Children with apraxia or phonological disorders need to imitate new words many times to learn the correct motor plan. Sometimes these children will be mostly non-verbal and may not even try to imitate sounds during therapy sessions. If the child has severe apraxia, he/she may not be able to volitionally vocalize yet. In other cases, children may be aware of the fact that they can’t correctly imitate sounds or that no one understands them when they try to talk. These kids may lack the confidence to try new sounds/words or may get frustrated to the point of shutting down very quickly. Here are some tips for working with non-verbal kids who don’t often try to imitate sounds:
- Introducing signing or an AAC device- You can teach children some power words, like “go, stop, all done, more, help” using sign language, pictures, or a voice-output AAC device. This will show kids the power of communication and teach them that they can use language to control their world. It also reduces frustration because kids are able to communicate some of their ideas and reduces pressure because kids are able to be successful with a communication skill. It’s important to try many different methods of communication to see what works best for your child. One advantage of using a voice-output AAC device is that the child will hear a verbal production of the word each time he/she uses the device.
- Play in front of a mirror- Some kids may not imitate sounds during the first couple of sessions. You can start by imitating gross motor movements or oral-motor movements in front of a mirror. You might have the child imitate clapping your hands or opening his/her mouth. Once the child imitates a variety of movements, you can start adding sounds to motor movements that the child imitates confidently. For example, touch your nose and say “ah” at the same time. The child may be willing to try vocalizing because it’s part of a game that he/she has already had success with.
- Use puppets- Play with puppets and have the puppets make simple sounds. You can open the puppet’s mouth widely and say “ah” or make the puppet eat silly things and say “mmmmm.” You can also pretend to tickle the puppet and say “ha ha.” Or make your puppet pretend to sneeze loudly and say “ooo” or “ah-ooo.” Give the child his/her own puppet and see if the child will try to imitate some of the sounds.
- Record the child’s voice- Many children enjoy hearing their own voices. You can make an audio or video recording of the child. If the child sometimes vocalizes spontaneously during play when there is less pressure to talk, it might help to record the child during play without his/her knowledge. Then you can watch/listen to the recording together and you can praise the child for using their sounds. There are also some great free I-Pad apps, like Talking Tom or Talking Ben, where animals will repeat any sounds a child makes using a funny voice.
- Sing “Row, Row, Row your Boat”- Sing this song using the lyrics “Row, row, row your boat gently down the stream. If you see a crocodile, don’t forget to scream! AHHH!” After you finish singing, scream and do something silly like waving your arms around or tickling the child. Then, sing the song again and pause after you say the word “scream.” See if the child will scream or vocalize to finish the song.
- Sing or hum the child’s favorite songs with microphones- Give the child a microphone and sing or hum songs. A lot of children enjoy hearing their voices through a microphone. You can get cheap echo mics from dollar stores or toy stores. Apraxia-kids.org sells a wonderful CD called “Time to Sing” specifically for kids with apraxia or other speech disorders. The words in the songs are slowed down to make them easier for kids to produce.
- Play an airplane game and fly your child around the room- If the child is small enough, you can pick him/her up like an airplane and fly across the room. Make a simple sound while flying the child, such as “ahhhh” or “puh.” You can vocalize slowly while you walk slowly with the child (“puh….puh….puh….puh”) and then start walking more quickly while you vocalize quickly (“puhpuhpuhpuh”). You could also whisper as you hold the child closer to the ground (you could use a vowel such “ah” or “uh” or make an “m” sound) and then raise the child up higher as you make the sound more loudly. Then stop moving and see if the child will vocalize to get you moving again.
- Use sound activated toys- You can buy sound-activated toys that move or turn on when the child vocalizes. Here is a sound activated crab: http://www.beyondplay.com/ITEMS/C255.HTM. This type of toy can be very motivating and fun!
I hope these ideas help!