Apraxia

[Guest guest]

Dorothy,

One of the things that is genetic about parkinson's is a sensitivity

to metal and pesticides and as far as removing your fillings w/o

chelating afterwards, I would ask Andy about that one but I know two

other people who had children after removing filling out of there

mouth and there kids are mercury toxic.

nne

-- In @y..., dask4t@a... wrote:

> In a message dated 5/10/2002 2:06:30 PM Eastern Daylight Time,

> marib005@h... writes:

>

>

> > The loose stools are a give away to blocked enzymes, at least for

my

> > kids, are they lighter in color?

> >

> >

>

> Yes, the loose stools were light in color and got lighter when I

took away

> gluten and put him on supps. After three months of that, I put him

back on

> gluten and stopped supps. Now his stools are really, really

normal. Normal

> color, doesn't smell as much as it used to and he moves his bowels

every

> other day.

> As for mercury, I did a hair test and applied counting rules

and he

> doesn't come up toxic. As to mercury history, I also had a lot of

fillings.

> After my first child, 18 years ago, who is completely NT, I had my

fillings

> removed and put in porcelin. My friend is a maxofacial surgeon and

he did it

> because he's a little on the health nut side, (I term I used before

finding

> all this stuff out, now I'm a little on the health nut side), and

told me it

> would be better for me to take all of them out. I did. That had

to be three

> or four years before I got pregnant. I don't remember ever

breaking a

> thermometer.

> My mother was diagnosed with manic depression when I was

about four

> yo. She has been on many different medications through the years.

Now she

> has parkinson's on top of everything. We found out that Stelazine,

on of the

> medications she took for a long time, (which is recommended as a

short term

> drug), causes parkinson-type syndrome, so.... I don't know.

> We're going on vacation for two weeks. During that time, my

husband

> and I will be trying to come to a decision. Do we go out and look

for a Dan

> doctor and chelate or do we think he doesn't need it? It's a tough

decision

> because we really don't have the money to spend. I spent a fortune

on supps

> and trying foods that he could have while on the gfcf diet and

throwing them

> out, bought a food processor, bread maker, special cookie cutters,

books and

> more books, plus some money for therapists and the nutritionist.

Once my son

> starts school, June 3rd, and I am back to work on a more consistent

basis, (I

> only get paid for the amount of work I do), I'll be able to afford

some more

> expenses.

> So, for right now, we're on a wait and see. Thanks for your

input.

> Once I determined he was not mercury toxic, I almost dismissed

chelation

> altogether. Now I'm thinking about it again.

> Dorothy

>

>

>

[Guest guest]

In a message dated 5/11/2002 10:24:56 AM Eastern Daylight Time,

marib005@... writes:

> One of the things that is genetic about parkinson's is a sensitivity

> to metal and pesticides and as far as removing your fillings w/o

> chelating afterwards, I would ask Andy about that

nne,

Very interesting. I will add this one to my argument with my husband.

He's not thrilled with chelating.

I really have to get to a DAN doctor. I think that's my next move.

Dorothy

[Guest guest]

People that have strokes are in a state of aphasia sometimes. Apraxia is a

result of dyspraxia with no speech. Dyspraxia is when there is some speech

present and a motor planning concern.

[Guest guest]

Hi!

I thought apraxia was related to motor planning problems with speech

and separate from word retrieval problems and cognition problems. I

believe that no speech falls more under aphasia. Please correct me if

I am wrong.

Tina

> Apraxia means no speach. Apraxia does not effect the cognitive

ability to

> understand yes from no.

>

>

>

[Guest guest]

Hi!

Our discussion of apraxia made me curious about the different

defintitions that may be applied to this term. So I did a search on

the web and I grabbed the following definitions which refer to

apraxia in kids as Developmental Apraxia of Speech. I think DAS with

speech motor planning problems is what I think of when I hear the

term apraxia.

Regards,

Tina

" Apraxia is difficulty forming sounds into words. The term

developmental apraxia is used when children have this problem. "

, MA, " Developmental Apraxia, " Communication Skill

Builders, 1988. " Although the exact speech breakdown and its severity

varies from child to child, children with verbal apraxia fail to

establish the full repertoire of English phonemes, that is, the set

of articulatory gestures requisite for producing all the English

sounds. Each child evidences less than normal ability to imitate a

speech signal (phonemes, syllables, words). These children's

spontaneous emission of speech patterns, as well as their imitated

speech production, demonstrates faulty articulation, difficulty with

combining and sequencing phonemes, and a struggle to deliver speech. "

Gerald Chappel, " Childhood Verbal Apraxia and Its Treatment, " Journal

of Speech and Hearing Disorders, 38, 3.

" In DAS, the child has difficulty carrying out purposeful voluntary

movement sequences for speech in the absence of paralysis of the

speech musculature. "

Edythe Strand, Ph.D., " Childhood Motor Speech Disorder Treatment, "

Seminars in Speech and Language, Vol. 16, No. 2, May 1995

" ... the differential diagnosis 'developmental apraxia of speech' has

been assigned to a subset of children who differ from children with

other developmental speech disorders in that their articulation

errors are accompanied by apparent difficulty in producing and

sequencing the volitional (voluntary) movements (non-imitative) that

generate speech. "

Hodge, Ph.D., " Assessment of Children with Developmental

Apraxia of Speech, " Clinics in Communication Disorders, 4 (2), 1994

" In its purest form DAS is a disorder of the ability to translate

phonemic and linguistic codes to differing planes of movement over

time. "

Deborah Hayden, " Differential Diagnosis of Motor Speech Dysfunction

In Children, " Clinics in Communication Disorders, 4 (2), 1994

" DAS is a motor speech disorder in the ability to regulate control

over movement sequences. DAS is a separate disorder that requires a

motor treatment, although it will probably co-occur with other

neuromotor deficits. DAS is remediable if the clinician knows that

control of speech movement must be the focus of treatment. "

a Square, " Introduction, " Clinics in Communication Disorders, 4

(2), 1994

" Developmental apraxia of speech is a neurological disorder that

affects the planning and production of speech (, Jakielski, &

Marquardt, 1998). A child with DAS exhibits speech deficits in the

absence of paralysis or weak musculature. DAS is a loss in ability

to voluntarily position the articulators (e.g., lips, jaw, tongue) on

a consistent basis when speaking. This disorder interferes with the

child's sequencing of sounds into words. In other words, the child

has the ability to produce the sounds, but when he/she tries to

purposefully plan speech, the articulators do not always function

together properly. "

[Guest guest]

,

I am not an expert, just a mom, but here is what I see as the difference.

Can someone please tell me the difference between oral and verbal

apraxia?

Oral would involve a child not being able to blow, suck, pucker, move tongue

on command etc...My child could suck from a straw from age 12 months on but he

had a lot of trouble with puckering etc... My son has oral apraxia and until

this was addressed it did very little good to focus on the verbal. Verbal is

speech: Like dropping the beginning consonants, not being able to motor plan

sentence structure etc..

Also how would I know if my son has sensory issue in the oral motor

area?

My son tended to overstuff his mouth and would even gag himself from

overstuffing.

I'm trying to get private therapy for him and wondering what would be

best for him.

Depending on the diagnosis, if your child has oral apraxia do not every

neglect the oral motor work. Verbal tends to require a LOT of repetitive work,

etc...

Every specialist has a different opinion on what works for what....

I hope this is of some help.

JENNY

(extremely confused in Boca Raton, FL)

[Guest guest]

Hi there, I also live in Boca and have a wonderful group of therapists...

