Why would a Person with Angelman Syndrome need Speech and Language Therapy?
What Can a Speech and Language Therapist Do for Individuals with Angelman Syndrome?
Various Methods of Speech/Communication Therapy for Individuals with Angelman Syndrome
Why would a Person with Angelman Syndrome need Speech and Language Therapy?
Individuals with Angelman Syndrome, regardless of genetic subtype should receive and will benefit from speech and language therapy ("SLT"). SLT will encompass much more than merely facilitating an individual to produce sounds. Functional communication for an individual with Angelman Syndrome will alleviate potential behavioral issues, frustration and isolation that can occur if someone cannot make themselves understood.
A speech and language therapist can generally address an individual's speech, language, communication, swallowing difficulties, cognitive aspects of communication and sensory awareness related to communication and swallowing.
It is likely that all individuals with Angelman Syndrome will need intensive functional language building on a regular basis. Individuals that are non-verbal can develop appropriate communication skills with effective therapy and consistency. SLT should focus on the numerous forms of communication tools available in order to assist the individual in finding a communication skill set or skill sets that best fit that individual. Individuals with Angelman Syndrome continue to learn and the various therapies should be continuously addressed as the individual's skills mature.
In many states, therapies under early intervention, which encompasses birth to three years of age, will focus on functional and medical goals. Once a child turns three, the goals shift focus to educational goals to be provided by the school district. There are other avenues to obtain SLT, potentially through private insurance and regional centers to name a few. There are other options that are available to your child and should be researched accordingly.
The human brain lays down the language pathways, not just verbal language, but basic understanding of language, at a young age. The earlier an individual is introduced to speech/communication therapy, the better the chances that functional communication can become a reality for individuals with Angelman Syndrome.
Parents, caretakers and therapists should use any method of communication available. This would include use of body language, exaggerated words and sounds, laughter and other emotion sounds, pointing, pantomiming. Different techniques will work with different individuals; therefore, all possible forms of communication should be explored in order to build on the communication skills for an individual with Angelman Syndrome.
TopWhat Can a Speech and Language Therapist Do for Individuals with Angelman Syndrome?
SLT involves much more than simply teaching a child to correctly pronounce words. In fact, a speech therapist working with an individual with Angelman Syndrome may work on a wide range of skills including:
1. Non-verbal communication. This may include teaching gestural communication, or training with PECS (picture exchange cards), electronic talking devices, and other non-verbal communication tools.
2. Oral Motor exercises. Oral motor exercises can decrease the sensitivity in and around the mouth. In addition, a therapist trained in oral motor can assist the individual in forming sounds, proper chewing, and many other areas.
3. Feeding therapy. Feeding therapy may be appropriate for individuals with feeding difficulties which may include an immature chewing pattern, overstuffing, difficulty drinking, choking, and aspirating to name a few. A feeding specialist can assist in determining the best way to approach feeding and drinking methods for a child. Feeding therapy and SLT can overlap, for example, feeding therapy can be linked to tongue and lip lateralization that could potentially aid in speech production. Feeding therapy may also be provided by an occupational therapist.
4. Speech pragmatics. It's all well and good to know how to say "good morning." But it's just as important to know when, how and to whom you should say it, sign it, or indicate it.
5. Conversation skills. Knowing how to make statements is not the same thing as carrying on conversations. Speech therapists may work on back-and-forth exchange, sometimes known as "joint attention." This type of skill set includes verbal and non-verbal communication exchanges.
6. Concept skills. A person's ability to state abstract concepts doesn't always reflect their ability to understand them. Speech therapists may work on building concept skills.
7. Cognitive skills: A speech and language therapist may work on an individual's ability to discern between object, pictures and drawings in order to assist communication skills.
In a typical speech session, a speech therapist might begin with sensory integration, and then use signing, music, games, computers, and pictures to help introduce and facilitate a communication model that has intent, can be replicated outside the speech session setting, and can be applied to a wide variety of life settings.
TopVarious Methods of Speech/Communication Therapy for Individuals with Angelman Syndrome
Augmentative and Alternative Communication Method ("ACC"). Generally, the AAC is the primary approach speech and language therapists may take when designing a program for individuals with Angelman Syndrome. AAC may include sign language, body language, and computer devices.
Signing. Although many individuals with Angelman Syndrome have difficulty with fine motor movements, sign language may still be an option, and can be modified to facilitate this form of communication. Additionally, individuals with Angelman Syndrome may exhibit difficulty with imitative skills; however, that skill can improve over time, particularly with exposure to repetitive sensory motor experiences.
