Helping Children Find Their Voice

Therapy for Childhood Apraxia of Speech

South Central Rehabilitation Services | 1002 Jefferson Street, Laurel.

Feature written by Kristie Reddoch, Journalist, Impact

In the heart of Laurel, MS lies South Central Regional Medical Center which offers various services and clinics to its surrounding communities. One of those services offered by SCRMC is that of Speech Therapy and Rehabilitation which has become an important and life changing aspect in many of its patients’ lives, but especially for the Knight family from Collins, MS in the life of four-year-old Judah Knight.

Heather Knight, wife to Justin and mom to Judah and his older brother eight-year-old Joshua, shared how they found their way to SCRMC’s Speech Therapy program.

“Our journey here started about two years ago. We found out when Judah was two-years-old that he had a tongue and lip tie.”

Knight’s motherly intuition had kicked in early, which led her to initially bring her concerns to their pediatrician.

“I felt like Judah was not speaking as much as I thought he should be, especially with having an older son, just seeing Judah’s journey versus Joshua’s. I know all of them develop differently, but I brought it up to my pediatrician and he was a little concerned, so he went ahead and did a speech referral.”

The Knight family’s journey with speech therapy began at a private practice where they confirmed Judah’s tongue and lip tie. However, not too long after undergoing regular speech therapy appointments and evaluations, even after correcting the tongue and lip tie, Judah’s speech therapists thought he could possibly have something called Childhood Apraxia of Speech (CAS).

“Basically, what that means is in Judah’s mind, he’s saying everything just like it should be, and it does not come out that way,” Knight explained. This leads to things like deletions in speech where certain sounds or consonants are left out making it difficult to understand.

The Knight family had a connection to SCRMC through their friend Janna Tyler, M.S., CCC-SLP, ASDCS, who works there as a speech language pathologist, so they reached out to her to ask if she knew of anyone in her department who had experience working with CAS, and this was how the Knights initially connected with Judah’s current Speech Language Pathologist, Sherri Davis, M.S., CCC-SLP, ASDCS.

“We call it a motor planning disorder,” explained Davis, providing more detail about CAS, “because the plan from the brain to the mouth doesn’t get through in completeness. When the plan from his brain says, ‘This is how you say that word,’ his mouth can’t coordinate it. And it’s not just in words, it’s mostly in things that go together. We don’t work on single sounds or single words because that’s not how we talk. We talk in phrases and sentences, so we need to be able to move from one sound to the next one. A lot of times our kids with apraxia either can’t or the movement is disjointed, so we work on trying to help them from sound to sound.”

Davis, whose original degree is in Psychology, decided to pursue Speech-language Pathology after working at Ellisville State School for several years.

“A lot of the behaviors that we saw in our persons there were related to their inability to communicate effectively, and so when Dr. Rich Saniga was a consultant down there and was a professor at USM said, ‘Hey, I think you should look into speech,’ I did. Then I got in and I found out that I love it! It’s not always easy, but it keeps me engaged. There’s something very rewarding about helping somebody to be able to communicate effectively in their life.”

“I tell her almost every week she is just a God-send,” stated Knight. “I don’t know how else to put it.” Knight has a background in education as a teacher and currently homeschools her two boys full-time. Her teaching experience has given her tools to help teach her kids as they develop, but with never having heard of CAS, Knight felt ill-equipped to provide the right kinds of tools her son needed. However, seeing the progress Judah has made with Davis has made all the difference in the world.

“At first, therapy was rough, as you can imagine, with a two-year-old. But after about six months, he was so excited about coming here, and looked forward to it every week. I would go back with him, but I just stopped that six months ago because he finally said, ‘Mom, I can do this myself.’ Just seeing Sherri work with him and how patient she was with him, but also challenging him and giving him—through play and games—things to focus on, those skills that he was lacking, those deletions, those consonants, and try different ways to get it to where even if it wasn’t the exact sound it should make to make it understandable. I’ve just seen such a growth in him, especially the past six months.”

Davis explained how the beginning of Judah’s journey was more about building that relationship of trust.

“A lot of kids that have apraxia, because they’ve had such failures with communication, they don’t want to talk. They don’t want to talk around somebody that doesn’t know them, who can’t figure out, and who won’t take the time to figure out what they’re saying, so that’s one reason he wouldn’t talk to me when he first came is that he’s had a hard time with it.”

Nowadays, Judah is able to have conversations with people, and he loves talking with them. On this particular day, he shared stories about the new family dog named Butters, and Davis shared how Judah has progressed using the example of the word “Butters.”

“We worked on getting all of those syllables in there because Butters is ‘Buhs’, so we work on saying ‘Butters.’ So, although he’s made tremendous progress, there’s still things that I have to just remind him.”

Perhaps one of the best examples of Judah’s progress through speech therapy is that he is now able to say his brother’s name, “Joshua,” whereas when he first came in, what came out was, “Ha.”

Davis talked about the importance of continuing education in her field as not everything she knows and practices today came from everything she studies in school.

“All of us here do a lot of continuing education, and CSA is one of the things that I started learning about. I don’t just learn from one person. I’ve taken several courses on it to learn different ways because you want to make sure that you’re helping each child where they are, and getting the most success with what you use with them. So, what might work with one kid might not work with another one, so you just kind of have to see how you can help them best.”

Davis also shared some common symptoms of CAS that parents can be on the lookout for if they suspect their child may have something like CAS.

“Sometimes when they’re very young, they don’t babble a lot and don’t make a lot of sounds. Sometimes when we look at it, we see there’s inconsistent errors. So, they may say a word three times and say it differently every time they say it. Sometimes you see them, their mouth—we call it groping—but their mouth or their tongue or lips are trying to find the way to form, to say that sound, or to say that word, or to move from that sound to the next sound.”

Davis also explained how it can be common for children with Childhood Apraxia of Speech to have other forms of Apraxia such as Limb Apraxia or Oral Apraxia. Thankfully, SCRMC’s location in Laurel has Physical Therapy, Occupational Therapy, and Speech-language Therapy all together so if other forms of therapy are needed, the therapists are able to work together to help accomplish a unified, related goal with each therapy session to help each patient progress.

While there is no known cause for CAS, people like Davis at South Central Rehabilitation Services are making it their mission to learn as much as they can in effort to help as best as they can. CAS is rare, but Judah’s story is one of hope and encouragement.

“Seeing him grow so much and seeing his strength throughout this process has given me strength,” stated Knight. She offered some encouragement to other moms and parents out there who may be going through something similar.

“Don’t ever give up trying to find what’s best for your child. Don’t ever ignore your mom gut instinct. Always mention it, get it checked out, give yourself peace of mind, and if there is something that needs to be addressed, give it all you’ve got because in the long run it’s going to pay off for both of you. It has meant so much to us to be able to have somewhere local where they care about us, and care about my child.”

Judah’s story is also one of answered prayer.

“In the past six months, that development of being able to do his consonants and do his words and his speech has just exploded. I tell everybody we have prayed for two years for him to talk, and now he talks 90 to nothing! So, some days it’s like, ‘Did we really pray for this?’” stated Knight with laughter. “My husband will come home after being at work, and I’ll be like, ‘Okay, I need like five minutes where no one’s talking to me.’ It’s so good. So good.”

South Central Rehabilitation Services offers a variety of services, including physical therapy, occupational therapy and speech therapy. If you know of someone who is experiencing speech-language delays, help is available locally. A physician referral is required. For more information about the program, please call 601-399-0530 or visit scrmc.com.