Jonas is a top speach pathologist here and is very involved with my sons

development. I also have a great OT who has been with me since we moved here

from NY a year ago...I've fired quite a few therapists, unfortunately this is

not NY as far as the availability of competent therapists...

Need any help call me 561-241-5197

Judy

<superj777@...> wrote:

Can someone please tell me the difference between oral and verbal

apraxia?

Also how would I know if my son has sensory issue in the oral motor

area?

I'm trying to get private therapy for him and wondering what would be

best for him.

Every specialist has a different opinion on what works for what....

JENNY

(extremely confused in Boca Raton, FL)

[Guest guest]

Daphne, thanks for your reply. I met with the speech therapist today

and she showed me how has weakness in his tongue, lips, etc.

Also, isn't able to completely imitate tongue movements. I would

have never known it especially since I thought the fact that he could

blow bubbles, candles, suck from a straw etc. meant that he didn't

have any oral motor issues. Thanks for your input.

[Guest guest]

Hi .

The weakness could co exist with the motor planning problem of

apraxia as we talk about in 'Is Your Child A Late Talker'

http://www.cherab.org/information/latetalkerhandout.html however if

it's only weakness in the mouth it would be dysarthria -not apraxia. You

need a good neurodevelopmental exam together with speech pathologist

exam to know the difference so you can use the most effective

therapies. strengthening or motor planning or both. Not being able to imitate

tongue movements on command

when the child wants to can be from either weakness (dysarthria) or

motor planning problems(oral apraxia) -either way it would be considered an oral

motor problem.

http://www.cherab.org/information/speechlanguage/oralapraxia.html

Weakness (hypotonia/dysarthria) vs. motor planning (apraxia) -the

trick in spotting one from the other isn't really hard once you have

an idea what to look for. In a nutshell if your child moves his

face to make faces at times -but just can't do it on command -and

wants to, tries to (sometimes over and over) -that is apraxia.

Below is a recent archived message to another member who questioned

if her child was really tired or not. It covers the parent friendly

ways of knowing weakness from motor planning. Hope this helps!

" Your son could say he is tired for a number of reasons -not sure if

I can quickly cover them all but I'll try.

A. Avoidance. He isn't comfortable learning or trying -or he

doesn't like what he is doing. This could also include frustrations

and self esteem reasons.

B. Physical limitation. He has motor planning and/or weakness

problems in his body. The motor planning would inhibit his ability

to skillfully move his body the way he wishes if he has motor

planning problems in the body (more global apraxia) The weakness in

the muscle (hypotonia) would cause him to tire faster than other

children.

If you are not sure if your child has motor planning or weakness

problems of the muscle -the neurodevelopmental MD (well -a

knowledgeable one!) will be able to let you know when you take your

son to see him/her. Most of our children in this group have mild

low tone somewhere in the body together with motor planning

problems. Most of our children do not have the type of hypotonia

that is typically picked up at birth (floppy baby) however some in

this group do.

http://www.medterms.com/script/main/art.asp?ArticleKey=3479

Apraxia is not a cognitive nor a behavioral disorder, so these types

of symptoms if present would not be an indication of whether the

child is apraxic, yet could be present as conditions secondary to

the diagnosis -or indications of another diagnosis. If a child does

not have signs of oral apraxia, nor any other soft signs we

typically are finding in children with apraxia such as mild

hypotonia/low tone, motor planning problems in other areas of the

body, or sensory integration dysfunction, and he is still nonverbal,

it would be difficult to know if the reason for his delay in speech

was from apraxia/another disorder of speech vs. a simple delay.

Apraxia is a motor planning disorder which used to be uncommon in

children and appears to be on the rise. There is a difference

between weakness of the muscle, which would require strengthening

therapies, and motor planning problems in the muscles which would

require therapies to reinforce motor planning around the mouth. Of

course again -your child may just have a simple delay.

Here is a simple parent friendly way of having a better idea if it's

hypotonia (low tone/weakness) or motor planning problem (apraxia)

A child with apraxia can breath in and out of his nose all day long.

But " on demand " if you put a tissue to his nose and tell him to blow

out -he may breath in instead!

or...

A child with apraxia can lick his lips once in awhile when nobody is

asking him to -and he doesn't need to (no food is there) but when he

is asked -or he wants to because he wants to lick off food -he can't

figure out how to move his tongue -or which way to move it.

Apraxia is like trying to write the word apraxia while looking in a

mirror. Can happen -just not often enough -and rarely is there

control.

A child with hypotonia -depending on the weakness of the muscle -

can't do the movement -and never does the movement. So you wouldn't

see your child do it ever. If the weakness is mild, they may do the

movement but will tire quickly.

Hypotonia is like trying to pick up a fork with a wet noodle.

Doesn't happen -you never see it.

Most of the children we outreach to in CHERAB have a combo of both

low tone (hypotonia) and motor planning problems (apraxia) to some

degree -so for most of us - you and the child will be dealing with

both issues in the child -which is way frustrating for all. Therapy

needs to help with motor planning as well as strengthening -and

never give up hope no matter what. I've personally seen children

that " shocked " the experts with their progress no matter how severe

no matter how delayed.

Try to find activities that your son enjoys and see if his

motivation changes. I also find that if you do the activities

around other kids/friends most children are more likely to push

themselves.

Roller blading on the grass may not be as much fun, or as easy, for

example, as roller blading on a smooth surface at a roller rink with

lots of music and if needed -two people holding his hands to help

him glide along at a pace that is comfortable for him. Does he

like T ball and the kids he was playing with? Does he like karate,

swimming, a game of tag, bowling, riding his bike -any activities?

Watch to see if he tires walking at places like amusement parks -

many of us with children that have hypotonia wouldn't dream of going

to a place like that without a stroller...for years and years -years

after other parents with children the same age have their stroller

collecting spider webs in the garage. Actually -if you need a

stroller longer than other parents for your son -another possible

sign of hypotonia.

You want to know if your son is being lazy -or is doing the best he

can and is frustrated due to limitations. You want to push hard

enough to motivate and help without breaking -that's the fine line

we walk with out special needs kids.

As far as what to ask the pediatrician/neuroMD -that is all covered

in The Late Talker http://www.speech-express.com/late.talker.html

(being that my co author is a developmental pediatrician you will

get the inside scoop!) And for the person that asked about insurance

- " covered " (in the book too)

Hope that helps! "

=====

[Guest guest]

Thanks for the descriptions of hypotonia vs. apraxia. My

daughter has both like you describe.

Anyway, one of our occupational therapist told us that when you work

on motor planning anywhere in the body, it helps with the motor

planning used during talking.

So, even if your child can't do motor planning activities involved

in the mouth, they may be able to do motor planning activities with

other parts of their bodies. One example is clapping. One of the

activities that I have done with my daughter is to imitate me

clapping. I alternate the rhythms, and then she copies me. I also

do this with jumping and all sorts of other activities.

Just trying to think of ideas for parents who are frustrated. There

are so many things that help our kids. It's mainly important to

provide a stimulating environment for them.

Suzi

> Hi .

>

> The weakness could co exist with the motor planning problem of

> apraxia as we talk about in 'Is Your Child A Late Talker'

> http://www.cherab.org/information/latetalkerhandout.html however

if

> it's only weakness in the mouth it would be dysarthria -not

apraxia. You

> need a good neurodevelopmental exam together with speech

pathologist

> exam to know the difference so you can use the most effective

> therapies. strengthening or motor planning or both. Not being

able to imitate tongue movements on command

> when the child wants to can be from either weakness (dysarthria)

or

> motor planning problems(oral apraxia) -either way it would be

considered an oral

> motor problem.