Moreover, while modified sign language is very helpful in aiding an individual to communicate, one of the main goals of teaching an individual to sign would be to allow the individual to be universally understood. For example, a wave is a universal hello or goodbye while a rub on the belly may indicate please to the family but to the general public it may not be understood. Any signing is beneficial and should be encouraged with a target of facilitating the individual in making the sign universally understood.
Picture Exchange Communication System ("PECS"). PECs assists an individual with communicating with the basic intent being an exchange of a picture in return the individual receiving the picture will honor the request. There are six phases of PECS. PECs is both successful and less costly than other higher end computer based methods. Please visit www.pecs.com for more information.
Burkhart Method. This is somewhat similar to PECS, in that it uses pictures to build a functional brain language map. Tailored to the specific person, it can use digital photos, or standard Mayer-Johnson type symbols. Please visit http://www.lburkhart.com/handdd.html for detailed information.
The Dr. Calculator Method. Specific to Angelman Syndrome, Dr. Calculator espouses using a method called "Enhanced Natural Gestures" as a means of communication.
He has also written a book entitled "Promoting functional communication in AS", as well as receiving grants to study communication in Angelman Syndrome.
Computer Devices. There are a variety of technology communication aids that can be used, such as simple one button switch devices, and as sophisticated as eye gaze and voice output computer based technologies. The trained speech and language therapist should have industry contacts with the companies that make these technologies, and can arrange a demonstration and trial of any device to find the best 'fit', should a family decide to go this route. Additionally, speech therapists, early intervention service providers and school personnel can assist in contacting individuals and/or companies specializing in AAC evaluations and recommendations. Industry names that are common include Dynavox, Go Talk, Cheap Talk, Tango, among others. Click here for an overview of some devices.
Alphabet Therapy. Alphabet Therapy is a new, innovative, and tailored approach to teaching academic skills to individuals with Angelman Syndrome. This method was developed by Terry Jo Bichell, mother and scholar, as a means to teach her son. It has grown to include a team of therapists that can be contracted to come into your home and run teaching sessions. This method has gained tremendous anecdotal praise. Please visit www.alphabettherapy.com for more information.
Vital Stim Method. VitalStim Therapy can be administered by trained speech therapists on children with Angelman Syndrome. Vitalstim uses small electrical currents to stimulate the muscles responsible for swallowing. It is commonly used for dysphagia, a condition that causes discomfort or difficulty swallowing and generally affects the elderly. However, for children with Angelman Syndrome, this can be a viable opportunity to strengthen muscles that are critical to our children's oral motor skills and improve their ability to swallow. Given that AS children typically have low tone, this noninvasive therapy can target specific muscles vital to swallowing and provide the routine exercise the muscles need to properly function. Vital Stim centers are located throughout the United States, and many speech therapists are either specifically trained or aware of the method. Click here for more information.
Prompt Method. Mainly used to teach and promote verbal skills, Prompt Method is a useful tool to add to the speech/communication therapy toolbox as it breaks words down into base parts and provides a great foundation for teaching sounds, which can lead to words, which can possibly lead to speech and/or speech approximations. Please visit http://www.promptinstitute.com for detailed information on the resources available.
These examples are a sampling of the methods available to parents and caregivers to help design a speech/communication program for the individual with Angelman Syndrome. It is also useful to view what the autism world has available, as non-verbal communication is a key aspect of addressing communication in autism as well.
It is important to stress that individuals with Angelman Syndrome can and do learn. The key is repetition as well as consistency. In addition, creativity assists in keeping the attention of the individual. Be prepared to use a variety of communication modalities, as this will only enhance the language acquisition abilities of the person using the methods.
Many times, it is useful to begin a speech/communication session with occupational sensory integration therapy, to address any sensory needs the person may have that can interfere with learning. For example, a person may need strong sensory input prior to beginning speech sessions, such as swinging, deep pressure therapy, therapeutic brushing, and joint compression. All these therapy modalities assist in centering the individual by meeting their sensory needs prior to the speech/communication/oral motor portion of the therapy. By providing the sensory input prior, the individual may be more attentive to the task at hand rather than attempting to fulfill a sensory need during the learning session.
Please keep in mind that SLT is just one part of the total holistic therapy approach, meant to augment occupational therapy (which includes sensory integration) and physical therapy (which can include therapies such as therapeutic horseback riding and swimming).
This document prepared by Maiddy Dunigan, Elke Sprow, and Kena Richert.
TopThe Content above is for informational purposes only, it is not a substitute for professional medical and or therapeutic advice, diagnosis, and/or treatment. Do not attempt to implement therapies without first seeking the advice of a professional therapist or medical provider as treatment has many consequences that must be medically and therapeutically addressed.