Part Six: A Plug-in for Prosody
One of the biggest complaints about kiddos with apraxia is that they sound a little like a computer. Most therapists attribute the computer like voice to a prosody deficit. Prosody – simply defined is when we use stress, inflection, and varied length/rate of speech while communicating. Most kids with apraxia have difficulty using prosody correctly in their speech.
I believe this deficit in prosody can be somewhat explained. When a child has been taught and has memorized speech movements on a word basis – but hasn’t learned how to transition from one word to another – they literally have to finish their word – start their mouth again in a neutral position and then begin the next word. These unnatural breaks between words makes the speech sound computerized. The speech movement is not fluid. We do not produce speech one word at a time the same way we write words. Our speech is always connected and we move from the sound at the end of one word into the beginning sound of the next word fluidly without any breaks. But, unless apraxic kids have been specifically taught these transitions they will struggle producing them fluidly.
This makes it seem like we need to practice producing each word transitioned into every other possible word to achieve this – and again we can feel overwhelmed. But the truth is – we can achieve this fluidity by simply focusing on the Movement Pattern Generalization Theory. In this theory (as previously mentioned) you really only need to focus on practicing movement patterns (2 pure speech sounds with the movement in between). Now – typical speech therapy already targets many, many movement patterns. When working in a syllable, word, phrase basis. However, I think we often overlook one very important factor. This factor comes in when we begin working on consonant blends (consonant-consonant movement patterns). In most of my therapy life I have worked on consonant blends that only occur within a single word (ex. skip, slide, bread, bleed, green, cats, part, just, etc.). This usually consists of /s/, /l/, and /r/ blends (because those are usually the only consonants that combine with other consonants in the same word). But in connected speech made up of words, phrases, sentences, etc. we really have consonant-consonant combinations of all kinds. So why don’t we ever practice those combinations? For example… the sentence “I want more” actually consists of the consonant-consonant blends /nt/ and /tm/. As a therapist- have you ever taught a /tm/ blend before??? Well – usually with typical speech kiddos you don’t have to. But with apraxic kids you must!!! You cannot forget about all consonant-consonant blends or movement patterns.
So in conclusion – the best, and simplest way for a child to learn all things necessary to be a fluent speaker is to focus on movement patterns. A movement pattern consists of two pure speech sounds and the movement in between. And you must not forget about consonant-consonant movement patterns. ALL consonant-consonant movement patterns (not just those containing /s/, /l/, and /r/). These patterns are necessary in creating fluid and connected speech that sounds natural. It is only when a child is able to produce connected speech, without breaks between words, that they will be able to obtain the appropriate prosody in their speech.
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