> http://www.cherab.org/information/speechlanguage/oralapraxia.html

>

> Weakness (hypotonia/dysarthria) vs. motor planning (apraxia) -the

> trick in spotting one from the other isn't really hard once you

have

> an idea what to look for. In a nutshell if your child moves his

> face to make faces at times -but just can't do it on command -and

> wants to, tries to (sometimes over and over) -that is apraxia.

>

> Below is a recent archived message to another member who

questioned

> if her child was really tired or not. It covers the parent

friendly

> ways of knowing weakness from motor planning. Hope this helps!

>

>

> " Your son could say he is tired for a number of reasons -not sure

if

> I can quickly cover them all but I'll try.

>

> A. Avoidance. He isn't comfortable learning or trying -or he

> doesn't like what he is doing. This could also include

frustrations

> and self esteem reasons.

>

>

> B. Physical limitation. He has motor planning and/or weakness

> problems in his body. The motor planning would inhibit his ability

> to skillfully move his body the way he wishes if he has motor

> planning problems in the body (more global apraxia) The weakness

in

> the muscle (hypotonia) would cause him to tire faster than other

> children.

>

> If you are not sure if your child has motor planning or weakness

> problems of the muscle -the neurodevelopmental MD (well -a

> knowledgeable one!) will be able to let you know when you take

your

> son to see him/her. Most of our children in this group have mild

> low tone somewhere in the body together with motor planning

> problems. Most of our children do not have the type of hypotonia

> that is typically picked up at birth (floppy baby) however some in

> this group do.

> http://www.medterms.com/script/main/art.asp?ArticleKey=3479

>

>

> Apraxia is not a cognitive nor a behavioral disorder, so these

types

> of symptoms if present would not be an indication of whether the

> child is apraxic, yet could be present as conditions secondary to

> the diagnosis -or indications of another diagnosis. If a child

does

> not have signs of oral apraxia, nor any other soft signs we

> typically are finding in children with apraxia such as mild

> hypotonia/low tone, motor planning problems in other areas of the

> body, or sensory integration dysfunction, and he is still

nonverbal,

> it would be difficult to know if the reason for his delay in

speech

> was from apraxia/another disorder of speech vs. a simple delay.

> Apraxia is a motor planning disorder which used to be uncommon in

> children and appears to be on the rise. There is a difference

> between weakness of the muscle, which would require strengthening

> therapies, and motor planning problems in the muscles which would

> require therapies to reinforce motor planning around the mouth. Of

> course again -your child may just have a simple delay.

>

> Here is a simple parent friendly way of having a better idea if

it's

> hypotonia (low tone/weakness) or motor planning problem (apraxia)

>

> A child with apraxia can breath in and out of his nose all day

long.

> But " on demand " if you put a tissue to his nose and tell him to

blow

> out -he may breath in instead!

> or...

> A child with apraxia can lick his lips once in awhile when nobody

is

> asking him to -and he doesn't need to (no food is there) but when

he

> is asked -or he wants to because he wants to lick off food -he

can't

> figure out how to move his tongue -or which way to move it.

>

> Apraxia is like trying to write the word apraxia while looking in

a

> mirror. Can happen -just not often enough -and rarely is there

> control.

>

> A child with hypotonia -depending on the weakness of the muscle -

> can't do the movement -and never does the movement. So you

wouldn't

> see your child do it ever. If the weakness is mild, they may do

the

> movement but will tire quickly.

>

> Hypotonia is like trying to pick up a fork with a wet noodle.

> Doesn't happen -you never see it.

>

> Most of the children we outreach to in CHERAB have a combo of both

> low tone (hypotonia) and motor planning problems (apraxia) to some

> degree -so for most of us - you and the child will be dealing with

> both issues in the child -which is way frustrating for all.

Therapy

> needs to help with motor planning as well as strengthening -and

> never give up hope no matter what. I've personally seen children

> that " shocked " the experts with their progress no matter how

severe

> no matter how delayed.

>

> Try to find activities that your son enjoys and see if his

> motivation changes. I also find that if you do the activities

> around other kids/friends most children are more likely to push

> themselves.

>

> Roller blading on the grass may not be as much fun, or as easy,

for

> example, as roller blading on a smooth surface at a roller rink

with

> lots of music and if needed -two people holding his hands to help

> him glide along at a pace that is comfortable for him. Does he

> like T ball and the kids he was playing with? Does he like karate,

> swimming, a game of tag, bowling, riding his bike -any activities?

> Watch to see if he tires walking at places like amusement parks -

> many of us with children that have hypotonia wouldn't dream of

going

> to a place like that without a stroller...for years and years -

years

> after other parents with children the same age have their stroller

> collecting spider webs in the garage. Actually -if you need a

> stroller longer than other parents for your son -another possible

> sign of hypotonia.

>

> You want to know if your son is being lazy -or is doing the best

he

> can and is frustrated due to limitations. You want to push hard

> enough to motivate and help without breaking -that's the fine line

> we walk with out special needs kids.

>

> As far as what to ask the pediatrician/neuroMD -that is all

covered

> in The Late Talker http://www.speech-express.com/late.talker.html

> (being that my co author is a developmental pediatrician you will

> get the inside scoop!) And for the person that asked about

insurance

> - " covered " (in the book too)

>

> Hope that helps! "

>

> =====

>

[Guest guest]

Nick -Simple answer is that yes 75% or most of the time a two year old child

that

fits your description will outgrow his delay in speech.

And even if your child is in the other 25% and does have a

impairment of speech most likely with interventions he will overcome at least

well enough that most others do not notice it. It's lucky for your child

he has a parent like you that is out there searching -those

are the children in the 25% that will typically be OK!

Below are two recent archived messages that may help -if not we have

a wonderful and intelligent group here who will have so much more to

add so let us know! (and Happy Thanksgiving!)

First one was for a nonverbal five year old:

" Hi Kathy!

What is your child's diagnosis? Does she appear to understand all

you say even though she can't speak verbally? Does she play with

toys appropriately? What are her favorite things to play with?

Does she enjoy going to the zoo? the movies? Does she act strange

ever in large groups or when things are very loud, or when you try

to get her hair cut or hug her? Does she eat well? Are there

certain textures she avoids? Have you had an evaluation by a good

neurodevelopmental MD who is knowledgeable about apraxia? I can't

stress enough the importance of taking your child to a professional

that is knowledgeable in the case of medical! (or don't take her or

she'll just be slapped with a label that may or may not be

appropriate) What do her speech or occupational therapists think

she has? How often does she have therapy? Do they do motor

planning therapy for apraxia or strengthening therapy for weakness?

Do they do both? (and I hope she's getting multisensory therapy

overall!)

Have you read The Late Talker book which is a book for any child

that has delays in speech and covers all of these feelings?

http://www.speech-express.com/late.talker.html These feelings of

depression and hoplessness are normal -but so are feelings of

denial, fear, anger, and acceptance. Understanding you are not the

only one going through this and that there are many who went through

it with their child and are now on the other side may be helpful.

If not the book also provides numerous comforting ways to help

yourself and child. To me knowledge is powerful -at least once you

have knowledge, and you try to help your child the best you know

how, you know you are doing all you can do. "

And for a child about your child's age (2.7 years):

From: " kiddietalk " <kiddietalk@...>

Date: Sun Nov 9, 2003 12:56 pm

Subject: Re: HELP! for latetalker grandson

Your grandson is very fortunate to have such a loving grandparent!

