address therapeutically each piece that needs to be addressed. Because any given diagnosis can manifest in so many varied ways, we look at the child as an individual, rather than seeing them as characterized by a label.  I may be working on motor planning for speech in a child who would not technically qualify for a CAS diagnosis but who needs some help on articulation from a motor planning perspective. (And we’re also working on oral motor skills and language and sequential processing and anything else that needs help.) See what I mean? Or a child with CAS may also need to be working on auditory sequential processing and receptive language, in addition to the motor planning activities. Therapy is about what any given child needs to work on. Because this is our paradigm at NACD, we don’t need to label and diagnose children.  But I do understand that NACD is a unique organization.  For those who need to obtain an official diagnosis—and certainly there are valid reasons when this is necessary—a speech/language pathologist is typically the person to provide this diagnosis.


How is the treatment for Apraxia different from that for a speech delay?

Whether a child has delayed language development, articulation impairment, CAS, or something else, we always want to be sure we are covering all aspects of the child that need help. So my answer is that it depends on the child. But in general, there will be much more emphasis on exercises that address motor planning for speech in the case of CAS, compared to language or articulation therapy. But as I mentioned before, it’s not uncommon to have delayed language in conjunction with CAS, so in some ways these treatments may overlap for some children.

What is the prognosis for a child with Apraxia?

The prognosis for developing intelligible, functional verbal communication in a child with CAS is great with lots of hard work!


Obviously Speech Therapy is very important part of treatment, but what can parents do at home to help?

Don’t look at the formal speech therapy session as the primary solution. The time spent at home is much greater than the time spent in therapy. So use therapy as a guide and carry through with those activities at home every day. If they aren’t provided, ask your therapist for daily home activities.


What apps can be useful with Apraxia?

First, as I have mentioned numerous times in things I have written, apps are only tools. They are resource materials. They don’t take the place of a therapist or parent working with the child; but they are easy tools to use when working with your child. (In other words, a child shouldn’t be handed the iPad to work on speech independently!) The NACD Home Speech Therapist apps (Speech Therapy for Apraxia; Speech Therapy for Apraxia-Words; Speech Therapy for Apraxia—2-Syllable Words; and Speech Therapy for Apraxia-Ending Sounds) are great for working on motor planning for speech, whether with a child with apraxia or speech delays or even straight articulation errors and phonological processes.


Any other resources you would like to share?

There are many materials out there now labeled for use with apraxia. And I think they all have their benefits. As with apps, though, they are merely tools. The benefit comes with the quality of their application and implementation. So I suggest observing therapy and keeping your home practice and materials consistent with what is being taught and practiced in therapy.  Lots of consistent practice and lots of repetition is needed!


Thank you so much for talking with us today and helping us learn more about Apraxia.  We really appreciated the chance to get to know you!

Thank you, Mary! My pleasure.

You can check out the NACD Apraxia Apps by following this link:
Appstore link :Speech Therapy For Apraxia Bundle

And you can enter to win them here:

Mary is originally from England but now lives in California with her husband, dog, cat and three children. Mary and her family love Apple products and own an iPad2, iPad3, iPad Mini, iTouch, iPhone5 and several MacBook Pros. They also love cub scouts, skiing, camping and hiking. The family iPads are also used for therapy for their daughters Apraxia (speech disorder).

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