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I just wanted to collect some links here and invite anyone who knows anything about this to join in.  

 

I tried ds on the games here http://creatingmusic.com/BlockGames/NewGames/BlockGames.html and have determined he is not tone deaf.  So that means it's the apraxia and just an ability to produce the sounds.  That's not shocking when you think about it that way, sigh.  So Creating Music sells cds of games like that  http://www.creatingmusic.com   but I'm thinking they're sort of like Earobics, in the sense that if you have a deficit and working memory issues, they're going to be really hard.  So I think it might be necessary to back up even further, sort of the musical equivalent of LIPS...

 

http://www.pediastaff.com/blog/music-rhythm-and-their-potential-benefits-for-childhood-apraxia-of-speech-647 This article had some good ideas on working on the rhythm part of it.  (fill in the blank, sing with a metronome, walk and talk)  

 

I was looking at xylophone/glockenspiel, melodica, and recorder, to see if any of those might let him work with music.  I'm afraid he would wham and get really physical with a glock, though I'm not sure.  I thought I might google for some printable glock music to try with him.  Probably there's something online?  

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I found this old board post, which had some ideas I thought I could try on him.

 

http://forums.welltrainedmind.com/topic/314820-so-from-singing-thread-tone-deafness/?do=findComment&comment=3199490

 

 

Kirch

Posted 03 October 2011 - 12:30 AM

Hmmm . . . that's a tough one. It's not unusual for kids even at that age to not really be matching tone well, but if she can't tell that b - b on the piano does not sound "right" when she's trying to play a scale and she can't match *any* pitch you sing to her--that sounds like it's beyond the norm, I think. Has she listened to/been exposed to lots of music, especially vocal music (songs--recordings, you singing to her, at church or somewhere else, etc.?). The fact that she has trouble imitating rhythms too intrigues me--I almost wonder if it might be more of an auditory processing issue than tone-deafness. Can she repeat back other things she hears without difficulty? Can she follow simple multi-step directions?

If it really is just music, there are some more things you can try. With pitch, your first goal would be getting her to recognize and be able to demonstrate high vs. low. I wouldn't expect most 6 yo's to be able to distinguish the difference in size between a third and a 5th--they're really not that far apart. Try games where you squat down and speak in a really low voice and then stretch way up high and speak in a high (think Mickey Mouse) voice. Sing songs in various voices--use low and high voices for the same song. For example, one thing I like to do with preschool/K and even some 1st graders is to sing "The Itsy Bitsy Spider." First we sing it normally. Then we sing, "The BIG DADDY SPIDER CRAWLED UP THE WATER SPOUT" in a BIG, low voice. Then we use a high, squeaky voice to sing, "The little baby spider . . ." Also try doing roller coasters--have her point her finger down low and say "Aaaaahhhhh" starting in a low voice, swooping her voice and finger up like a roller coaster, then back down the other side. You can then use that to try to help her match pitch with you--if she's too high or low, ask her to slide up or down the roller coaster until it sounds the same as you. It might also help her to hear it if you let her sing a note, then you sing a different note and move around until you match her pitch--see if she can tell when you match her.

For more specific pitch-matching, you might try solfege hand signs (do-re-me, etc.), especially if she's a more kinesthetic learner. The falling minor third (sol-mi) *is* the easiest for most kids to sing accurately. Try adding words to it, or even just singing her name--that might be easier for her to sing back to you. Songs like "A Tisket, A Tasket" that use sol-mi a lot are good too.

For rhythm, the place to start is making sure she can keep a steady beat--unless she's got that internalized, she's not going to be able to do much else. Play a game where you take turns choosing ways to keep the steady beat (clapping, tapping nose, patting legs, tapping foot, waving arms back and forth, etc.) both without and with music--especially if you can find some songs with strong beats (like marches). Put on some music and march around the room to the beat. From there, start playing the "repeat after me" game in 4/4 time at walking speed. Clap a rhythm and see if she can clap it back to you--I'd also speak the rhythms (ta's and ti-ti's) as you clap (the more senses involved, the better!). Start with 4 quarter notes, then quarter-quarter-half, then half-half, then half-quarter-quarter. If she can do those, go on to quarter-quarter-eighth-eighth-quarter, then q-e-e-q-q, etc. For the most part, don't try harder ones until she can accurately repeat the one you're doing. 
 

 

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What I wish I could find is something physical, something hands-on, where we could integrate pitch and voice into something we can do and feel.  That's why I was thinking the glock, but I don't know.  

 

His prosody when he reads is bad too.  (flat with odd attempts at going up for questions)  Since prosody = intonation plus rhythm, anything I can do to improve melody and rhythm in singing should improve his ability to do it with speech and reading, seems to me.  And conversely, maybe as we work more on prosody in speech it will carry over to the singing?  I'm still looking for a good source on that.  I read this really dry booklet Teaching Pronunciation Using the Prosody Pyramid - MCAEL  which filled in a lot of holes for me but still didn't leave me with a concrete PLAN for what to do, sigh.

