Is an iPad a Helpful Tool for Children with Motor Speech Difficulties?

I often get this question from parents of children on my caseload and in my experience, an iPad can be a highly motivating effective therapy tool for children presenting with motor speech difficulties. After a thorough assessment is competed by a Speech-Language Pathologist (SLP) and therapy goals are set out, an iPad can be used in treatment to help children improve speech sound production and motor speech planning. Parents can also download the apps to continue practicing what he or she has learned in the therapy sessions at home.

What are motor speech difficulties?

The act of speaking is a highly sophisticated one as it involves processes of our brain and muscles of the mouth, face, tongue and palate. We start with an idea and then we have to correctly assemble the string of sounds and words. This all happens within a blink of an eye. For a child with motor speech difficulties this process in not an easy one. A child who is presenting with motor speech difficulties has trouble saying sounds, syllables and words. She knows what she wants to say, but her brain has difficulty coordinating the muscle movements necessary to say those words. Many children with motor speech difficulties are able to hear the words (the may have normal hearing), and are able to understand what they mean (they may have normal receptive language), but they can’t turn what they hear into the fine-motor skill of combining consonants and vowels to form words.

Common characteristics in children presenting with motor speech difficulties:

• Children often make atypical or inconsistent speech sound errors. Each time they try to say the word, it may sound different each time. For example, when popping bubbles the child may say “op”, “pa” or “bop” for “pop”.

• Groping is also a common characteristic. Children who “grope” are making wrong turns while they are seeking out the correct articulatory placement (moving their jaw, lips, tongue to make the movements needed for particular speech sounds)

• The difficulty they have with certain speech sounds will vary depending on the context of the sound and/or word. Their ability to say particular sounds will be influenced on what other sounds are in the word, how complex the movements are, and where the sound occurs in the word (beginning, middle, end).

• They may have vowel distortions, attempting to say a vowel sound in isolation or in a word, however it comes out incorrectly  

• They may have a limited number of consonant and vowel sounds

• They may drop syllables from words. For example, “na” or “nana”  for “banana”

• They have difficulty imitating simple words

• Children with motor speech difficulties are harder to understand in connected speech rather than single words

What is involved in motor speech therapy?

Motor speech therapy is a dynamic, shaping process which requires the child to be actively engaged.  The child must attend to the clinician’s face, verbal models and instructions and take multiple turns for improved motor speech movements/sounds.
The clinician or parent supports improved speech production through a number of cueing techniques and feedback on the child’s performance. In treatment of children presenting with a motor speech difficulty, it is generally understood that frequent practice of sounds and words help to improve speech and reduce some of the pressures associated with expressive language. Effective Ipad apps with carefully chosen targets provided by the SLP can be part of an effective treatment plan by offering predictability, presence of carrier phrases, and frequent practice of target sounds and speech movements.

Helpful Hints for making the most out of your therapy session with the iPad

Learning improves when a child is emotionally and cognitively engaged in process. If an iPad is used in your therapy sessions, an app must be carefully picked and planned and structured to maximize the child’s motivation and attention and to support learning. The SLP or parent must create opportunities for multiple repetitions of target words in a manner that is supportive and motivating and does not result in too much communication pressure. Research suggests that 100-150 practice opportunities per therapy session are necessary to support motor learning. When practicing targets with an app consider how to provide the child with at least 20-30 response opportunities.
You MUST have control over the iPad (which may mean holding on to it and holding it up away from your child) to elicit your target word before they get to take a turn in the game or activity. Otherwise, it will turn into an activity where the child is quiet and or playing alone and does not get the much needed opportunities for repetitive practice of target words and phrases. There are a variety of iPad cases which allow you to slip your hand in and use the iPad with one hand so that you can quickly pull it away and have the other hand free for providing tactile prompts if needed.
You will need to pause the app to allow the child to fill in the target word or phrase.
It is important to provide adequate time for the child to attempt productions. Children with motor speech difficulties may need extra time to respond.
Many children may become distracted by the music in the app. Turn the volume down or off if it becomes a distraction. Most iPad apps have a button to control the volume by giving you the choice to have it turned on or off.
Encourage them to watch your face and listen to your models so he receives maximum visual and auditory information before the child produces the target and takes a turn.
Give feedback to your child after each attempt at the target word or phrase so that they know what they were successful at and what they need to attempt again. This feedback should be demonstrated by the SLP in the therapy session and will depend on the specific goal. For example, if the goal is to improve lip rounding and the target word is “go” verbal feedback can be provided after each target such as “nice round lips” or “Let’s try that again with nice round lips”. The amount and type of cueing and feedback will be decided by the SLP.

Final Thoughts

Most importantly, the iPad should not be viewed a replacement for a comprehensive speech therapy assessment and treatment plan.  An SLP can assess your child’s specific motor speech skills and create individualized goals at a level appropriate to the child’s motor capabilities.  Further developing and building on these skills. Core vocabulary and phases are based on specific movement patterns and sounds that are functional and important for the child and family.
Speak to a qualified SLP who specializes in this area.  They can recommend specific apps to be used at home in conjunction with an individualized therapy plan to maximize results in a fun and productive way that you and your child will both enjoy!