Join me for my first episode in Season 2 of the SLP Mommy of Apraxia Podcast as I talk to Breanna Waldrup, speech/language pathologist and director of the private non-profit Child Apraxia Treatment. We talk about her role as the director of the foundation, it’s mission statement and elements of Dynamic Temporal Tactile Cueing (DTTC) for the treatment of CAS.
You can now go about your day. If you are interested in reading more, I will summarize the research below.
NDT stands for neurodevelopmental treatment. It was created by a physical therapist named Berta Bobath and her husband as a treatment for cerebral pasly (NDTA, 2005). According to (Paris, B. Theoretical Base of NDT), the Bobath’s believed that movement is not learned. Rather sensations of movement are what help children learn effectively.
Since that time, it’s been researched since it’s conception primarily in the physical and occupational therapy realms. More specifically, with cerebral palsy and gross motor skills. I found no information related to NDT for childhood apraxia of speech. There was one paper that did a relational study looking at the effectiveness of NDT on gross motor function with children who had cerebral palsy and a general developmental delay. The criteria for developmental delay though was loose and it’s not clear if these children had a diagnosed motor planning disorder as in developmental coordination disorder (Lee K.H. et al, 2017)
The most recent and up to date summary article on NDT was done in 2018 by Besios and colleagues. The conclusion,
This does not even address children with dyspraxia, developmental coordination disorder or CAS.
Research does show that many children with CAS can be at risk for motor impairments (Iuzzini-Seigel, 2019). However, it is out of the scope of a PT or OT to be treating childhood apraxia of speech.
In a 2014 systematic speech review by Murray et.al, it states,
Speech production is a complex motor skill with extraordinary spatiotemporal demands, requiring coordination across many different muscle groups.
The review looked at 42 articles and 90% made explicit reference to utilizing the principles of motor learning.
A recent 2020 review done by Springle and colleagues found,
Findings of six systematic reviews, two of which were conducted with relative rigor, suggest that motor programming treatments have the best evidence base for treatment decisions pertaining to CAS. Clinicians are referred to online resources to implement these treatments according to published protocols.
In short, NDT is not a recognized treatment in childhood apraxia of speech. CAS is a lifelong neurological disorder affecting the planning and programming of the movements needed for speech. As such, the best approach according to available research is treatment incorporating the principles of motor learning.
Laura Smith, M.A. CCC-SLP is a 2014 graduate of Apraxia Kids Boot Camp, has completed the PROMPT Level 1 training, and the Kaufman Speech to Language Protocol (K-SLP). She is the author of Overcoming Apraxia and has lectured throughout the United States on CAS and related issues. Currently, Laura is a practicing SLP specializing in apraxia at her clinic A Mile High Speech Therapy in Aurora, Colorado.
We are currently in the middle of the COVID 19 pandemic. I have two children. A daughter 10 who has a host of disabilities, and my son 7 who is neurotypical.
They are currently in my son’s room in his bunk bed having a sleepover. He made sure to change out the batteries in a unicorn light she has, and helped her make the bed extra cozy.
The kids haven’t played with friends at school or in the neighborhood for a month now. It’s very hard on them. I actually didn’t know how hard though until one night this week after dinner. Jace my son, had been able to connect with his school buddy via fb messenger. He was giddy. In a random moment he told me,
“Grownups don’t understand how hard this is for kids.”
Tonight we had just returned from a walk and I was watering the flowers and grass. My children were racing their scooters with a neighborhood kid down the road making sure to keep 6 feet apart. It was pretty cute. I think my kids actually know what 6ft means now.
As I said, I was watering the lawn when I heard loudly,
Silence filled the street. I immediately looked up. My son had said that to a neighbor kid who was racing them.
The kid innocently asked, “What does that mean?”
Jace said, “It means there is stuff she can’t do that I can do and I’m her little brother.”
Time for me stood still.
No one spoke. I held my breath.
Then they all returned to riding as though nothing had happened!
To say pride filled my heart is an understatement.
I can say honestly I hate this pandemic. There is so much to hate in life right now I could write an entire blog. However, there is so much good!
My kids have sleep overs with each other and love it! My kids love each other! My kids STAND UP for each other. We are a family and we have made the best of a hard situation. We play games. We ride bikes. We take walks.
However what gives my heart the most pride, is Jace advocating for his sister.
At bedtime tonight I caught him alone and asked if he told someone Ashlynn had a disability. He seemed worried and started explaining before I interrupted and said it wasn’t his fault.
I praised him for defending his sister by speaking the truth, and he gave me the biggest bear hug.
Oh my little buddy. I feel so bad so much added pressure is on him. That being said, I will order my son a shirt that says “Advocate like a brother” because that is exactly what he does.
When you have a special needs child, you realize you have to teach the world about them. When you have an Ashlynn, like I have, you realize Ashlynn has something to teach the world.
I had never considered two very important words to the human body called “motor planning” that if impaired, affect everything a person goes to do.
