Thread by @ekverstania

Thanks to lobbying by nonspeaking autistic people and their allies, professionals who work with autistic people in South Africa are becoming increasingly aware of apraxia as a major factor in the struggles of autistic people with high support needs.

Apraxia is a problem with purposeful movement. In nonspeaking autistic people, this typically affects the whole body. Many nonspeakers call it the body-mind disconnect or the brain-body disconnect.

A variety of methods help nonspeaking autistic people learn better control of their movements. Some of these methods, such as Spelling to Communicate, involve prompting, i.e. guiding an apraxic person through simple instructions to help them learn control.

Oral-motor apraxia is a specific type of apraxia. It's the inability to volitionally sequence oral movements of the speech structure for nonspeech tasks in the absence of neuromuscular deficits such as paralysis or muscle weakness.

In simple terms, a person with oral motor apraxia is unable to make the movements needed to speak, but it's not because there's something wrong with their muscles or nerves.

Because this is just an oral (mouth) motor (movement) problem, a person with this condition can still "volitionally sequence" other movements in the rest of their body.

Recently an advertisement from a prominent South African ABA company appeared on Facebook.

"Apraxia is common in children on the autism spectrum," said the ad. "Find out more about how PROMPT can help children on the autism spectrum. Children can create new neuro-maps for speech." The advertisement then went on to promote a book by the company's founder.

This advertisement is misleading for several reasons. Firstly, it appears to be based on the traditional misconception that autistic people who struggle with speech just have an oral motor problem.

This is not what most nonspeaking people are telling us. They describe a problem which goes beyond speech movements alone: a whole-body apraxia.

Secondly, the advertisement ignores the self-reports of ABA survivors who were subjected to PROMPT.

Some nonspeaking autistic children benefit from speech therapy, and speech may even become their primary mode of communication.

But most nonspeaking autists have great difficulty with both gross and fine motor skills, and do not benefit from speech therapy, including PROMPT.

Nonspeaking apraxic autists within the Autistic Strategies Network have described their experience with therapists using PROMPT at ABA schools as horrible and disheartening.

For the anxious parent of a nonspeaking autistic child, the choice of therapies is bewildering. Adhering to a few principles can make the difference between years of sadness and a fulfilled life:

🙂 Value communication over speech.
🙂 Presume competence.
🙂 Listen to many nonspeakers when they say what works for them.

The Autistic Strategies Network is a collaborative initiative of both speaking and nonspeaking autistic people. We invite you to listen to nonspeakers and to support Africa's nonspeaking autistic revolution.

https://twitter.com/ekverstania/status/1378353804958179336

Read the full article about the difference between prompting to help strengthen motor skills in apraxic autistic people, versus the PROMPT© method (not the same thing!).

autisticstrategies.net/prompt-versus-…