When teaching a new word, please don't segment!

Segmenting is when you teach each sound in the word separately. It creates robotic speech and does not help the child move between the sounds.

Apraxia therapy is all about movement.  Children with childhood apraxia of speech have difficulty moving from one sound to the next.  

When teaching words, especially two syllable words, it is tempting to segment, to separate the sounds in the word to make it easier to elicit imitation of all the sounds in the word.  However, segmenting the word creates unnatural speech and does not solve the problem.

So how do we work on helping the child produce all the sounds in the word without segmenting?

We need to use multisensory cueing to help the child move from one sound to the next.  The most valuable technique is called simultaneous productions (part of the DTTC hierarchy), which is having the child say the word together with you. 

The child needs to watch your mouth and stay in the movement with you.  It's important that you both start saying the word together and then continue through the word, by stretching the sounds, particularly the vowels, as you move through the word. We initially start with a slow rate, which helps the child feel the movements, and then move to a natural rate of speech. 

IMPORTANT: Make sure that the child starts with the articulators in the right place. This is called initial configuration, and sets the child up for success.  For example, if the first sound in the word is an /m/, cue the child to start with his lips together.  

There is another very effective cueing technique called forward and backward chaining that involves pulling the error sound out of the word, practicing it accurately, and then putting it back into the word. 

Click here for a link for more information about forward and backward chaining.

Click here for a blog post with more information on movement.

When is segmenting words okay?

Children with CAS often have difficulty with reading, specifically their phonological awareness skills.  This includes the ability to break apart the sounds in a word and put it back together.  We often need to include phonological awareness skills in our therapy to help them succeed with reading. It is important to help the child produce the word smoothly after segmenting it.

Check out readingrockets.org for more information on building phonological awareness skills.