Sounds like your grandson does not have an oral motor weakness, or

at least an obvious one -or some of what you said he is doing he

would not be able to do. (moving tongue freely, blowing whistles)

http://www.cherab.org/information/speechlanguage/oralapraxia.html

Apraxia is the ability to do movements on command. From what you

wrote I'm guessing your grandson is able to 'on command' move his

mouth and tongue freely. It's easy to check this -just put peanut

butter on various parts of his lips and see if he is able to lick it

off. Make a game of funny faces in the mirror and see if he can

copy the faces. Does he smile when you say " smile " ? I'm sure all

of this he is doing fine -just checking.

The fact that your grandson is able to imitate any words said to him

may also rule out verbal apraxia -but I would not know.

If you rule out oral and verbal apraxia -that does not rule out yet

another impairment of speech, nor does it rule out that this may be

just a simple developmental delay in speech which he will just

outgrow. 75% of late talkers are just that -late talkers. So there

is a good chance he is just a late talker. I'll share the rest of

this however just in case.

Does your grandson have any neurological " soft signs " such as

hypotonia or sensory integration dysfunction?

http://www.cherab.org/information/speechlanguage/parentfriendlysoftsigns.html

Has anyone evaluated your grandson? After three in the US he would

be evaluated for Early Intervention services through his town

school, and at his age it would be through Early Intervention

through the state. (birth to three) Was he evaluated by both a

speech pathologist as well as an occupational therapist? Was/were

they knowledgeable about apraxia? (If your grandson wasn't diagnosed

by an occupational therapist as well and professionals or anyone

suspects apraxia -I highly recommend you request that for your

grandson too either through Early Intervention as well as private

through insurance for many reasons)

To answer any questions you may have about taking your grandson to

see a neurodevelopmental MD if he has not yet been to one and if

verbal apraxia is suspected... in one word - " Yes!!! " I would have

your grandson diagnosed (private) by a neurodevelopmental medical

doctor (developmental pediatrician or pediatric neurologist) who is

knowledgeable about apraxia and other neurologically based multi-

faceted communication impairments for numerous reasons. Reasons

include (but not limited to)

*having a " hero " on the outside of the school who can assist in a

therapeutic plan and oversee your grandson's development over the

years

*advocacy support with the insurance company

* ruling out or confirming any neurological soft signs or any other

reasons for the delay in speech

*help those that ask " why isn't he talking yet " understand this is a

medical condition -and has nothing to do with your child's cognitive

ability. (if in your grandson's case it doesn't. Apraxia in itself

does not affect a child's cognitive ability -and speaking early or

late is no indication of a child's intelligence. Also contrary to

popular belief -most who have speech impairments have average to

above average intelligence)

I would also have at least one private " out of pocket " (if possible)

exam with a knowledgeable speech pathologist as well if this has not

been done yet. This SLP can coordinate with your grandson's MD, and

school therapist and other professionals, and again be there to

assist in a therapeutic plan, help set goals and oversee your

grandson's development over the years if needed.

Networking with parents of other speech delayed children is also

possibly one of the best moves you could make in your grandson's

recovery. Others will steer you to the " right " professionals and

programs in your area -and help answer questions.

Check your state resources at Speechville to find local support

groups and resources.

http://www.speech-express.com/regional-resources.html

http://www.speech-express.com/communication-station/regional-support-groups.html

(BTW -for anyone who is either running or starting a support group -

due to The Late Talker book and the many who will see your group,

please make sure your info is up at this website and accurate)

As always -make sure all testing done on your grandson is

nonverbal. Right now that he is young most likely it will be.

While in Early Intervention as well it will be easier for you to

advocate for him for appropriate nonverbal testing now that you are

aware (most are not -and even intelligent PhDs and MDs are not

aware) However as a group we are now working on having laws passed

on behalf of all the children like your grandson who continue to

have verbal delays through school years. There is much in the way

of verbal based tests in the schools that obviously those of

preschool children are not aware of. Without laws in place and

awareness as to why this is inappropriate, inaccurate and

detrimental -this verbal based testing of cognitive and receptive

ability on verbal disabled children/teens/adults will continue.

For all your other questions including what type of testing -just

read " The Late Talker "

Here are parts of an article that based on The Late Talker book

success I was asked to write for a parent magazine that should be

published shortly:

" ...early intervention is undoubtedly beneficial, even if the child

does turn out to have a simple delay in speech and nothing more. In

addition to helping give speech a boost, speech pathologists can

help in providing strategies for relieving communication

frustrations while the child is learning to talk.

The strong reason for early intervention however is for those

children who have more than just a delay in speech: those with a

disorder of speech. 25 percent of late-talking children do not grow

out of their problem before starting school. Waiting and seeing is

no great comfort should your child be one of the unfortunate 25

percent. The benefits of one-on-one speech therapy as early as

possible for children in this group are overwhelming. If you

happened to be the parent of one of the children in this 25%, you

would also quickly learn the difficulties faced daily in securing

critical ongoing speech therapy services for your child through

insurance companies. Children with a delay in speech may not

require any therapy at all, or perhaps just a month or two for a

jump start. Those in the 25% however may require years of intensive

therapy to have hope of a verbal future.

The U.S. Department of Education agrees, saying that Early

Intervention increases the developmental and educational gains for

the child, improves the functioning of the family, and reaps long-

term benefits for society. Early intervention, says the department,

results in children needing fewer special education and other

services later in life and being retained in a grade less often. In

some cases, it says they become indistinguishable from non-impaired

classmates.

If your child is under the age of three and you're concerned about

his development, obtain a speech and hearing evaluation through your

insurance company, which is typically covered. You can also

schedule your child for a free or subsidized evaluation through your

local birth to three early intervention program. If your child is

three to twenty one, you could secure a free evaluation through your

town's local school. Under the Federal law your child is entitled

to a " free and appropriate public education " (FAPE) which in

addition to the educational component, must include " related

services " such as speech, physical and occupational therapy if

needed. For preschool age children this program is usually called

a " preschool disabled program. "

....If your child does not qualify for free early intervention

services and your insurance will not cover therapy, yet you still

believe your child would benefit from speech therapy, there are

still options if cost is a factor. Check with local universities

near you that have speech and language departments to find therapy

services offered by graduating students for nominal fees. These

services are typically overseen by PhDs, experts in the field.

Having had one child that was " just " a late talker, and one child

with a severe ongoing speech disorder, in both cases I would highly

recommend seeking professional evaluations if you suspect a delay.

From running a nonprofit that outreaches for children with speech

delays and disorders, I can also tell you that the guilt of parents

of speech disordered children that took the wait and see approach is

far worse than having to gripe about therapy services for a speech

delayed child that may have provided the child with the boost he or

she needed to become the normal talkative child today who was " just "

a late talker yesterday.

[Guest guest]

Karyn wrote:

> Jordan never had any gross motor skill issus, EVER. In fact, that's

> what really threw all the docs! The hypotonia was missed <I knew it

> was there.....> because he rolled, sat, crawled and walked early. He

> did EVERYTHING early...much earlier than his peers. AT the baby

> group, he was the first babbler, the first walker, the first runner,

> the first to master all the physical tasks. But still not

> understandable (although he did make a LOT of noise.) So because non

> of the other " markers " were seen, he was just considered a " late

My child was like this as well. As he has gotten older though it has

become more apparent that even though he has a very strong drive and

still often starts things first he lacks the coordination and balance to

really move along. My son was the first boy in his 3 year old preschool

to write his name. But he never gained the proper pencil grasp and in K

he is one of the poorest writers despite being one of the most advanced

academically. When kids are bright the Peds are very quick to say

speech problems will simply go away. We missed out on lots of early

therapy years because my son had an advanced vocabulary (if one could

translate). Getting full PT and OT evaluations are really important too

even if things seem fine. But anyway we see things come and go. My son

does much better with longer words now in getting them understood but he

still really lacks some of the basic sounds. So basically he is

compensating more at getting people to understand him but he still lacks

the proper foundation of sounds to really progress.

