Tag Archives: PROMPT therapy carryover

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.