Tag Archives: Kaufmann Cards

PROMPT Therapy – Session 2

Noah had another session with Marcus today. Noah is trying soooo hard to do the things Marcus wants him to do. I have to remind myself that Marcus doesn’t know how far Noah has come, nor can he really tell how difficult all this is for Noah. Part of what Marcus works on with Noah is getting his mouth positioned in exactly the right position for each sound. Then Marcus fine tunes the sound so that Noah’s sound productions sound 100% normal. It’s been amazing to hear some of the sounds and words that come out of Noah’s mouth without any impairment whatsoever. Noah has to work very hard with Marcus to get them out, but they are definitely in there.

I have a couple questions floating around in my mind. One is how much of this will carry over into Noah’s speech outside of therapy. If he can make a good word approximation for, let’s say, go, won’t he choose to make that word approximation that is obviously easier for him than going to the trouble to shape his lips correctly in order to form the word?

I think the answer to this will only come with time. I feel like my hands are tied behind my back because I can’t really replicate the kind of therapy Marcus is doing with Noah at home. I don’t have the know-how. Marcus says in time he will show me things that I can do at home with Noah, but for now the articulation therapy stuff all has to come from Marcus. He says we have a lot of work to do. Every individual sound that Noah is making he makes a compensatory ending sound to that is of equal force. We have to get rid of those compensatory sounds because they affect his intelligibility. He needs to move his jaw less and his lips more. I suppose the bigger feature, the jaw, is easier for him to control than his lips.

I am thrilled that Noah is getting this therapy now, even though it looks like he is going to have to unlearn some of the speech patterns he picked up over the last couple years.

Marcus did say something today at the end of the session that nearly took my breath away. He said something along the lines of if he did diagnose apraxia even when there were other underlying neurological issues, he saw a lot of evidence that would support that diagnosis in Noah. (Can you tell I’m trying really hard not to exaggerate anything?) He is seeing a lot of sequencing issues that are typical of apraxia now that he’s had a couple sessions to get to know Noah. I noticed today that he used some hierarchy approximations that reminded me very much of the Kaufmann apraxia cards Noah has done so well with. It was bittersweet to have my suspicions confirmed, and it just confirmed to me that Marcus is the right person to treat Noah, because he is identifying what I have been seeing for so long. PROMPT therapy is a very effective treatment for apraxia as well as other speech disorders, so at this point the diagnosis is not important – Noah is getting appropriate treatment either way.

Noah’s Courage

Our quiet little Noah seems to be coming out of his shell.  Our landlord was out here the other day talking to a contractor, and Noah ran up to him and signed deer and pointed.  When Noah wants something, he has no problem letting us know, and he has even been signing complete sentences like “I want milk, please.”  I think children with Down syndrome and other speech delays often communicate much more freely with family than they do with others, so seeing him run up to our landlord was very encouraging.

Noah also has started getting the final P onto some words.  Pup and pop are really the only words he can get that final consonant onto.  I can’t wait to see the progression, though.  Miss L, Noah’s SLP says he is following the natural progression of language development, which is excellent, he’s just doing it very slowly.  I love being able to understand just where he is in his language and what is around the bend.   He is also doing great with the Kaufmann cards; he progresses through the sounds exactly the way they progress on the cards.

The kitchen scavenger hunt PECs game I made for Noah has turned out to be a real winner.  I had no idea he did not know where so many things were in the kitchen.  We’ve played the game two times now, and today he remembered some of what he learned the first time.  I LOVE to see that!!!  So often in the past when I worked on teaching him something, like colors, every time we sat down to work it seemed like we were starting from scratch.  Eventually he started remembering, but it took A LOT of repetition.

I also made a third set of the cards and cut them up to play Memory with Noah.  We’re still playing with all the cards face up, but He and Bella really enjoy matching; and I figure when he is ready, it will be easy to transition to the traditional Memory Game method.  Being able to use the same cards in different ways is the BEST way for kids to learn and really internalize new vocabulary.

I’m still getting used to using the iPad to boost Noah’s cooperation and learning experience.  The motivation is high on the iPad, but he is getting frustrated easily. 

Today was Noah’s last hippotherapy session until September when the weather cools down.  I’m contemplating having him take a break from physical therapy until after Andres’ surgery.  It’s a tough call because his therapist says he is really starting to get into running and playing with her.  We have to take some time off anyway, because insurance won’t cover all 52 weeks of the year.  It’s just hard to know when a good time to take a break is.

Anyone wondering what Noah is doing while I’m writing this?









He’s supposed to be napping and was wanting to get up, so I told him to read to his stuffed puppy.  He’s “reading” to his stuffed puppy.  Awwwww.

Capturing Teachable Moments . . .

. . . even when they’re not what you were planning on teaching.

I realized this evening I really didn’t do preschool with Noah today, so I pulled out the Kaufmann cards and the iPad and sat Noah down at the kitchen table.  I found a cute little app with simple puzzles that I wanted him to try, and I thought it would be a good motivator for the Kaufmann cards.  The idea was he’d repeat one Kaufmann word three times and then get to click and drag one puzzle piece. 

Actually, it was working great, although for a few words he was so intent on the puzzle that he rushed the word and wasn’t interested in giving it his best effort.  On top of that, let me tell you, adding in a motivator like that means it takes a LOT longer to work through a stack of cards than the old-fashioned, sit and do nothing else  until you are done with this stack.  Although, come to think about it, the old-fashioned, sit and do nothing else until you are done with this stack usually elicits such a negative, whinny, I really don’t want to do this and I’m going to make sure you know it response, it may be that the time difference is really negligible.

The good news was that when helping him with the puzzle app, I got to reinforce the opposite pair “top and bottom” and introduce a new word, “corner.”  Noah is still figuring puzzles like this out, so I had to direct him a lot about where on the screen to drop the pieces.  I had an “aha” moment and realized “top, bottom and corner” were much better language-wise than “there.”  Catch that teachable moment! 

This was such a good reminder to me that when working with a speech-delayed child, if your priority is speech, never be so focused on other goals that you miss an opportunity to introduce new language.  Think “language” every moment, whether you’re trying to elicit speech in that moment or not.  (Whatever you do, don’t try to make your speech-delayed child speak during every teachable moment.  Receptive language, especially for children with Down syndrome and autism is just as important as expressive language, although our children are usually more delayed in expressive language than receptive.)

How about you?  How are you capturing teachable moments, and just what is it that you’re teaching?