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I wonder if you had him chant rhythmically if it would help with prosody (not sure if chant or rhythmic is exactly what I mean, so bear with me). If you think about it, other than singing or screaming/crying, when do we really string all that sound together smoothly? So maybe pick a single sound, and then hold it at one pitch. Then, start holding it for varying lengths of time. Maybe compare it to blowing bubbles in the pool, but you do it with your voice. If you're sure he won't drown trying, you could have him make a continuous sound into water like he's blowing bubbles. Don't try the rhythm with sound in the water.  :lol:

 

aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

 

then

 

aaaa aaaa aaaa aaaa aaaa

 

and so on. You might need to turn a flashlight on and off (or do red light/green light) to show him how long to hold. Don't try to make it rhythmic in the metronome sense. Just rhythmic in the starting and stopping in varying lengths sense. Those of us with terrible rhythm can't do new things rhythmically. It's just too difficult.

 

If it works/helps, then you can move up to doing this with individual words. Like, HHHEEELLLPPP [my mom is trying to drown me by asking me to make sounds in water]. Sorry, I'm a little slap happy today.

 

Remember that prosody and ASD go together even in kids that don't have speech issues, so it's probably a combination of things. 

 

At some point, maybe it would help to give him some kind or arm swinging motion to go with how long you're holding/breathing when stringing sound together (like a conductor). He might not be sure where to breath when he sings. (I'm thinking about how it messed with his speech to learn to blow bubbles in the pool.)

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Yes, we did some chanting with text for songs he picked.  We could do some more.  We got away from it with the funeral.  He seems to be willing/able to sing one song a day with me.  Today he sang Farmer in the Dell with me.  A few days ago it was Bingo.  So that's moving up.  The chanting we were doing with cross-body tapping, trying to get the brain and music and speech just to connect.  It was also helping with rhythm.  

 

I LOVE your elongated vowels and stoplight with flashlight idea, wow!  That would totally work with him.  

 

So he'll do one song with me and try a 2nd, but he's just too worn out at that point and leaves.  Wild.  

 

Now I'm interested to try extended sounds on him.  That he might actually be able to do, because he has much better breath support now.

 

So if somebody reads this who knows, what do they do for prosody with ASD kids?

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It worked!  I got /ah/ extended with the flashlight for a note, then /E/ for a 2nd note.  He matched me when I said it, then had a hard time recovering.  I used my hand to show down and he went down a bit and found it.  Had a hard time holding it, but it seems like a little seed of a thought there, something to work with, a way to access it!  And the flashlight game is a concrete, fun way to practice.  But his endurance for it, very short, hmm.

 

See the bummer is, I'm going to have to decide whether to do things myself or fund the music therapist.  I guess what we're seeing here is it's so *hard* for him that a half hour with a therapist would accomplish the same amount or more as if I knocked myself out for his endurance (5-6 minutes) 5 days a week.  And if we do stuff at home AND at therapy, it would be jet fuel.  

 

I didn't know if he actually had any ability in there or if it was sort of hopeless, but it's clearly not hopeless.  It's just really stinkin' hard, really hard.  And now that I'm seeing how hard it is, I don't think I *want* to be the one doing that.  Everything I do with him is hard, mercy.  It really skews the relationship.  He needs to do fun things with his mom and not have everything be therapy.

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Cricket, that's interesting.  I've already had him in to THE place in our state (literally) to go, and they did a full, full exam for the regular stuff and then ran as much of the screening as they could and observed.  He was 6 at the time, so obviously they couldn't go all the way.  Thing is, he has *no* issues with figure/ground.  He's in a terribly noisy gym 2-4 days a week for gymnastics, multiple hours at a time, and he has no issues comprehending or participating that we can tell.  So either he's faking it and a good lip reader, or he's ok.  Well, given how odd communication with him can be, maybe he's faking it.  I could have them do the full screening when he turns 7.  But even if I just take him into Chipotle, he's fine.  I can ask dh because they were just there.  A child with obvious APD will go functionally deaf in that environment.  Ds is fine, and dd, who is borderline, gets frustrated but survives.  

 

But it's definitely interesting.  I don't know what's causing this.  It may be the apraxia and motor planning.  The psych just lobbed everything to wicked EF.  EF can cause meta-cognitive, meta-linguistic, meta-anything issues.  On his language testing, he's not noticing the bits, and it goes back to meta-awareness and EF, as utterly preposterous as that sounds.  And it's not just the psych saying that, because a separate SLP from the ps said that was how she interpreted those results too.  And it's what the CELF5 testing materials show.  

