What is spelling as communication?

Spelling utilizing a letterboard or keyboard is a form of alternative and augmentative communication (AAC). Practitioners who are trained to teach this skill will coach students with apraxia to learn the motor skills needed in order to accurately point to letters. The letters then combine purposefully to form words, followed by phrases, and eventually open ended thoughts and ideas. Through the careful use of a prompting hierarchy, students progress in learning from concrete to more abstract topics while also advancing through increasingly more difficult motor skills, working towards the goal of typing independently on a keyboard and accessing voice output technology.

What is apraxia?

Apraxia/Dyspraxia is a motor planning disorder often associated with autism. It is so prevalent, in fact, a 2015 study shows nearly 2/3rds of persons with autism also have apraxia. This disorder is characterized by difficulty initiating and completing motor tasks especially on demand. Speech is one such motoric function, explaining why autistics are often nonspeaking (40%) or unable to produce reliable speech. Spelling on a letterboard helps students with apraxia learn the purposeful motor skills needed to spell reliably and, through practice and coaching, coordinate their brains with their bodies so they can communicate their deepest thoughts and ideas.

How do I know if spelling as communication is right for MY child?

An understandable first question!  Over the years everyone has heard of some therapy or intervention that “miraculously” helped somebody else’s child but how do you know if it will help yours?  In the case of S2C your child will benefit if (s)he is a:

• Nonspeaker 

• Minimal Speaker

• Unreliable Speaker (someone who scripts, is echolalic, can speak but cannot answer questions reliably or cannot have a conversation)

Essentially, if speech is not an effective method of communication for your child then S2C will likely help.

My child has some speech, should I still try using a letterboard?

Yes.  Spelling as communication also helps minimal speakers and unreliable* speakers communicate better.  

*An unreliable speaker is someone who is unable to carry on a conversation and/or their words often don’t reflect what they really meant to say. There are numerous examples of what this can look like but here are just a few:  They might say “no” to everything even when you’re certain they mean “yes;”  they might give the same answer to a question every time even when it’s not the correct answer in that situation.  For example: they’re visibly upset and you ask them “how are you feeling?” and they answer - per usual - “happy”; or they script the same verbal loops over & over & over even after you’ve closed the loop or answered their request a dozen times.

How many sessions will it take before I can communicate with my child?

This is very individualized and depends on a few factors.  The acquisition phase is what we call the period of time when a speller and his/her communication regulation partner (CRP) are building skills on the letterboard together.  The speller is building the motor skills needed to coordinate the brain & body into working together for accurate spelling while the CRP is becoming adept at prompting as well as following the speller’s flow.  How much time a speller and CRP practice together has the biggest impact on how short or long the acquisition phase is for that student.  (FYI, frequent practice is recommended for any apraxia intervention, spelling as communication included.)  Other factors that also influence this phase include additional motor or health challenges besides apraxia which effect motor planning, visual-motor skills and overall coordination. Nonetheless, regardless of the individual motor differences any student brings to the table, the brain is malleable and a nonspeaker can learn to do this with practice in time.  

Is there a difference between “speech” and “expressive language?”

Speech is a motor skill.  By moving the lips, tongue, and jaw along with the use of breath passing through vocal cords a non-apraxic person can make sounds with their voice and speak words.  Expressive language, on the other hand, is a purely cognitive ability.  Let me explain: while listening to someone speak your brain interprets the noises it’s hearing as speech sounds (this is called receptive language) and then another part of your brain starts having thoughts about what it is you’re hearing (THIS is called expressive language).  Both of those things happen in your brain and do not require speech to occur.  But if you’d like to share those thoughts you need to use some form of motor planning to do so.  You might write those thoughts down, type them out, use sign language, gesture, make a facial expression, or speak them.  If you are unable to speak it’s not that you don’t have expressive language.  You have plenty of thoughts, you just don’t have a reliable motoric way to share them with others.

In summary: speech is motor, language is cognitive. Just because you don’t have the ability to speak does NOT necessarily mean you have an expressive language delay.

How old does my child have to be to begin trying to use a letterboard?

Generally speaking a student as young as 4 or 5 years old is often ready to begin this process. Contact us to discuss your child’s unique profile to help decide if it’s the right time!

Can I practice spelling with my child at home?

Not only “can” you, but YES please do!!!  Sessions always include teaching both the student and the parent.  Parents are strongly encouraged to continue practicing with their children at home so they can become fluent communication regulation partners (CRPs). We strive to always do some in-person parent coaching during the student’s lesson, but Zoom sessions are also available to give feedback on submitted video clips from home.  See our clinic offerings page for more information.

What if I don’t live in San Diego, could I still become a TA client?

We welcome out of town clients and offer scheduling options to accommodate traveling families (see Visiting Client Intensives).  Many of our clients are from out of town and have seen significant results/progress coming every 2, 3 or 6 months for coaching.  You can also explore some of the services offered through our sister company, Empowered2, which include a week long immersion program offered in Florida as well as California as well as an 8-week online CRP training course.