Question
Hello, I have a 2 1/2 year old son who has apraxia. I am also a speech language pathologist. He is missing the short i and e sounds. Do you have any ideas on how to target these vowels? Thanks so much.
Answer
While limited vowel repertoires and vowel distortions are two frequently reported errors in children with apraxia of speech, I am a little confused as to whether your saying these are the only errors he has, or if they are just some of many errors? Most children with CAS that I have seen have significantly reduced phonetic inventories and many sound distortions, so if you are saying that these are his only errors, I would ask if you are confident that the diagnosis is correct? If he only has short vowel e and i difficulties, he's not only doing pretty well for a 2.5 yr old, but, if he hasn't been diagnosed by an SLP with extra training in motor speech disorders, he may not even have CAS. Something to check out.
Next, I'm wondering how much speech he has and how intelligible he is? Especially when a child is very young, it may be difficult, even for a qualified SLP, to make a definitive diagnosis if the child does not have a lot of speech. Plus, if he does not have a lot of speech, and/or is highly unintelligible, targeting short vowels may not be a priority as they will not go as far to improving intelligibility as perhaps some other more salient vowels or consonants would.
That all said, it is difficult to teach these sounds, particularly to differentially teach them. They are both front, lax vowels. /I/ is more front and closed, and /E/ is more mid-position and open, so one strategy might be to embed them into words with consonants that would facilitate these slightly different placements/mouth positions (i.e. put /I/ in a word with more front consonants, and /E/ in a word with more mid-back consonants). With an older child, you can use something like the Lindamood Bell vowel circle to visually show the placements of and differentiate among the vowels, but for a very young child, that would not be viable. Perhaps modeling them in slow speech in open VC words so the vowel is elongated, in an effort to make it more auditorily salient for the child would be helpful (eeeeeeeeeeeeeeeegg - for egg; or iiiiiiiiiiiiiiiiiiiiiiiiiiiiit - for it). Those would be my initial thoughts, anyway.
Good luck.
Sue Caspari, M.A., CCC/SLP, is a speech-language pathologist working in private practice in the Philadelphia area. She has more than 10 years experience working with children and adults with neurogenic speech and language disorders in early intervention, and hospital settings, including the Mayo Clinic. In her current practice, she works primarily with, and as a consultant and advocate for, children with severe speech production disorders. She has advanced knowledge and experience in the areas of childhood apraxia of speech (CAS) and alternative and augmentative communication. Sue conducts workshops on CAS, and speaks on apraxia of speech at national conferences such as the American Speech-Language-Hearing Association's (ASHA) annual meeting. In addition to her clinical practice, Sue works as an educational software development and marketing consultant. Sue is an associate member of the Academy of Nerulogic Communication Disorders and Sciences and a member of ASHA's Neurophysiology and Neurogenic Speech and Language Disorders Special Interest Division; is licensed in the state of Pennsylvania; and holds a Pennsylvania teaching certificate for the speech and hearing impaired.
