New term. New goals. New sounds. Thank goodness. As I told Miss Sally, your speech therapist, “I’m all effed out.” Yep. Been doing /f/ words for too long now and I’m sick of saying, ”Bite and blow.” F-initial, f-middle and f-final. Time to move on.
Miss Sally tells me we’re going to try /k/ because that will increase the intelligibility of your speech. But it could take two years to master as it’s a tricky sound for kids with apraxia. She pulls out a tongue depressor and pops it on the front of your tongue and asks you to say /k/. After a few goes, you can do it! In fact, you grab the tongue depressor and start pressing down on your tongue with it while repeating /k/, /k/, /k/. You’re like a gym junkie pressing weights. Miss Sally then gives you a few words with the /k/ sound on the end. The tongue depressor gets popped into your mouth at the end of the word to elicit that elusive /k/. And you do it well. You are very happy when you are given your very own tongue depressor to take home to practice with. Within a couple of weeks, we don’t even need the tongue depressor anymore!
Miss Sally also decides to try some /s/ blends. Usually your /s/ gets dropped at the start of words with an /s/ blend, so ‘snake’ becomes ‘nake’. Up to this point you have never been able to produce blends. Yet with the help of a picture of a snake to remind you to say /s/ followed by another picture, you are soon saying a few words with /s/ blends – spot, spoon, snow, sneeze, sneak.
I leave feeling real proud and elated. You, my little superstar have reached two speech goals in one session – a difficult throat sound and your first blends. I want to tell everyone, but know they will think I’m crazy to be so excited over these little steps in your speech development.
I think Childhood Apraxia of Speech is like a puzzle. Each piece of the puzzle is a different speech sound. At the start, we only had a handful of pieces. We’ve had to find and add in more pieces along the way, gradually building up your repertoire of sounds. Each piece may need to be worked on and fine-tuned for weeks or months before it fits securely into the puzzle, only to pop out again at obscure times. Then we have to link each sound to the others, creating all the sound connections needed – /m/ is not learnt in isolation. We also have to practice /ma/, /me/, /mo/, /moo/. Initial, middle and final sounds must all be mastered in simple CVC words. Two and three syllable words are practiced slowly to get the right sound transitions and later to get the right emphasis. All the puzzle pieces are intricately connected in an even more complex way than those 3D puzzles.
The intricacy of speech. I think it’s amazing. I never realised how complex the movements are that our mouths, tongues and lips do to produce speech until I had you, Noah. It’s a wonder any of us ever learn to talk without intense help. We’re so unaware of the complexity of speech when it comes easily to us. But you’ve had to learn the intricacy of the movements from scratch. At the start, you had vowels and /m/ and a lot of /d/ – so many words were “da”. Whilst the puzzle is not complete yet, we’re adding more pieces and making more connections with the guidance of your speech therapist and the hard yakka of daily practice. In years to come, you may not even remember the struggle or the hours of practice. You’ll simply have the completed puzzle, perhaps with a few missing pieces and the ability to produce speech as effortlessly as most people. I will smile and remember the work that went into putting that puzzle together and the special bond we’ve had because of it. Together we’ve learnt a language that goes beyond love.