Monday, May 2, 2011

Ms. J and Magic

I haven't spoken much about Ms. J recently. She's the local apraxia expert we're fortunate enough to be seeing twice a month. We saw her again yesterday morning. She is so good. She has amazing one-on-one sessions with Ava. I shamelessly eavesdrop through the door. She takes my 26 month old little girl and gets her to work on her speech for 50 minutes straight and enjoy it the whole time.

She's also magical. I will go and she will tell me work on something (the one I remember most is "work on two-word phrases"). I will tell her, "Sure!" while thinking to myself, "Yeah, right! There's no way Ava will be doing that in the next two weeks, she isn't even close." Every single time, Ms. J has been right. Every single time. She was right about the two word phrases. She was right when Ava first started being able to imitate final consonants. She was right about using the hand signals.

Well, this time she told me to work on the /k/ sound. I've been trying off and on to stimulate a /k/ production from Ava. I'll say, "Say /k/." Ava will respond, "/t/". Every time. She just can't make a /k/ or /g/ in the back of her mouth. Think about it for a second. Try to explain how to make the /k/ sound. It would go something like this:
  1. Bring the back of the tongue up to the roof of your mouth so that you completely block all air flow from your mouth. Leave the front of your tongue down.
  2. Build up air pressure behind your tongue.
  3. Now, let the air out in a little explosion by dropping the back of your tongue down. If you do it right, it will make a /k/ sound.

Ok. Now imagine trying to explain that to a two year old. Just not possible. So, when we're trying to stimulate a sound a child isn't making we have to use indirect methods. Sometimes you're lucky and the child can imitate the sound even though they aren't using it on their own. Or sometimes it is a sound that is easy to see, like /m/, because you make the sound with your lips. Then you might be able to help the child make the sound by showing them how. But /k/ is made in the back of the mouth. You can't just have the child watch you.

Ms. J took an indirect approach to getting Ava to make a sound in the back of her mouth. Essentially she had Ava open her mouth wide. Then she used a tongue depressor to hold down the tongue tip which will often force the back of the tongue up. Ava hated the tongue depressor and was happy to open her mouth wide if only the tongue depressor stayed put away. Then Ms. J had Ava imitate a kind of growling, "scary" sound. With the mouth wide open and the head tilted slightly back, making that noise is a giant step towards making a /k/ sound because you're making a sound way in the back of the mouth by moving the back of the tongue up. That's the first step we needed. Hopefully over the next two weeks I will be able to use that technique to shape a true /k/ sound from Ava.

If you had asked me two days ago if I thought there was even a possibility of getting a /k/ out of Ava in the next couple of weeks I would have said, "No way, absolutely not." One visit with Ms. J later and I think there's a distinct possibility. Magic I tell you. Magic.


  1. That's really interesting about the /k/ sound - I got my son to say it the other day...of course I was bribing him with a cookie and showing him the sign and saying /k/ over and over again...he kept saying /t/ and eventually, it came out loud and clear and ANGRY! I had to cheer and give him his cookie. :) It also helps having a friend that has the /k/ sound in the beginning of his name - when he wants his friend, he will now go up to him and say /ka/ for Caden - baby least it's progress. :)

  2. I've definitely done the bribing thing too. :-) Early on, I could only get Ava to try to imitate by offering her froot loops.

    It's great you got a /k/ sound from your son. Ava doesn't have one at all yet. It's really hard to understand her sometimes when every /k/ is a /t/ and she just leaves off the ends of words altogether.

    Progress is good though, so I'm definitely not complaining.

    Good to hear from you, Gentle Blue!

  3. How do we find a Ms. J of our own? My grandson (27 months) has been diagnosed with moderate CAS. They recently moved; he loved his old therapist and she worked with him 2 times a week for 1 hour each time. He sat at the table and interacted for 1 hour. In his new city (in North Carolina), he is getting 15 minutes twice a week. Both situations were/are through some governmental program. He likes the new therapist. We want the best for him and would like to have a therapist who is an expert in CAS. Do you have any suggestions on finding a Ms. J for us?


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