Self Regulation Interferes with Speech Progress - click picture

As a Speech and Language pathologist I have been working with a six year old girl, who has apraxia of speech and regulation challenges.  After 3 years of speech therapy with another therapist, she is still very reluctant to make more than 1 attempt to produce challenging speech sounds and sound combinations, despite positive reinforcement and encouragement. She has made some progress but she would benefit from more motor sequencing practice and sound shaping activities to improve her production of target speech sounds.  Her reluctance to make repeated attempts appears to be due in part to her frustration with apraxia of speech, but she also shows signs of regulation issues when she refuses to do non-speech related tasks throughout her school day, if they appear challenging to her.  At those times, she tends to shut down by not speaking at all and not participating in any non-verbal ways until she feels the demand for the challenging task has passed.  In an effort to engage her participation in the more challenging speech therapy tasks, I have introduced speech practice drills which increase in difficulty in very small increments, from the sound in isolation to 1 syllable to C-V-C words, and we continue only as long as she is being successful.  Given this type of therapy, she has been more willing to attempt repeated trials of the sounds and words that she has produced successfully.  As a result, her production of the target sounds is improving and I have not observed any shut down behavior during therapy sessions.  It appears that providing her with therapy tasks on which she can feel a high degree of success has allowed her to be more regulated and increased her willingness to attempt slight increases in the level of difficulty of speech tasks.