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Finding the Words

New speech therapy provides touch cues to help young boy articulate words.

Gage.jpg Five-year-old Gage Wallace is full of energy and is eager to learn.

When the Tuscola kindergartener arrives for speech therapy at Sarah Bush Lincoln, he scampers to his desk and quickly engages in interactive games. He does his best to answer questions asked by Speech Pathologist Michelle Meyer, but he gets frustrated when the words don’t come.

Gage is keenly aware of the words he’s expected to say, but he struggles to say them. He was diagnosed with autism spectrum disorder and speech apraxia at a very early age. Both disorders limit his ability to speak. “It’s frustrating, as a parent, because people assume that because he cannot talk he’s not intelligent. But that’s so much not the case! I think that’s what causes him the frustration,” Melissa Wallace, mother of six, said. In fact, Gage is already reading and he’s academically advanced. “It’s hard to watch him struggle with things that seem so simple,” she said. “There’s so much we take for granted in being able to speak and have conversations.”

While Gage has made slow but steady progress with traditional speech therapy since beginning in September 2012, his parents are hopeful that a new therapy method will accelerate his progress. In June, Gage started PROMPT® speech therapy sessions with Michelle, after she completed a specialized training in the new technique. 

PROMPT® “Prompts for Restructuring Oral-Muscular Phonetic Targets” is a language-based technique that uses touch or tactile/sensory cues to the lips, tongue and jaw to help children feel how their mouth should be moving when they say a word or phase. The technique develops motor control and proper oral muscular movements, while eliminating unnecessary muscle movements.

Michelle analyzed Gage’s speech to determine which motor patterns he would need to work on. After developing a therapy plan, she started using touch cues to manipulate Gage’s lips, tongue and jaw to help him understand the movement required to produce specific sounds. Such sensory input helps Gage build muscle motor memory, which makes the movements more automatic over time. Michelle repeats target words or phrases in unison with Gage to provide auditory input, as well. 

“It’s a whole new approach to therapy,” Michelle said. While traditional speech therapy relies on auditory and visual systems to provide information about sound production, PROMPT® therapy adds another dimension by adding sensory input. “I feel like it takes every aspect of communication and wraps it all up into one approach,” she said. “We analyze the child’s cognitive linguistic skills, social skills and motor skills, and we work on all of them at the same time.”

PROMPT® therapy sessions differ from traditional therapy sessions since traditional therapy relies heavily on repetition and PROMPT® therapy stresses speech production that happens in functional situations, Michelle explained. “I look for activities through which I can get those repetitions, but we’re also doing something with it and not just drilling,” she said. 

In a recent session with Gage, Michelle pulled out the book “Go Away Big Green Monster” to work with him on articulating his vowel sounds and reciting repetitive phrases. He put eyes, ears, a nose and a mouth made of felt on a monster puppet and then played around the room while reciting lines from the book. “We are working on developing functional communication,” she said, excited by his progress. 

Gage’s mother is also impressed. While she was not sure how he would respond to the hands-on approach, she said, “He took to it very quickly. He’s learning where his lips need to be and where his tongue needs to be. Gage even leans into Michelle when he is struggling with a word as if to say ‘okay – show me how to do it.’ They work well together.” While Gage has a long way to go, he is starting to use more and more words, with a little encouragement, his mother said. She emphasized, “It’s been a great help.”

“Kids on the autism spectrum have been very responsive to the PROMPT® approach because of the sensory input,” Michelle said. “It’s really fun when they figure out it’s working, and you see their faces light up like ‘Hey, I just did that!’” Eager to help more kids with speech/language disorders, she is now using the PROMPT® approach with more than 75 percent of her clients.

“It’s been really fun for me to learn something new and to see the results I’m getting,” she said. Michelle plans to attend a second PROMPT® therapy workshop in January and is working to receive complete certification in 2016.

For further information or to arrange an appointment with a speech-language pathologist, call SBL Speech-Language Pathology Services at (217) 258-2568.