Question
I work with 14 yr old nonverbal Autistic child with Apraxia. He uses chat box to communicate and some gestures. He produces some repetitive strings of some sounds through the day. He is not able to phonate or produce a sound when asked. The SLP thinks tha
Answer
There is limited information from which to form a comprehensive response; however, I will try to address what I believe to be the primary question s it possible to teach a nonverbal adolescent who has autism and apraxia of speech to speak at age 14 years?
If this 14-year-old boy has autism and apraxia of speech, and has received on-going speech-language pathology services, then verbal communication will be very difficult to teach, if it is possible at all, because of his dual diagnoses and age. But to back up a few steps, you first want to be certain that he does have apraxia. Please be aware that just because a child with autism is nonverbal does not mean that he has apraxia; apraxia is not necessarily the cause of a lack of speech in a child with autism.
How might you be able to tell if this child is nonverbal because of apraxia, as opposed to the child being nonverbal because of autism? I would look for signs of oral-motor and limb apraxia. If this child's apraxia is so severe that he cannot generate phonation at will, then you likely will see apraxia in other motor systems. If he does not exhibit apraxia in any other motor systems, then I would need to see the results of a comprehensive speech apraxia examination before determining a diagnosis of apraxia of speech.
With the limited information provided, I would recommend that you work with this child's communication device to continue to establish functional communication skills. Numerous researchers have reported that establishing communication using an AAC device facilitates the development of language. And should speech also develop, then this work on establishing communication and language will serve as a strong foundation.
Kathy J. Jakielski, Ph.D., CCC-SLP is Associate Professor and Department Chair of Communication Sciences and Disorders at Augustana College in Rock Island, IL. Dr. Jakielski's area of expertise is early normal and disordered speech acquisition, with an emphasis in Childhood Apraxia of Speech. She has over twenty years of varied clinical experience working with individuals with severe speech impairment.