{"id":299,"date":"2013-07-27T16:33:31","date_gmt":"2013-07-27T22:33:31","guid":{"rendered":"http:\/\/speechchick.com\/?p=299"},"modified":"2013-08-14T16:40:54","modified_gmt":"2013-08-14T22:40:54","slug":"a-systematic-approach-to-viewing-and-treating-apraxia-of-speech-part-three","status":"publish","type":"post","link":"https:\/\/speechchick.com\/?p=299","title":{"rendered":"A Systematic Approach to Viewing and Treating Apraxia of Speech: Part Three – The Movement Pattern Generalization Theory"},"content":{"rendered":"

Part Three: The Movement Pattern Generalization Theory<\/span><\/b><\/p>\n

Have I ever mentioned how much I love working with children with Apraxia???\u00a0 It fills me with a great amount of passion – the kind of passion that leaves me sitting awake quietly at night thinking, pondering, and praying for inspiration and guidance about how to treat it better.<\/p>\n

These late night brain storming sessions have led me to what I call the Movement Pattern Generalization Theory.\u00a0 While lying in bed one night I started thinking about kids with articulation and phonological disorders and comparing them to kids with apraxia.\u00a0 One of the main differences I have noticed about kids with artic\/phonological disorders and kids with apraxia is the \u201cgeneralization\u201d of skills.\u00a0 It seems to me that kids with artic\/phono disorders don\u2019t necessarily have to be taught how to say a sound in every possible articulatory context to learn how to use the sound correctly.\u00a0 They could be taught how to use a sound in a few contexts, with increasing difficulty, and that skill would generalize to other contexts.\u00a0 For example \u2013 if a child with articulation\/phonological concerns could say the sound \/b\/ and could say the sound \/eI\/ it is highly likely that they would be able to say the word \/beI\/ (\u201cbay\u201d).\u00a0 But what about a child with apraxia???\u00a0 A child with apraxia may be able to say the sound \/b\/ in one word, and the sound \/eI\/ in another word \u2013 but might still struggle putting those two sounds together to form the word \/beI\/ or \u201cbay\u201d.<\/p>\n

So my next question was why???<\/p>\n

Well, I wasn\u2019t sure.\u00a0 So \u2013 I read a bunch of research on apraxia \u2013 anything I could find (disappointingly there is not much out there).\u00a0 And I couldn\u2019t find an answer.\u00a0 But what I did find was a deeper clarification into the definition of the disorder itself.\u00a0 So \u2013 I ask you \u2013 what is apraxia of speech???<\/p>\n

Well, the definition is extensive, and to be honest \u2013 a little confusing.\u00a0 But \u2013 one thing stood out to me time and time again.\u00a0 We all know that apraxia is a motor speech disorder \u2013 right.\u00a0 But what does that mean?\u00a0 For me it works best if I change the word motor to movement.\u00a0 Apraxia is a MOVEMENT disorder.\u00a0\u00a0 So it makes sense that we should be targeting the movement \u2013 not just the sounds themselves.\u00a0 But how???<\/p>\n

Well, my initial thoughts totally overwhelmed me.\u00a0 I began thinking that since generalization is so limited in children with apraxia I was going to have to target every single word in existence in order for these children to speak.\u00a0 This literally made me cry.\u00a0 How would this be possible.\u00a0 It would take forever.\u00a0 And I really wished for a better way.<\/p>\n

Then \u2013 and this was during another sleepless night \u2013 it hit me.\u00a0 With this theory and these questions in my mind \u2013 I developed a systematic way to view and treat this disorder.<\/p>\n

