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Lehigh Valley Health Network Rehabilitation Services Helps 6-Year-Old Boy Find His Voice

At age 3, David Counterman could barely speak. Today, he speaks in almost complete sentences and is looking forward to starting kindergarten.

david counterman story

Like any first-time mother, Holly Counterman worried about her son David’s development. While he hit all the usual milestones, she noticed that around the age of 2 his speech began to decline. “I noticed that he was actually losing words, and he just stopped babbling and talking altogether,” she says. 

David began working with the Pennsylvania Department of Education Early Intervention Program, and while he made progress, Holly felt that more could be done. She began taking David to see Kimberly Puzio, speech language pathologist with Lehigh Valley Health Network Pediatric Rehabilitation Services

Finding a reason

When David began seeing Puzio at 3 years old, he was mostly nonverbal and used sign language as his primary mode of communication. Puzio’s first course of action was to find the cause of his speech issue. 

An evaluation revealed that David had childhood apraxia of speech. “Apraxia of speech is a speech sound disorder where the message from the brain to the mouth gets mixed up. It’s a motor coordination disorder,” Puzio says. 

Fortunately, childhood apraxia of speech is treatable. Puzio began seeing David and his mother up to three times a week for speech therapy and says Holly was an active participant in her son’s therapy. 

“It’s really important that everyone in the family is involved in the process because the work needs to continue at home. Holly was great in making sure what we were working on at therapy was carried through into David’s home life, as well,” Puzio says. 

In the beginning, Puzio focused primarily on imitating vowel sounds because that’s what gives people the most information related to the message being communicated by the speaker. Within just a few months, Holly says, she saw a huge difference in her son. 

“He went from barely speaking to putting together almost full sentences,” she says. 

Making speech therapy child’s play

Holly acknowledges that keeping David entertained and engaged during speech therapy wasn’t always easy. “There were definitely times that we struggled, but we tried to make it as fun as possible. We set up rewards, and Ms. Kim had activities to make his speech therapy fun,” she says. 

Puzio says because children learn through play, she incorporates a lot of David’s favorite activities into speech therapy. “David is very tactile, so we’ve made slime, done Play-Doh. I know he likes video games, so we even practice words related to that since that’s important to him,” she says. 

Now 6, David only sees Puzio once a week and is looking forward to starting kindergarten in the fall. Holly says she continues to work with him at home and is grateful that she got help for David when she did. 

“It’s a tough pill to swallow, to realize that your child is different, but it doesn’t make it any better for them if you don’t tackle it head on,” she says. 

For more information on pediatric rehabilitation services, visit

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