 

But that's definitely noteworthy that one explanation of prosody issues can be APD.  It may be I need to take him back when he's 7 and have them finish the screening.  My quick googling of APD and suprasegmental issues like that made it sound like they both don't use them and don't process them.  Is that your experience?  I need to see.  I've been trying to wrap my brain around this enough even to know how I would assess that.  Maybe I have some numbers for that in the testing that was done?  Anyways, I think I've finally wrapped my brain around how, and I thought I'd try it today.  So I'm looking at whether he can *perceive* the differences in the prosody vs. whether he can *produce* the differences in the prosody.  And then I guess you could further distinguish whether he perceives the differences but doesn't comprehend them vs. not perceiving because you're inattentive vs...

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If you can afford it, I'd suggest a soprano or alto xylophone over a glock. Most kid glocks don't have removable bars, which increases frustration, the pins are thinner and more fragile if they do, and the tone is rather shrill. A true Orff xylophone can practically survive a war zone, and are often used in music therapy as well as music Education for that reason. I suggest Sonor because you can get ones that have a full 2 octave range, which adds more versatility, with soft rubber, yarn round mallets for the sake of everyone's ears.

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On glock music-look for recorder music. You can get letter-note versions of basically anything you want, easy to read, and over 90% playable on a glock or other Orff instrument, but much more accessible to kids than recorder. Hal Leonard has a lot of nice collections of Disney and other popular kids songs.

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If it's true apraxia, then that means he does not have the motor planning down to know how to move his mouth, tongue, etc. to make the right sounds.  So just jumping into music won't help.  You need to teach him the motor planning skills.  How is his speech?  If his speech is generally pretty good, then maybe it's a speech blending issue.  If so, I'd recommend working on very simple music therapy, starting with two syllables and two notes.  (You go "up" a note on the syllable that is naturally accented.)

 

If he struggles with basic speech, then I'd backtrack and really work on mouth/tongue movements for each letter sound. 

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Uh yeah, moderate to severe apraxia.  He has had PROMPT since he was newly 2, with an instructor level.  That's why I've never attempted or pushing singing until now, because he wasn't at all ready.  He's considered 80% intelligible and has things we're working on.  I do think, from what I'm reading, that the actual control (how to control your voice AND articulate AND control your breath) all at once are complicated and just a lot to plan and figure out.  So yes, it's the apraxia.  I thought about it some more and asked dh.  He has no issues in noisy backgrounds like Chipotle, and his gymnastics coach reports no comprehension issues even though it's noisy there.  It's the apraxia.

 

He initiated singing BINGO today, so we're making some headway.  I went through some Raffi cds Kbutton suggested to me, and basically for comfort he would be at that toddler, pre-easy level, sigh.  He did well with the sentences we worked on today for focus words.  I wrote a simple sentence like a rebus with pictures on a whiteboard and then moved the magnet along to pick what we were emphasizing.  We did this with statements, questions, and exclamations.  I think it's all going to work together, the melody work of prosody and the melody work of singing.  And really, BINGO is a great song, since he's humming.

 

We'll just keep drip, dripping at it and see what happens.  The music therapist is at a school, so that won't start for a couple weeks yet.

 

I'm not meaning to sound defensive there, btw, but I am a bit.  I've never made secret of my ds' apraxia and it's in my sig.  His therapy is effective and we paused it to focus on reading.  That might be a controversial one, but it's the choice I made and it was for the best.  Now we have the scholarship and are getting more speech therapy.  It's not his ability to say the words that is holding him back, because he can chant them.  It's the ability to control his voice AND get the words out at the same time.  And I can totally agree it's the result of the apraxia.  However the SLP is making no indication of having an answer for that, and I don't consider it an acceptable outcome.  She farms out expressive language, and I don't have enough scholarship or time or energy for that.  So prosody, music, none of this is getting hit by the SLP and falls to me.  And I don't consider it acceptable for him not to be able to sing, therefore I want him to be able to sing, whatever it takes.

 

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Cricket, I'm not upset at you.  I'm a little touchy on the apraxia thing apparently.  :)

 

I think we could talk past each other on the APD thing.  The only way I have of quantifying the auditory processing issues is using our local resource, a university that will run the SCAN3.  So what's curious to me is what would happen if you took the scenarios TG is talking about and run the full testing on them.  I have no clue.  Since my dd tests as borderline crunch on one of the parameters and has a LEA (left ear advantage) but not enough parameters to require a full APD test or get her a diagnosis, it seems perfectly reasonable to me to say that some people will be functioning like that, with relative weaknesses that we can verify and support but that don't get them an actual diagnosis.  I think it's a point well-taken and interesting to ponder with ds.  