I never thought my child would struggle to speak. Struggle to walk. Struggle to run or skip. To read. To write. To pay attention. To understand. I never expected any of these things and when they came each one felt like a small storm over my life. Did you notice I said MY life. That’s because even though the storm was happening to Ashlynn, she has never acted like there was a storm.
Ashlynn has always attacked every obstacle with a smile and positive attitude. And because of this, she has grown, thrived and conquered.
I am human and have hurts, pain, disappointment, fear, anxiety or trepidation. Each time I have though I look at my daughter who has every reason to have a negative attitude, yet she never does. She has some natural superpower to turn lemons into lemonade.
Though I try to shelter my kids from the news to reduce anxiety, it is somewhat unavoidable. Though they have taken daily bike rides with dad and walks with mom, the obvious cloud of social distancing hangs over our heads. The days blur. Ashlynn has said numerous times she misses her teachers and has shed tears. Always though and I mean ALWAYS, she will follow it up with a “but.” For example, tonight taking a shower she said,
“This is hard mommy. I miss my teachers because of the corona virus.”
I acknowledged that it was very hard but reminded her we do hard things. She always responds with a “but” that bridges to a positive. Tonight it was “I miss them BUT we can zoom them and see them that way and next year in 5th grade I will see them again.”
I smiled. A song somewhere in my memory bank played “always look on the brighter side of life.”
I have to admit that so many times I want to say no. Even though my intellectual brain knows exercise is the best medicine, I have an internal protest. However, I never regret going. Today she tripped over something because she was staring at her fitbit and she burst out laughing. She was in hysterics that she rolled her ankle because she wasn’t paying attention. Girlfriend has ADHD and dyspraxia that contributed and instead of getting upset, she laughed at herself. And her laugh isn’t a simple laugh. It’s full and rich and contagious.
I thought I would teach my child about the world, but turns out she had something to teach us. My sister once said she spreads sunshine wherever she goes and I can attest this is true. Keep shining Ashlynn Kay, the world needs your light.
Captain’s log Colorado United States, Planet Earth Day 2 of Social Distancing.
I joke, only kind of. I was a big Star Trek geek when I was younger and I can’t help thinking the current pandemic is a new frontier.
The COVID-19 AKA CoronaVirus of 2019 has infiltrated the world to a level I have never witnessed during my time as a passenger on cruise ship Earth.
This is a letter to “my tribe.”
My social media tribe or should I say TRIBES.
Social media gets a lot of criticism, but to me social media when used properly is a gift. It’s all about perspective.
No one nationwide, make that worldwide is immune to current events. It’s easy to go down the pat of fear and uncertainty and think the worst, feel alone, or worst yest, develop contempt and an “us versus them” attitude.
My tribe is not location specific. Thanks to social media I have many, many tribes that span the globe through a shared experience.
The COVID-19 experience is worldwide. It’s global. We’re all in this together. It is a common enemy that does not see country, policy, ethnicity, or socioeconomic status.
We are ALL in this together. It is prudent to follow the advice of health experts, and at the same time I”m grateful for platforms that remind us of our shared humanity in any corner of the Earth and connect us to this shared and blessed experience of being human.
Though you may be part of many tribes that foster connection and unity, may we all not forget that we are all part of a worldwide HUMAN tribe and remember we will get through this together.
Much Love,
Laura
Laura Smith, M.A. CCC-SLP is a 2014 graduate of Apraxia Kids Boot Camp, has completed the PROMPT Level 1 training, and the Kaufman Speech to Language Protocol (K-SLP). She is the author of Overcoming Apraxia and has lectured throughout the United States on CAS and related issues. Currently, Laura is a practicing SLP specializing in apraxia at her clinic A Mile High Speech Therapy in Aurora, Colorado.
Normally on this day my social media news feed is filled with jokes and memes about Pi day. Today though, I never even thought about it until I saw a faint shadow of a meme posted hiding in the onslaught of posts regarding the CoronaVirus – aka Covid-19.
I am 39 years old. In that entire time I have been exposed to the Gulf War and Desert Storm, SARS, 911, The Great Recession of 2008, H1N1 otherwise known as the “swine flu” that struck the country when I was giving birth to my first child in 2009.
I remember the “swine flu” vividly because children were not allowed to be visitors in hospitals during that time, and my niece was distraught she couldn’t come hold and cuddle her new baby cousin.
In uncertain times, it’s easy to solely focus on: Fear. Worry. Uncertainty.
If being a mom to a child with apraxia and related disabilities has taught me anything, it’s that I’ve lived and have been living with all of these things already. That is the reality of having a child with unique needs.
It has also taught me, that no matter WHAT the challenge, together, as a family, we can of course take necessary and sometimes uncomfortable measures, but at the end of the day, we keep our focus on joy, love, faith, and family.
Laura Smith, M.A. CCC-SLP is a 2014 graduate of Apraxia Kids Boot Camp, has completed the PROMPT Level 1 training, and the Kaufman Speech to Language Protocol (K-SLP). She is the author of Overcoming Apraxia and has lectured throughout the United States on CAS and related issues. Currently, Laura is a practicing SLP specializing in apraxia at her clinic A Mile High Speech Therapy in Aurora, Colorado.