Target Movement Gestures, Not Sounds in Isolation

Full transcript

Hi, it's Nicole coming in from the NYU Motor Speech Lab. Today I wanted to talk quickly about one of the harder aspects of making the shift into motor speech therapy that we're seeing come up a lot.

We talk about how we target words, and Dr. Strand refers to these words as movement gestures. The premise is being really thoughtful in how we select these targets, and we pull this information from our dynamic assessment. With these words, or movement gestures, what we're working on is the efficiency of the motor planning system. The idea is that the target words get better, but the child also gains the skill to then generalize to other words or movement gestures.

One of the hardest things we see in getting on board and making this shift is that clinicians are still thinking about sounds in isolation. We're still seeing goals come in for kids who have childhood apraxia of speech with a single-sound goal, like B in initial position, let's say. And I just want to explain quickly why this is not the way to go.

Let's say the target word we're working on is "bye." You see how my setup for the B in "bye" is very different from the setup for the B in "boo," which requires more of a rounded lip because there's that rounded vowel coming after. Or think of "bee": I'm now retracted.

So if I'm just thinking about B as a single sound, and I'm not thinking about the word, I'm really not helping this child if I'm only picking words that start with B. Working on "bye," and thinking about the entire movement gesture and that beautiful diphthong, is how...