Delfina’s path to improvement: facing apraxia of speech with the PROMPT method

Delfina, an 18-year-old girl, and her mother, Gabriela Martínez, traveled a long and challenging path facing apraxia of speech, a neurological disorder that hinders the ability to plan and coordinate the movements necessary to speak. Through the PROMPT method, Delfina made significant advances in her communication skills, transforming her life and that of her family.

The Challenge of Apraxia of Speech

Apraxia of speech is a specific disorder that affects a person’s ability to plan and execute the movements necessary to speak, even though the muscles involved are in good condition.

Gabriela, Delfina’s mother, recounted her experience to Viví Mejor, explaining how they discovered the PROMPT method and the significant progress that her daughter achieved. Delfina, who also has a developmental delay of genetic origin, did not speak at the age of two and her attempts at communication were limited to babbling. Despite multiple speech therapy, kinesiology, and occupational therapy treatments, there was no evident progress in her ability to talk about herself.

Through the PROMPT method, Delfina made significant progress in her communication skills.

The discovery of the PROMPT Method

The change began when Gabriela met a new professional who suggested that Delfina could benefit from the PROMPT (Points for the Restructuring of Oral and Phonetic Muscle Targets) method. This therapeutic approach, developed by American speech therapist Deborah Hayden, relies on tactile-kinesthetic manipulation to guide the movements necessary to produce speech sounds. Gabriela, a former special education teacher, dedicated herself to researching the method and discovered that in La Rioja, Argentina, Gabriela Sánchez had founded an institute specialized in intensive PROMPT treatments.

In 2013, Gabriela and Delfina traveled to La Rioja to undergo therapy. Surprisingly, on the second day of sessions, Delfina was able to say “pan” clearly, something she had never achieved before. Gabriela described this experience as a milestone that changed her lives, as Delfina could finally begin to express her basic needs.

The importance of treatment

Since then, Delfina received intensive PROMPT treatment twice a year in La Rioja and continued her regular sessions with a speech therapist trained in this method in Santa Fe. Gabriela emphasized the importance of early detection and intervention, noting that many children with apraxia can benefit greatly if given the right support early.

“Kids who have apraxia cannot speak on their own. They need this information so they can produce speech sounds. In my daughter’s case, in addition to apraxia, there are other components such as hypotonia and a high-arched palate. But the PROMPT method was essential for her to communicate,” Gabriela explained.

With the right treatment and support, children with apraxia of speech can overcome enormous challenges.

The impact on family life

Facing Delfina’s diagnosis was a great challenge for the family. Gabriela recounted how, despite having consulted several professionals, it was the PROMPT method that finally gave them tangible hope. “It’s terrible to have a person who wants to tell you something and can’t. But when Delfina started talking, it was a total change in our lives. Now she can tell if she’s hungry, if something hurts or if she wants to be with someone. It’s a fundamental change for their autonomy and well-being,” Gabriela said excitedly.

An innovative and effective technique

The PROMPT method involves tactile manipulation of facial muscles, the tongue, and other parts of the articulatory system to teach children how to produce specific sounds. Each phoneme has an associated PROMPT, allowing therapists to physically guide patients to understand how to position their muscles and joints for speech.

It proved to be effective not only for children with apraxia of speech, but also for those with other communication difficulties. The technique requires specialized and detailed training, and in Argentina, professionals like Gabriela Sánchez play a crucial role in its implementation and dissemination.

The role of pediatricians

Gabriela made an urgent call to pediatricians to become more involved in the early detection of apraxia of speech. “A child who at two or three years old does not have a sufficient number of phonemes needs help. Pediatricians must be attentive and refer these children to specialized speech therapists to avoid losing valuable time,” she emphasized.

A full life despite difficulties

Despite the challenges, Delfina managed to integrate herself into various activities. Currently, she is finishing her evening primary schooling at the Ceferino Namuncurá school and participates in contemporary dance classes. Gabriela highlighted the importance of inclusion and continuous stimulation. “She was always included in groups of children without pathologies, which empowered her enormously. She copies and imitates her way and is happy,” she said.