[Guest guest]

Jordan never had any gross motor skill issus, EVER. In fact, that's what really

threw all the docs! The hypotonia was missed <I knew it was there.....> because

he rolled, sat, crawled and walked early. He did EVERYTHING early...much

earlier than his peers. AT the baby group, he was the first babbler, the first

walker, the first runner, the first to master all the physical tasks. But still

not understandable (although he did make a LOT of noise.) So because non of the

other " markers " were seen, he was just considered a " late talker. " Had I not

known and understood apraxia, it would have been missed. It was dismissed many

times by several of the docs who saw him because he was " too normal. "

Jordan's language gets clearer every day, and he can string up to 7 words now,

before it starts to break down. I'm confident that with the correct therapy,

his apraxia won't be very noticable at all, as he gets older. I do believe

these children can overcome this, when early intervention is implemented.

~Karyn

[ ] apraxia

. My question if a child, let's say two, has good motor skills and

is limited in words, is he ever able to overcome this problem and be

completely normal in verbal communication. Thanks, Nick

New book on late talking! http://www.speechville.com/late.talker.html

Information shared here is the personal opinion of each member. CHERAB

accepts no responsibility for the opinions and information posted on the list by

its members.

[Guest guest]

Hi brenda,

the slp's that worked with my son said the same thing, he started at 21months.

But.... said that yea it looks like apraxia, and they would be easier on him as

far speech goes. They worked on a lot of receptive language, i.e-pointing,

coloring, just talking about what they are doing and sometimes asking him to say

things. It worked well because he did not get frustrated but they did not work

on speech hardly ever, he needed a little push at that age to talk. I had to

push them to work on just one word to work on. On the postive side they worked

on oral motor stuff, he loved it. one therapist, had a train and he loved

trains, he was able to say train, she would say choo choo, he still says choo

choo for train, the slp's have influence. she changed his lable for train to

choo choo. We miss her she was great with him.

I hope this helped

chris

farmwidow@... wrote:

Hi again,

This is my second posting, thank you and for all who answered

my first posting.

Well now my son's therapist says she isn't ready to dx him with

apraxia as he is " young " (19 months). Everything I have read (loved

the Late Talker) points to him having apraxia and maybe even

dysarthria! He has 2 rare brain malformations, left-sided

weakness,sensory issues, eating issues, etc etc.... so I don't know

why she is back tracking after mentioning apraxia. She did agree to

change his speech therapy (after almost 1 year without any progress)

to apraxia related therapy. She has been wonderful this past year

and really does seem to have his best interest at heart. His

developmental pediatrician said the same thing " he is too young to

dx " but I am worried that they will wait til he is 3 to dx him with

apraxia and he will miss out on vital therapy. What should I ask

for? More therapy? How much? Different approach? Which therapy works

best for apraxia?

I started him on ProEfa today. How much do you give a 19 month old?

He weighs about 23lbs. I gave him one capsule in his juice, is this

enough?

Thank you all so much if it wasn't for this web site and

Schizbuddies web site I would go crazy!

Sincerely,

[Guest guest]

,

18 months is young for a verbal apraxia diagnosis but some say not

too young for an oral apraxia diagnosis. In any regard, it won't harm

him to treat it as if it is apraxia even if it turns out he isn't.

There are some good books out there. One by a Pam Marsalla and Easy

Does it for Apraxia available from Linguisytems. May be available

thru superduper.com.

How often is he getting therapy. They say 3-5 times a week, but home

therapy is just as good if you reinforce daily what the SLP is

showing you. make games out of blowing bubbles, blowing thru straws

to move objects, etc. Without follow through at home, good therapy

can be wasted. So if you can only get 2X a week but follow up the

rest of the week then that sounds good to me. Realistically speaking,

many people cannot afford private therapy unless their insurance

kicks in which is often difficult.

Cued multisensory therapy works well. We use to do therapy on a ball

which was a great stimulus and also worked on crossing midline,

language at the same time. Kaufman cards are great too, not sure if

he is too young for them.

In terms of Pro-efa most people start at 1 a day. If you feel more

comfortable starting with a half and gradually working up to 1 that

is probably a good option.

Good luck.

denise

Mom to 6 in 3 weeks.

> Hi again,

> His

> developmental pediatrician said the same thing " he is too young to

> dx " but I am worried that they will wait til he is 3 to dx him with

> apraxia and he will miss out on vital therapy. What should I ask

> for? More therapy? How much? Different approach? Which therapy

works

> best for apraxia?

> I started him on ProEfa today. How much do you give a 19 month old?

> He weighs about 23lbs. I gave him one capsule in his juice, is this

> enough?

>

[Guest guest]

,

Thank you for your response. Jerry is getting speech (regular) once

a week now but we are having a meeting in 2 weeks to discuss

increasing it to twice a week. I try to work with him every day but

he also has PT and OT therapy to do also so usually he is doing one

or the other every day. His therapist is worried about Jerry being

burned out on therapy. She is changing his program to be more for

apraxia. At this time he can't blow or make a lot of face gestures

but he has the best & biggest smile I have ever seen on a child!

I did start the PRoEfa 1 a day. I hope it helps him. I would even

love to hear a few babbles!

Thanks for the advice.

[Guest guest]

hi dawn- ther is alot of info about apraxia on the computer and the apraxia

website is great- many people on this site have children with speech

apraxia. it is hard to distinguish from being a late talker or having a

phonological disorder and usually the biggest most obvious sign is a child who

doesn't

talk and in my sons case truly could not repeat words. he only likes yellow

cruncy foods and has alot of sensory issues, he was also misdiagnosed with

autism. the best book i have read is the late talker book by

[Guest guest]

My little boy is four years old and is a late talker. He has had

speech therapy first through first steps. He is now in preschool and

has speech therapy in prescool. What is apraxia?

Dawn

[Guest guest]

Dawn,

Apraxia -what's that?

I asked the same thing less then 6 years ago and 2003 wrote a book

about it -go figure. I wish I didn't 'have' to know. We do what we

can to help our children. I like you knew what a late talker was of

course ...since 'both' of my boys were " late talkers "

http://www.cherab.org/information/familiesrelate/workandfamily.html

http://www.cherab.org/information/familiesrelate/letter.html

Most people use the term " late talker " for a child that is a bit

late to talk. Or they say " late bloomer " . Or " Just give him time

and he'll talk just fine " . Or " Einstein didn't talk till he was

___ " fill in the blank Or " He's not talking because you are doing

too much for him " Or...(you all know)

" Late talker " is a term used frequently for two year olds, less

often for a three year old who probably at that point is in some

type of Early Intervention and may instead be " diagnosed " as having

an " expressive language delay " , and even less often for a four year

old or older because at four or older it's more likely the child is

diagnosed with some reason for the delay...such as apraxia -which is

one of many disorders of speech. Just because a child is diagnosed

with a disorder doesn't mean that child will not have a verbal

future, it just means that they will require therapy to help them

get there (unlike those with simple delays in speech who will speak

with or without therapy -but just later)

75% of late talkers statistically are just that -children that talk

a bit later who have simple delays in speech. The strategies used

for apraxic children will still help to relieve frustration and

encourage speech if your child only has a simple delay.

