by Nour Hassoun, Jordan
Use Their Secret Powers
Searching and guiding kids to use their secret powers is the golden key to reach the best progress in the optimal time. Our champion will give you an example of using his secret powers to overcome his challenges and facilitate his ability to communicate for different functions.
Our champion started his journey with multiple challenges in the physical, language and social emotional domains. At 3 years of age, he was enrolled in an intensive speech-language and occupational therapy program. We started on a level where receptive vocabulary was a strength, nonverbal gestures were his way to communicate, his poor body awareness was affecting his attentiveness, and his inability to comply to instructions was affecting his use of vocabulary.
At this phase, our aim was to get him regulated, attentive and engaged to be ready to acquire provided skills. The secret power in this phase was his obsession in songs. While we were singing and dancing, we imitated the songs movements, vocalized to request and pretended variety of actions. Now our champion is engaged and attentive to open different circles of communication to request or protest using his voice.
And Here Where the Surprise Was!!
Our champion was not just vocalizing, he was using words and utterances to communicate. However, without using his articulators. A closer look at his speech indicated adequate production of vowels, limited speech sounds repertoire (/m/ and /n/) with limited sequences of motor movements, and glottalization of all stops. In addition, consistent hypernasality was noted with no history of cleft palate. These observations indicated his inability to move his articulators precisely in the correct sequence for speech (motor speech planning and programming) and a suspicion of non-cleft velopharyngeal insufficiency.
The Second Phase of Our Journey Started!!
Our aim in this phase was to expand his speech sound repertoire and use them adequately in the correct sequence for speech in addition to eliminating compensatory misarticulations (glottalization). The secret power was his ability to read at that young age and that he is a visual learner. Therefore, the most visible and stimulable sound /m/ was the best target to start with, moving to other bilabials and reaching lingual sounds. Video modeling of how each articulator is used in speech, and speech sounds cards cues were used as teaching methods with tactile and auditory cueing as needed. Accompanying to verbal communication, an AAC app was introduced to manage the frustration resulted by his unintelligible speech.
A Long Journey Ahead of Us!!
Our champion is 5 years now. He uses his AAC app to express his needs aiming to expand and practice his social communication skills in different situations with his peers. He has the sounds /m/, /n/, /p/, /b/, /t/, /d/, /k/, /∫/, /f/ /w/ and /h/ in his repertoire which increased his overall intelligibility. However, this increase revealed new challenges to face such as substitution of all fricatives with pharyngeal fricatives inconsistently and the processes of fronting and backing depending on the syllable structure of the word.
Looking forward to reaching the day where our champion is using his full communicative potential to connect with people and the world around him