Development of Self-made Gestures as an Adaptive Strategy for Communication in an Individual With Childhood Apraxia of Speech.

Individuals with childhood apraxia of speech often exhibit greater difficulty with expressive language than with receptive language. As a result, they may benefit from alternative modes of communication. Here, we present a patient with childhood apraxia of speech who used pointing as a means of communication at age 2¼ years and self-made gestures at age 3½, when he had severe difficulties speaking in spite of probable normal comprehension abilities. His original gestures included not only word-level expressions, but also sentence-length ones. For example, when expressing "I am going to bed," he pointed his index finger at himself (meaning I) and then put both his hands together near his ear (sleep). When trying to convey the meaning of "I enjoyed the meal and am leaving," he covered his mouth with his right hand (delicious), then joined both of his hands in front of himself (finish) and finally waved his hands (goodbye). These original gestures and pointing peaked at the age of 4 and then subsided and completely disappeared by the age of 7, when he was able to make himself understood to some extent with spoken words. The present case demonstrates an adaptive strategy for communication that might be an inherent competence for human beings.