It's for those children, like my Tanner, in the other 25% that the

Early Intervention is so important to be able to speak.

Here you can listen to Bilker at 5 years 9 months old. Both

's mom and dad and the professionals working with him through

the school thought was " just a late talker "

http://www.debtsmart.com/talk/brandon.html

I cried when I heard for the first time. That was when I

knew that my son Tanner did have apraxia as he was diagnosed with

(yes I was in denial)

What happened to -being viewed as a 5 year old " late talker "

is also why it's important to seek diagnosis 'outside of the school'

by speech, and if needed occupational therapy and medical

professionals that are knowledgeable. Years down the road -those

school professionals who may have missed the boat probably won't

even know you or your child to say " I'm so sorry "

Below are some differences between late talker and apraxia I've

written in the past that may help you understand a bit more about

the difference between " late talker or apraxia "

" My son Tanner was diagnosed with both severe oral as well as verbal

apraxia, but each child is different, and some may not go through

all the signs that Tanner had, with his severity, and/or some

children may have other aspects.

Here are the " late talker vs. apraxia " or delay vs. disorder signs

that I saw/see in my four year old Tanner as he was/is " learning to

talk. "

1. It took forever for Tanner to learn how to say ANYTHING other

than the word " ma " or the sound " mmm, " which were his only " words "

up until almost 3 years old. Even though the therapy he received was

not appropriate for apraxia (we didn't know this at the time), it

was some type of therapy, and it took months of this speech therapy,

1/2 hour sessions, two or three times a week (from 2 years, 4

months, to 2 years, 8 months) for him to learn simple sounds

like " t " or " ch " or " sh, " sounds most babies and toddlers say when

they babble.

During this time, even though Tanner was in speech therapy, we

followed our pediatrician's advice that Tanner was a " late talker "

and never knew Tanner was qualified for early intervention by the

state (a federal program) so we paid out of pocket for all the

therapy (insurance didn't cover it and even though we appealed, at

that time, we didn't know how to fight the denials). Tanner did

babble with some of these sounds, though rarely. Many apraxic

children babble very little. The problem was that when Tanner wanted

to use one of these sounds, on command, he didn't know how. Many

parents of apraxic children have examples, like us, of their child

starting to develop speech and then, for some reason, they losing

the speech they had developed. Since there is still no large scale

research on apraxia in children, nobody knows why this happens. In a

small research project by Tom out of the Pittsburgh

Hospital, the findings were that it required 81% more therapy for

apraxic children to show results than children with severe

phonological delays.

2. Tanner did not go through normal speech development as he aged.

He would say a sound (before 3) or word (3 and up) and not say it

again for months. Most children with delays of speech will learn

sounds and words and build upon that, in a developmentally typical

pattern.

3. Another frustrating aspect of verbal apraxia is that even when

Tanner learned how to say a sound like " p " before a vowel, he could

not say the same sound after a vowel, so he would either drop it, or

change it to another sound. For example, if the therapist modeled

(said) the sounds " pa, " Tanner could say " pa. " If the next word the

therapist modeled for him was " up, " Tanner would say " uf. " This has

to do with the difficulty of movement of the tongue and mouth

positions. Professionals refer to this as " motor planning " (which is

why apraxia is also called a motor planning disorder.)

4. Tanner understood us and knew what he wanted and developed his

own " sign language " to try to communicate. They say this is very

common with apraxic children. When Tanner has more to tell us than

he is able to say yet with words, he now also uses sound effects

with his unique sign/body language. He's actually pretty good at

making himself understood. (Remember Harpo Marx?) Many children with

apraxia have high receptive (understanding) ability, and low

expressive (talking) ability. There was never a doubt to anyone that

Tanner was intelligent and apraxia does not affect a child's

cognitive (intelligence) ability. (To discern your child's cognitive

ability, view what his/her evaluations state about expressive and

receptive ability.)

It is horrible that apraxic children are sometimes misdiagnosed as

autistic, or even mentally retarded. Apraxia can co-exist with

conditions like autism, cerebral palsy, downs, etc., but apraxia is

often times there " alone. " (I'll explain later on.) Too often,

children are diagnosed as having " receptive " delays, when they do

not have receptive delays. Receptive delays are a " red flag " that

there could be cognitive issues going on. It's one thing if there

really are cognitive issues, but seek second opinions privately from

a speech and language pathologist, developmental pediatrician and/or

neurologist knowledgeable about apraxia and other disorders.

5. Even when Tanner learned to say the sound " t, " if he tried to say

the word " pot " it would come out " pop, " because he will switch

the " t " to a " p. " The professionals say this is due to motor

planning difficulties and children with apraxia will carry the sound

from the beginning of the word to the end.

6. Tanner's intelligibility will " break down " the longer the word or

sentence is. Even with a model, he can't repeat back a longer

sentence using all the words yet, he will repeat back only a few of

the words.

7. Tanner never " picked up " speech like other children. He also

seemed to regress and didn't talk at all when he was around large

groups of children that were talking and playing, even when they

tried to play with him. He tended to do better with one other child,

or his brother and maybe one more. Then he would try to talk too.

Tanner's older brother was also a late talker, but that was because

of birth injuries that he was in therapy for from birth. (He's doing

great now! He's 6 and unless I tell someone, they never would have

known.) Where Tanner wilted in

groups of children, Dakota thrived, and Dakota did " pick up " speech

when I put him in a wonderful preschool a few times a week.

8. When Tanner started to use words, he would repeat the same sound

over, using sentence inflections, rather than saying the different

words. A good example is, he would point to the door, or out the

window, while saying, " die, die, die, die, die. " Of course that

meant, " I want to go outside. " I heard some apraxic children are

monotone, but that wasn't Tanner.

We would have to say to Tanner, " I...want...to...go...outside, "

really emphasizing and waiting after each word, so he could repeat

it. Tanner can now say many words clearly, but he still does better

when he hears someone say them first. Now at 4, Tanner will, " I doe

side now peas. Tay? "

9. Tanner's apraxia still affects his ability to use the back of his

tongue to say sounds like " k " or " g. " He substitutes the " k " for

the " t, " so cookie is " tootie. " And the " g " for the " d, " so girl

is " dirl. " He has yet to make either the " k " or the " g " sound, but

we are working on it. When Tanner said, " hud n' tiss, " the other

night, I had to stop and switch the " d " and " t " to know he was

asking for a hug and a kiss.

10. Tanner talks better when he is singing, or playing, when he

isn't thinking about it.

11. I could go on, but another one Tanner has developed now that he

is really pushing himself is stuttering (dysfluency.) This does not

always happen with apraxic children, it's partly developmental, but

it's not uncommon with apraxia. Many children with apraxia can

get " stuck " here for a bit. I say how cruel, he has trouble talking,

and to add stuttering to that is like adding insult to injury. Many

experts say his brain is working faster than his mouth. You can

visibly see him struggle to talk when he does. Lots of thought goes

into each word; you don't see that with late talkers. I never did.

Some " soft " neurological signs that are not uncommon to apraxic

children:

I thought Tanner only had apraxia, with no other issues, but I was

wrong. These other " issues " however are typically overlooked by us

as parents, and by many pediatricians. Tanner had

other " neurologically based " signs, hypotonia and sensory

integration disorder. I know that sounds severe, and perhaps they

could be, but fortunately because Tanner had early intervention, he

is overcoming them, and they are now only noticeable to experts.

