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Rapport in Apraxia therapy

Nov 11, 2022

Rapport is an extremely important part of Apraxia therapy

Therapists are always asking how I elicit a lot of repetitions in apraxia therapy.  Well, having a good rapport with the child is a good start.  Rapport is an extremely important part of apraxia therapy.  I believe in it so much that in my apraxia course I list it as a pre-cursor for therapy.  Many children that come to us for apraxia therapy have already received therapy and did not make sufficient progress.  This is not to fault the previous therapist in any way.  Many young children start receiving language based speech therapy between 2 and 3 years old and it may take some time to suspect that the child has childhood apraxia of speech.  So by the time child starts receiving motor based speech therapy, there may be frustration and poor self confidence.   Taking the time to develop rapport and trust will set up the therapy for success.  The child will trust you to help them produce the sounds accurately.

What are some ways that you can build rapport? 

  • Give the child choices of toys and activities.  This does not mean that it has to be a free for all.  I take out a few toys from my closet and have the child choose.  Choice make the child feel that they have some control and everyone like choice.  And practicing your target words in a preferred activity will lead to increased engagement and learning. 
  • Choose your target words carefully which will help the child be successful and build their confidence. 
    • Power words.  Meaningful words will keep the child motivated. 
    • At the beginning it is important to keep the target word list small so that the child can learn to produce some functional words quickly. 
    • Choose words with sounds that the child already has in their repertoire.
    • Provide cueing that helps the child produce the word accurately. 

And don't forget the you have to constantly work on maintaining that rapport.  As the child's skills grow, it is important to keep adding new words and syllable shapes.  However, this can also cause stress for the child.  So what can you do if you see that a particular word is difficult for the child?  Firstly, acknowledge that the child is working hard and that it is difficult.  Then remind the child that you are there to help them succeed.  And, sometimes it is okay to stop practicing that word for that session and practice other words that the child is successful with. 

One more thing to keep in mind.  The child may be having a difficult day or just tired.  Pushing the child to do more than they can do will set you up for failure. 

Therapy is a marathon, not a sprint.  So take the time to build that relationship and to nurture it along the way.

Click here to receive a handout on building rapport with your clients

Free Target Selection Handout for CAS

Learn how to choose target words for minimally verbal children, understand

multisensory cueing, and other do's and don'ts in apraxia therapy.