A call for dissemination and education

Gabriela Martínez became a fervent defender of the dissemination of the method. Through social media and personal contacts, she shared her experience and helped many other families discover this treatment. “Since I learned about PROMPT, I have been a disseminator. I have seen so many success stories that I cannot stop telling our story. It is crucial that more professionals train and that pediatricians know about it,” she said.

Delfina’s story is a reminder that, with the right treatment and support, children with apraxia of speech can overcome enormous challenges and lead full and rewarding lives. Gabriela concluded with a message of hope for other families: “If there is a solution, it must be provided to the children. Hope must never be lost. With the right support, anything is possible.”

The voice of a professional

Francisco Varela, neurologist, explained the difference between apraxia of speech and other speech disorders. “Apraxia of speech is a specific disorder that affects a person’s ability to plan and execute the movements necessary to speak, even though the muscles involved are in good condition.”

Varela highlighted that “the problem lies in the fact that the brain cannot give the appropriate orders to generate the sequence of movements necessary to produce speech.” Unlike other speech disorders, such as dysarthria, which is characterized by weakness or paralysis of the speech muscles, apraxia of speech is due to problems in the planning of these movements. This means that, although the muscles are physically healthy, the coordination of movements necessary for speech is impaired.

The distinction between apraxia of speech and other disorders such as dysarthria or aphasia is crucial, since each of these disorders requires a different therapeutic approach. Dysarthria, for example, is treated by strengthening speech muscles, while apraxia requires techniques to improve speech motor planning.

Recognition and prevalence

The term Childhood Apraxia of Speech (CAS) was recognized and standardized in 2007 by the American Speech-Language-Hearing Association (ASHA). According to Varela, “it is estimated that one or two in every thousand children are diagnosed with this neurological disorder.” This recognition has been crucial to developing more effective diagnostic and therapeutic approaches.

Causes and diagnosis

The causes of Childhood Apraxia of Speech can be varied. The neurologist explained that “Causes of CAS can include brain conditions or injuries such as strokes, infections or traumatic injuries, and possibly genetic or metabolic disorders. However, a specific cause often cannot be determined.” This uncertain etiological aspect makes the diagnosis and treatment of apraxia of speech challenging.

Diagnosis requires a multidisciplinary approach. According to Varela, “speech and language pathologists require an approach that can include everything from the anatomical study of the brain through images such as tomography or MRI to the performance of neurocognitive batteries with a focus on language evaluation.” This comprehensive approach is essential to distinguish apraxia of speech from other disorders with similar symptoms.

One of the most common challenges is differentiating it from other speech disorders such as dysarthria or aphasia. Additionally, identifying apraxia in children can be particularly difficult due to variability in normal speech development. However, this distinction is crucial since each disorder has different therapeutic approaches.

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Signs, symptoms and treatment

The interviewee listed several characteristic symptoms of apraxia of speech, including distortion of speech sounds, visible searching for the correct articulation of words and sounds, and errors in the tone or rhythm of speech (prosody). These symptoms can vary in severity and can significantly affect a person’s ability to communicate.

Treatment usually involves intensive, personalized speech and language therapy. According to Varela, “treatment may include repetitive exercises to improve pronunciation and speech flow.” In severe cases, alternative methods of communication, such as sign language or electronic communication devices, may be used. The key is an individualized approach that is tailored to the patient’s specific needs.

Impact on daily life

Apraxia of speech can significantly affect a person’s daily life. The professional explained that “it can significantly affect communication, which can lead to challenges in learning, social interaction and emotional development, especially in children.” These challenges can have a lasting impact on the lives of those affected, underscoring the importance of early diagnosis and treatment.

Tips for parents and caregivers

For parents and caregivers of children with apraxia of speech, Francisco Varela advised seeking early speech evaluation and therapy. “It is crucial to seek speech evaluation and therapy early. Parents must be proactive in obtaining support, practice consistently at home and provide an environment rich in language and emotional support,” said the professional. These efforts can make a big difference in the child’s development and her ability to communicate effectively.

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