Learning to say “Maggie”

Due to her Apraxia condition, it has been challenging for Maggie to learn to say her name. We have been working on it for several months. Her name has two vowels, two consonants, and two syllables, so we have been building step by step her ability to name herself.

We started with teaching her a sign for her name, which she picked up and started using right away. It has greatly expanded her ability to communicate, knowing how to sign her own name. All of a sudden she could tell us what MAGGIE wanted, what MAGGIE felt, what had been done to MAGGIE by her sister, and that mommy should hold MAGGIE.

Next we started targeting the word Maggie through her Gemiini discreet video modeling program. I will have to write a whole post about Gemiini, but suffice it to say here that it is a discreet video modeling program based on the new, breakthrough science concept that seeing a word pronounced builds the same neural pathways as saying the word yourself. It has mainly been tested in autistic populations, but some believe it is effective for Apraxia as well.

An average child needs to hear a word said 40 to 70 times before they will say the word. Kids with apraxia need to hear it hundreds of times. This is not esaily done in day to day conversation. Geminii discreet video modeling gives us the ability to target specific words and load them into Maggie’s brain hundreds of times through brief daily sessions. Gemiini has thousands and thousands of recorded videos which focus directly on the mouth of the speaker, and I can build custom videos for Maggie using the exact sounds and words we are working on in speech therapy.

Some experts don’t believe Gemiini works with the Apraxia population–it is controversial, and not enough studies have been done on kids that ONLY have Apraxia without accompanying conditions like Autism or Downs Syndrome. All I can say is that we have seen results using Gemiini from the very first session Maggie watched, and we have consistently seen results when we target our Gemiini videos to enhance and support our current speech goals and practices.

Here is a short example of what she sees when she watches a Gemiini video:

Here is a video of the very first time she tried to say her name, back in July 2015, after two days of viewing “Maggie” Gemiini videos.

More practice saying Maggie, more weeks of Gemiini videos, practicing Maggie one syllable at a time, and eventually we had another breakthrough, where Maggie was finally able to say her name correctly when prompted, although inconsistently (videos from November 30, 2015).

This was also the first (and to date only) time she ever attempted a sentence–if you listen very carefully, you can hear that she is trying to say “Maggie is my name”!

A few days later she was getting a little faster and a little less choppy (December 8, 2015).

Inconsistency is one hallmark of Apraxia, however, as this video taken December 30, 2015 shows. We are still working on saying “Maggie”. She is capable of saying it but has not yet learned it to the point of motor memory. That means that when she refers to herself, or when she is asked to say “Maggie”, she still has to work very hard to do so and many times she is not able to correctly reproduce the sounds. She will need to keep practicing and practicing until it becomes natural, just as you and I would need to keep practicing to learn to play a song perfectly on the piano without really thinking about it. That is the nature of Apraxia. You will notice in this video that when trying to say Maggie she says “mommy” a couple of times. We had been working on learning to say “mommy” right before we started working on Maggie, and she had just finally learned mommy. So when trying to say “Maggie”, she accidentally says the recently practiced “mommy”.

Happy New Year! Learning to say “mommy”

We have been working on saying “mommy” for months. Maggie has been able to say “mama” for a long time, but a few months ago she stopped saying mama and started saying “mah-eee”.

I feel that was progress for her because she was using both vowel sounds from the word mommy but she was not able to add the middle “m” sound (even though she could when saying mama) because the combination of two different vowels and two syllables was too much to concentrate on. That second m sound was a bridge too far.

In October I spent several nights in the hospital, and the day I got home Maggie said mommy perfectly couple of times. I am sure that she heard the word mommy a lot while I was gone. After that day, she was not able to repeat the word mommy, no matter how hard she tried. One hallmark of apraxia is inconsistency. The child might say it once, but cannot remember from one day to the next how she did it, until she has learned that word to the point of muscle memory.

We started having Maggie watch a Gemiini video modeling loop of “mommy”.

Here is a video from December 29th. I often work with her one syllable at a time. “Say mah, Say me, Say Mommy”. This has been a great stepping stone for multi-syllable words.

We made a breakthrough on 12/30/15 when she was finally able to say mommy on command more than once.

Although she struggled the first few times, saying “mah-eee” as she has been for months, this was a breakthrough for her, as she was finally able to imitate the word Mommy on command multiple times. I knew we could move the ball further downfield if we struck while the iron was hot, so later that night we worked on it again when the promise of chocolate chips led her to repeat it several more times.

Therapy Approach

This is a good representation of one therapy method I am using with her–answering but correcting her normal day-to-day attempts at saying “mommy”, using video modeling to give a lot of opportunity to hear and see the word said hundreds of times, impromptu practice sessions like the one posted above (walking around and playing at the same time), targeted practice while seated with a reward, aiming for multiple correct repetitions.

Choosing words

The words we are working on are specifically selected–we are prioritizing words that she needs and wants to say, which utilize consonants and vowels that she can say in isolation. Mommy is a good example as she calls me repeatedly many times a day (giving us many natural opportunities to practice), and she can say “m”, short “o” and “y” sounds in isolation. The trick is learning to string them together into a two syllable, two consonant, two vowel word.

Transitioning a word from therapy success to normal daily speech

Even though she was able to say mommy several times, whenever she called me that night she reverted back to her old way. I would respond to her, but gently reminded her of the proper pronunciation. We have been doing it that way for months, where I respond when she calls me but remind her of the correct pronunciation and often encourage her to try again. This time she was finally able to get it and it stuck. This morning (New Year’s Day), she has been calling me “Mommy” consistently with no prompting. She woke up this morning calling “Mommy! Mommy!” from her bed. She had slept all night, and woke up saying “mommy” correctly with no prompting, all on her own. I think she’s finally got it!!! We have been working consistently on learning to say “mommy” since she first said it in October, making very slow baby steps of progress along the way. After saying “mommy” a few times one night in October Maggie was not able to say the word “mommy” correctly again until the last week in December. It is music to my ears and a wonderful start to 2016!!