So \u2013 this is the way I view apraxia now.\u00a0 For typical speech kiddos we just have to teach the sounds and the kids fill in the stuff in between (the coarticulatory movement or movement pattern).\u00a0 We teach them how to produce Point A (\/b\/) and Point B (\/eI\/) \u2013 and they fill in the dots between the two to make a word (\/beI\/).\u00a0 But for kids with apraxia we have to teach not only Point A and Point B \u2013 but we also (and most importantly) have to teach them how to produce the dots in between the two points.\u00a0 We are literally teaching the MOVEMENT.\u00a0 It is not so much about the sounds we are targeting \u2013 but the movement between the sounds.\u00a0 So, we don\u2019t necessarily have to explicitly target and teach every single word in existence.\u00a0 We just have to target the movement from one sound to every possible other sound.\u00a0 Take \/b\/ for example, we need to teach kids with apraxia how to move into a \/b\/ from every possible sound, and move out of a \/b\/ into every possible sound.<\/p>\n

Since there are 35 pure consonants and vowels in the English language this means that in order to produce \/b\/ correctly in every word possible, there are 70 total coarticulatory contexts to target (35 _b targets and 35 b_ targets).\u00a0 Targeting all 70 contexts would ensure success producing the sound in any word in the English language.<\/p>\n

If you are still confused \u2013 let me break it down for you a little more.\u00a0 Let\u2019s take the word \u201cbaby\u201d (\/beIbi\/.\u00a0 The word would be targeted by drilling each movement pattern found within it.\u00a0 Each movement pattern consists of two pure speech sounds and the movement between them.\u00a0 So… the word \u201cbaby\u201d has 3 movement patterns: \/b~eI\/, \/eI~b\/, \/b~i\/.<\/p>\n

But here came the biggest question.\u00a0 If I targeted each of these 3 movement patterns<\/i><\/b> individually and separately – would they generalize<\/i><\/b> to the overall production of the word (without the specific word being taught)?<\/p>\n

So I put my theory to the test.<\/p>\n

I worked with one of my clients with severe apraxia of speech – focusing on individual movement patterns <\/i><\/b>(2 pure speech sounds with the movement in-between).\u00a0 I taught these movement patterns individually and separately.\u00a0 After my client had demonstrated success on the individual movement patterns I then presented words\/pictures that combined multiple movement patterns I had targeted.\u00a0 And guess what\u2026 he could produce them.\u00a0 They generalized!!!\u00a0 I didn\u2019t have to prompt or help him. It was awesome!!!<\/p>\n

Now the next step in my \u201cquest\u201d (I guess you could call it) is to take it even further.\u00a0 I wonder if drilling only VV, CV, VC, and CC movement patterns would generalize to all syllable shapes\/words\/sentences\/etc.<\/p>\n

If so \u2013 this would mean we would not have to target every possible word in existence, just every possible movement pattern.\u00a0 And in so doing \u2013 every possible movement pattern would generalize into the correct production of every word\/phrase\/sentence\/etc.\u00a0 So far I have seen drilling only CV and VC movement patterns generalize to CVC, CVCV, CVCVCV, VCV, VCVC, and VCVCVC syllable shapes\/words.\u00a0 So\u2026 I plan to continue testing out this theory (so long as it is clinically appropriate \u2013 and shown to be effective).\u00a0 I also plan on updating you on the progress I see and changes I make.\u00a0 So don\u2019t forget to FOLLOW ME in my 7 post journey through Apraxia.<\/p>\n","protected":false},"excerpt":{"rendered":"

Part Three: The Movement Pattern Generalization Theory Have I ever mentioned how much I love working with children with Apraxia???\u00a0 It fills me with a great amount of passion – the kind of passion that leaves me sitting awake quietly at night thinking, pondering, and praying for inspiration and guidance about how to treat it […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[54,59,34],"class_list":["post-299","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-apraxia-of-speech","tag-movement-pattern-generalization-theory","tag-speech-therapy"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts\/299","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=299"}],"version-history":[{"count":3,"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts\/299\/revisions"}],"predecessor-version":[{"id":343,"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts\/299\/revisions\/343"}],"wp:attachment":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=299"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=299"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=299"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}