 

I don't know to what degree auditory stuff is bothering ds.  I know at the convention we kept noise-canceling headphones on him because his behavior fell apart without them.  On the other hand, he can hear the instructions of his coach (figure-ground) and process just fine in a noisy gym for gymnastics.  Whether the gym has less noise than the convention, I don't know.  I also know that I have some really unusual sound sensitivities that it took a lot of years to figure out.  

 

So it's all interesting.  The SCAN3 at the uni would be the only thing I'd know to do, and they won't run that till he's fully 7.  They did parts.  He's not likely to go to a full APD label, just not.  Whether there's a specific relative weakness in one of the categories causing the prosody and music issues, that's really interesting to ponder.  It may not be something I get very satisfying answers on for a while.  I don't think I'm off-track doing interventions (from the music angle, from the speech therapy angle, from the meta-linguistic angle, etc.), because I think in reality ALL the angles are affecting it.  So to me I'm just going to try a variety of things and see where we get things to open up and get some movement.  If he can get some movement or change with a gentle nudge, then to me that's an area that's timely.

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A recorder would be much better to explore Rhythm.

With a recorder, when you blow a note?

You can vary the length that it is held, and also vary its volume from beginning to end.

Within speech, the notes are replaced by syllables.

So that the pitch of a syllable might vary as it is pronounced.

 

Each word has its own rhythm, which can be changed and give it new meaning.

Such as raising the pitch at the end of word,  turning from a statement to a question.

 

So that a wind instrument can used to explore this.

But an instrument that is struck or plucked, doesn't have this potential.

 

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Recorder would be very, very difficult for a child with apraxia, and focusing on the small oral motor movements would probably remove most of the benefits to teach rhythmic development. There's a reason why Orff teachers start using the xylophones in K/1 (or even younger), but don't start recorder until 9/10- and it's because it's just plain harder, and very difficult to get the level of success that can be achieved (part of Orff is that you adapt the instruments and music such that there is no risk of failure for the first several years). There are other schools of thought on recorder (Suzuki, for one) which start earlier, but I personally wouldn't recommend Suzuki recorder as a starting point for a child with apraxia because it begins with the lowest pitches, which have the greatest amount of oral and breath control required. This is intentional-if a child masters control of those notes, the rest of the range is pretty easy in comparison, but for a child with any sort of oral-motor control issue, whether neurological or muscular, that's dooming them to a LOT of frustration and failure. 6 is very young for soprano recorder even for a completely neurotypical child.

 

Along with rabbit trailing Orff, rabbit trail Dalcroze. Based on what I've read about Prompt, I think they might fit well together. It's harder to find a Dalcroze trained teacher, though (I've had a few workshops and short courses, but have not been able to do the full training yet).

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Dmmetler,

You raise an interesting question about the benefits to children with speech apraxia, playing with a recorder or a tin whistle?

How speech apraxia effects the development of a sense of awareness of the rhythmical structure of words?

 

Wind instruments are unique in the way that notes can be formed, and transitioned to the next note?

Where the crucial factor is 'amplitude'?

With a wind instrument, how hard one blows, effects the amplitude.

Also its onset and decay can be varied.

 

So that a note might gradually rise, and then abruptly stop?

Or it start with a high onset, and then gradually decay?

As well as stay at a level.

Also the length of the note can be varied.

 

So perhaps you can imagine how these different uses of 'amplitude', can be combined to create 'different Rhythms'?

 

Wind instruments are unique with their variation.

As with other types of instruments, they start at a high amplitude and then decay.

When we hit a key or pluck a string?

We can't vary its amplitude.

 

But rhythm is also fundamental to words.

Where notes are replaced by the way that syllables are produced, and then combined to form words.

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I'll have to get a recorder and see.  I had one years ago.  I'm cautious with anything I do with his mouth, because it can mess up the motor planning for his speech.  If he gets on the recorder and starts holding his lips a certain way and gets that motor planning cemented in, his SLP will have a cow.  She's already undoing the weird pulling down thing he does with his top lip because of the way he was taking breaths to go swimming.  Even though she worked with him on it, he didn't have enough maturity to carry it over to swim lessons and use his cognitive.  Now he's older, so we may get some carryover.  

 

So the theory is awesome, but I can't always make everything happen.  Come to think of it, I could also do that with a kazoo.  We used to have one around.  He didn't use to have enough breath support and control for a kazoo.  He should now.  Swimming is killer for that.  

 

And yes, he has horrific issues with rhythm.  So if prosody = rhythm + melody, he has problems on both to the most basic level.  Like literally, he couldn't even just clap once.  Sigh.  We worked on that and got basic things like the ability to tap or clap to a steady beat, but we haven't done anything more complicated. So that might be fun to take a simple starter instrument like a kazoo and do some rhythm patterns mixing beats and amplitude, hmm.  

 

What a life I lead.  Kazoos, playing cards, knex...

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