Both of these are treated by Occupational Therapists, but can be

addressed by Physical Therapists and Speech Professionals as well.

Hypotonia, or low tone, gave Tanner the appearance of a Cherub, and

that was his nickname when he was 2, " Cherub Boy. " Everyone said

that Tanner looked like a Cherub because he was so cute. Hypotonia,

however, needs to be addressed, because it affected Tanner's truncal

strength and breath control, which is important for many reasons,

including speech.

Tanner also had mild sensory integration (SI) issues. There is lots

of information online about SI, but mostly it makes the child seem

like the tantrum child, for " no " reason. Children with hSI do not

sense things like we do, the same way all the time. One example from

when Tanner was a baby (and this is before I knew what SI was, or

that Tanner had it) is that he would sometimes " freak out " when I

tried to bring him into a store. He would scream like he was in

intense pain, like there was a pin in him, tighten his whole body

and act hysterical. Other shoppers would look at me like, " What are

you doing to that child! " My sister, who is a certified nanny, was

often with me when this happened, and we would check his diaper,

offer a bottle, take all his clothes off, looking for what was

causing the screaming, but we never found anything. This same child

would go for shots and wouldn't cry. I used to call him the " tough

one. " More recently, I was tickling his arm and he said, " Ow! Hurt

me. " I asked him, " Does this hurt? " and tickled him again. He pulled

his arm away and said, " Yes. " Sometimes if I pat his head he

says " Ow, " too. SI is another unknown one, and it can affect

different senses. For Tanner, it's touch.

http://www.speechville.com/diagnosis-destinations/apraxia/verbal-

apraxia.html

More late talker vs apraxia from Speechville

http://www.speechville.com/diagnosis-

destinations/latetalker/questionsanswers.html

From: " kiddietalk " <kiddietalk@...>

Date: Mon Feb 2, 2004 12:38 pm

Subject: Down the road and off the road/parent observed stages of

apraxia

I first wrote this over two years ago in January 2002 for inclusion

in The Late Talker as parent observed stages of apraxia viewed

through our grouplist. This list was approved by all CHERAB

advisors

http://www.cherab.org/information/speechlanguage/advisoryboard.html

(but needed cleaning up which I never did)

We ended up not including this in The Late Talker because even

though approved, in the final cut we needed to edit out almost 300

pages for our book, and this included awesome pages that were

already completed. Dr. Marilyn Agin, Malcolm Nicholl and I chose to

leave in only the most critical information for a parent of a newly

diagnosed apraxic child to know.

