Question
How can I address social interactions with a child who is apraxic? What are some techniques that you use/incorporate to help the child communicate in social situations?
Answer
First, I would see where the most frustration is occurring. For example, if the child is not getting his or her turn when playing with peers, I would work on a functional phrase, such as 'My turn now.' The child should also learn the phrase with various tones. At first, the tone should be pleasant, but if no one is listening, an assertive tone will be useful. If the child is not sure if it is their turn, they can also practice it in a question form (rising intonation). This allows the clinician to be working on prosody as well as the functional phrase for a variety of situations.
I know of a wonderful school SLP who has a lunch club and she meets with a group of kids to work on pragmatic skills during lunch. This is useful for children with CAS as well as other communication disorders. She also goes out to the playground to see where communication breakdown occurs. If she sees her student with CAS using more physical communication than is acceptable, they work on phrases that give him a social script for more appropriate interactions. In this case, the child has the motor speech skills to obtain these phrases. If a child does not, then the clinician, family and school should discuss the use of an augmentative device to assist in social situations as well as academic.
Dr. Amy Skinder-Meredith received her doctorate from the University of Washington and her M.S. from the University of Arizona. She is currently an assistant professor at Washington State University Pullman. Her primary clinical and research interest is in children with motor speech disorders, and she has published and presented her research on childhood apraxia of speech (CAS) at national conferences.
Amy Skinder-Meredith, Ph.D,CCC-SLP
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