I still don't want to clean this up, or change from my original

writing from over 2 years ago -so here it is, what I still stand by

and what still needs to be studied in my opinion and what I'd travel

to hear a researcher explain:

~~~~~~~~~~~~

" Just like typically developing speech in a child, a child with

apraxia appears from the members of our large Foundation to have

stages they go through -and some children skip one or two -or pass

through some of them quickly or get stuck in one or more of them.

We don't know if all the member's children were properly diagnosed

with apraxia or not, but this may be worth looking into.

OBSERVED APRAXIA STAGES (?) THAT SHOULD BE EXPLORED FURTHER

Stage 1

non verbal stage

Where the child uses one or two sounds to communicate everything with

gestures, and made up elaborate sign. At this stage, depending on

the infant's or child's age you may not be able to diagnose verbal

apraxia, but neurological soft signs should be looked for, as well

as signs of oral motor problems or oral apraxia. An older apraxic

child who is stuck at this stage will be using augmentative devices

and could be at risk for misdiagnosis of cognitive ability if not

tested appropriately.

Stage 2

simple talk stage

Where the child begins to just like a typically developing child

learn new sounds or words, but unlike a typically developing child,

most (not all) appear to forget how to say the sounds or words

again, so they lose that ability to " build " their speech like most

other children do. This is in most cases the only stage that is

acknowledged by ASHA and described by most of the speech

professionals*. Please see examples above (breaks down with

longer utterances, etc.) An older apraxic child who is stuck at

this stage will be using augmentative devices and could be at risk

for misdiagnosis of cognitive ability if not tested appropriately.

Stage 3

Dysfluency stage

Where the child who seemed to be progressing so well suddenly begins

to stutter. Most speech professionals do not consider

classic " stuttering " only a normal developmental dysfluency.

However with apraxic children this stage is especially frustrating

in that if the apraxic child does go through this stage, they appear

to get " stuck " here. In speaking to members from the CHERAB

Foundation who's apraxic child goes through this stage, there is

frequently another member of the family who is a stutterer, which

may mean there is some type of genetic link. Type of therapy to

provide to an apraxic child at this stage that is appropriate is not

clear and depends on which expert you speak to-in some cases there

are direct oppositional views.

Stage 4

Baby Talk stage

Where the child who is now talking and being understood continues to

mix up past and present tense, as well as sentence structure, and

frequently will leave out the " little words " like " the " and " a " .

This may not have anything to do with SLI as discussed above, an

apraxic child typically does keep sentences shorter than average,

but there may be children diagnosed in the SLI area that are

apraxic, and visa versa -and being there is a genetic link

to both SLI as well as apraxia, a closer look needs to be taken at

this stage. A five year old apraxic child who receives appropriate

therapy, including some of the recent discoveries we will talk about

later, may progress faster than previously stated, however just like

in the previous stage, apraxic children also seems to get stuck in

this stage. An example would be " Me want doe too " for " I want to

go too " or " Mommy me walk store too? " for " Mommy can I walk to the

store too? "

Stage 5

Full language stage

Where the child, teenager, or adult apraxic has learned strategies to

overcome the apraxia enough that it's not noticed by the average

listener. However upon closer observation you will notice that an

apraxic in the full language stage will frequently use less

sophisticated language. An example comes in right here. Instead of

saying " an apraxic in the full language stage will frequently use

less sophisticated language " they may say " an apraxic in the full

langwish stage will not sound as grown up most of the time " So in

other words, there will still be words that he or she can not

pronounce correctly, and being aware of them, will avoid them and

substitute when they can. They can be highly intelligent, but due

to their lack of expressing themselves using sophisticated language

at times others may not know this. This is perhaps in some ways

just as frustrating a stage as any other. In some cases maybe more

so because now that they are " talking " and talking fine most of the

time, ASHA professionals may not consider them candidates for

further services. The genetic possibilities and medical involvement

needs to establish these stages, including this one, so the

population can understand and accept this disability just like they

do for those with poor eyes or poor hearing. This is an example of

a late talker that unfortunately for all did not " just start talking "

Stage 1: Most professionals don't know how to diagnose oral or

global apraxia, or diagnose suspected verbal apraxia in this stage.

This is the way almost all professionals as well as online sources

were back in 1999 when Tanner was first diagnosed. If we knew then

what we know today through CHERAB and The Late Talker -Tanner could

have had early intervention from when he first regressed at 11

months old. Can't change that which is sad -but for that reason I

continue to do what I do to raise awareness.

Stage 2: The only stage talked about (and talked about and talked

about) This is what I call the " around the corner " stage which is

covered well...well for the most part -but still the soft signs -the

multifaceted aspects are typically left out by most -soft signs like

the hypotonia, sensory integration dysfunction (called DSI instead

of SID so as not to confuse it with the sudden infant death syndrome

which my oldest son Dakota was at risk for), oral apraxia and other

motor impairments even just mild one in other areas of the body -and

new to our attention stuff like constipation and trouble blowing

their nose on command. Just today Glenn and I were driving the

boys to school and Tanner needed to blow his nose. 'Most' of the

time now today Tanner knows how to blow his nose due to lots of

practice. But like anything with apraxia -most of the time doesn't

necessarily mean all the time. I handed Tanner a tissue and he put

it up to his nose and breathed out through his mouth. I said " No

Tanner -use your nose to breath out silly! " I then helped him and

he breathed out of his nose softly -not enough to do anything. So I

said " OK you have to breath out harder so breath in and then breath

out really deep OK? " Tanner breathed in really deep and when he

went to breath out I took the tissue and really quick stuck it up to

his nose before he could breath out -but that didn't work either

because we both started laughing. Then he sneezed.

Stage 3 and 4 -not all children go through -but too many do to leave

them out, or the child is diagnosed with something else. As I know

with Tanner through Dr. Dale -Tanner's dysfluency stage was

not classic stuttering and as Dr. said " You are correct

that we have done an injustice in not studying apraxia in children

enough yet. For this reason we don't know what is 'normal' for an

apraxic child as to how long they will stay in the developmental

stage of dysfluency, but we are finding it can be quite long "

And Stage 5 -that's the one where parents see their child as " cured "

and even though they may leave the group at stage 3-5 -most leave at

5 not realizing there are strategies for older children/teens and

adults in this stage too.

EFAs speed things up a bit so children may advance quicker -but

again EFAs are not a cure -or not a complete cure. I'd like to add

to that neither is therapy a cure. Apraxia is an impairment that

one can learn to overcome and live a successful life with. Just

like a stutterer -those that don't know may not even be aware there

was any type of impairment of speech.

=====

[Guest guest]

Hi Charlotte- thank you for replying. My son could repeat words, but would

only repeat maybe once and then would not repeat for a long time. He is four

now and can talk. The Preschool that he is in now is amazing you would not

believe the progress he has made. He started when the was three. When he

started he could only say a few words. Now he is a chatter box, but now that

he has started talking he is stuttering. His Dr. says that alot of boys his

age stutter, but in his case it is more like he is trying to get the word

out. His Dr. says that is a form of stuttering.

Thank you,

DAWN

-- Re: [ ] Re: Apraxia

hi dawn- ther is alot of info about apraxia on the computer and the apraxia

website is great- many people on this site have children with speech

apraxia. it is hard to distinguish from being a late talker or having a

phonological disorder and usually the biggest most obvious sign is a child

who doesn't

talk and in my sons case truly could not repeat words. he only likes yellow

cruncy foods and has alot of sensory issues, he was also misdiagnosed with

autism. the best book i have read is the late talker book by

[Guest guest]

My advice is YES, have him checked out by a reputable pediatric nuerologist.

Also, I would give him fish oil. I started my son on Nordic Naturals Juniors --

1 cap/day. This is a natural thing which will not hurt and can only help.

b8c4d3g0 <b8c4d3g0@...> wrote:

My son has had therapy since he was about 7 months old. He is now 3

1/2. When we started therapy he didn't know how to do anything;

rolling, sitting, he would curl up his legs if we put him in his

exesaucer or try to have him stand on his feet, he would gag before we

even put baby food into his mouth. When it came to eating solids, we

had help from therapy. He was diagnosed with low motor tone basically

from head to toe. His lips were really flat looking when he smiled.

With all of his therapy he looks basically like a normal little kid.

Just looking at him you would not think anything was ever wrong with

him. His speech is excellent, but yet he has had a hard time with

mouth therapy working. He seems to get better and then gets let go

and regresses and then is back in therapy again. He has had excessive

drooloing until recently. He has a hard time with puckering, moving

his tongue ways when we ask him to, making a popping sound with his

lips, etc. His new therapist thinks he may have some Apraxia. Does

anyone have a child that has been diagnosed with Apraxia that does not

affect speech? I asked her if I should get him checked out, but the

therapists response was all they would have me do is therapy for him

anyways? Any suggestions???

[Guest guest]

Thank you for your reply. What does the fish oil do? Where do you

purchase them?

Thank You,

>

> My advice is YES, have him checked out by a reputable pediatric

nuerologist.

>

> Also, I would give him fish oil. I started my son on Nordic

Naturals Juniors -- 1 cap/day. This is a natural thing which will

not hurt and can only help.

[Guest guest]

Here are your answers:

What does the fish oil do? It seems to help the brain to work with the mouth.

Read this atricle:

http://www.cherab.org/information/dietaryeffects/Englemed.html

Where do you purchase them? Here is a pointer to where I purchased fish oil. I

use Nordic Naturals 3-6-9 Juniors. I use 1 cap/day.

Again, in my opinion it can help and not hurt. Verify with your pediatrician.

Good luck.

b8c4d3g0 <b8c4d3g0@...> wrote:

Thank you for your reply. What does the fish oil do? Where do you

purchase them?

Thank You,

>

> My advice is YES, have him checked out by a reputable pediatric

nuerologist.

>

> Also, I would give him fish oil. I started my son on Nordic

Naturals Juniors -- 1 cap/day. This is a natural thing which will

not hurt and can only help.

[Guest guest]

hi- our son wouldnt eat baby food either and he never said a word until he

was 3.5 but hes doing much better now, we did the kaufman at 4 and that was the

only deffinitive testing we did-charlotte- the apraxia was discovered by his 2

slps after he did start to talk because he kept leaving the ends of his words

off

[Guest guest]

My son is going to be 8 in September. He was diagnosed with verbal apraxia

around the age of two also. He still doesn't speak. He is just now starting to

make more sounds. He says mom now but that's it. We have had very good help

with it. He has a dynavox machine that he uses to speak to us and he knows

some sign language. If you have more questions about it feel free to ask

because

my family is going through it also.

JIll D

In a message dated 6/28/2008 6:47:56 P.M. Central Daylight Time,

jbmistletoe@... writes:

>

> We were told my nephew may have apraxia. He is a little over 2 and

> does not speak. He makes a moaning sound when he is trying to get

your

> attention. He is very smart. Points to shapes and letters when

> asked. He smiles and laughs. We know he understands what we are

> saying. Only problem, he doesn't talk. He said Dada when he was

> around a year, but since then no other words.

> I'm trying to find out information on this and get a feel to how

this

> can be helped. This was just her second time having him

evaluated.

> They haven't said this is what it is for certain, but the evaluator

> seems to feel that this is what it is.

> Is this something that can be helped with speach therapy. Is this

> something that he is going to struggle with for the rest of his

life.

> The therapist mentioned to start teaching him sign language. That

> almost made me feel as if he would never talk. Can someone please

> share their experiences with this?

> Thank you!

>

Hi,

Jeanne here. I wanted to let you know that some children feel

comfortable learning to sign because that is a easier way for them to

start to communicate, It doesn't mean that it is a substitute for

speech. Once the sounds or words approximations come it they may not

want to sign anymore but try and communicate like my son would.My

older son who didn't talk at all at birth had learned a few signs but

wanted to talk anyway, I would ask him yes or no questions, even

though he couldn't answer but he would nod or shake his head. It

really helped because he was so frustrated and had tamtrums.Some

children don't want to learn to sign and use Picture Exchange

Communication System (PECS)also. There is no right or wrong answer

each child is different and has tolerances to therapies,and

exercises,and some cases are more severe than others.There is no

shortcut, but you have to go thru it. Hope this helps.

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