it is possible to just be apraxic, right?

[Guest guest]

my son was evaluated in march and was diagnosed with verbal apraxia

only. the more i read though, the more it seems as if children with

apraxia have other things going on as well. now i keep looking at my

son with a magnifying glass, but still don't see any signs of

hyptonia, SID, etc. so my question is, he could just be apraxic, right?

[Guest guest]

I have read that children can be ONLY apraxic, with no other issues,

but other issues or disorders often go along with apraxia, and to

make things more confusing, children with autism and PDD often have

apraxia too. So, apraxia can be stand-alone or one problem among

others. In the case of my son, he does not have SPD, but he does

have sensory issues along with not speaking. He doesn't have

hypotonia, but he is on the low end of normal tone (or was, we've

improved this through OT).

I hate the idea of putting our kids under the magnifying glass and

fretting over every little thing, but I think the more you know the

more you can help. It's kind of a double edged sword.

>

> my son was evaluated in march and was diagnosed with verbal apraxia

> only. the more i read though, the more it seems as if children with

> apraxia have other things going on as well. now i keep looking at

my

> son with a magnifying glass, but still don't see any signs of

> hyptonia, SID, etc. so my question is, he could just be apraxic,

right?

>

[Guest guest]

My son doesn't have those soft signs either, although people always seem to

try to search for them. Before he was diagnosed as apraxic he was

diagnosed with SID. When we went to a true expert in that area she said he

clearly didn't have those issues! He hit every milestone early as a baby

except words (even babbled early, but isolated sounds.) He is still

advanced in gross motor skills and also fine motor skills aside from pencil

grip and individual finger control where he has some motor planning issues,

but not severe enough to be considered motor dyspraxia.

He does have other things going on in the sense that he also has a language

disorder which his SLP believes is due in part to his apraxia (not saying

it correctly so he isn't hearing and storing language correctly.) She said

she has seen this before, but it's not as common with apraxia as having a

high receptive language. His speech production disorder is classified as

severe and his language disorder is classified as moderate to severe with

expressive language, not receptive, being what pushes it to border over a

lesser classification.

So the short answer is YES! There is such a thing as " just " apraxia!

Sometimes it seems like those children are in the minority, but it is

possible! I count my blessings that for my son it is just speech and

language issues and not a slew of other things that further complicate

daily life. He doesn't talk well or much, but day to day we don't have

major issues like so many others I know with special needs kids.

Miche

At 06:19 AM 6/13/2006, you wrote:

>my son was evaluated in march and was diagnosed with verbal apraxia

>only. the more i read though, the more it seems as if children with

>apraxia have other things going on as well. now i keep looking at my

>son with a magnifying glass, but still don't see any signs of

>hyptonia, SID, etc. so my question is, he could just be apraxic, right?

>

>

[Guest guest]

Who diagnosed it's just apraxia?

It's clear that nobody but a neuroMD (neurodevelopmental

pediatrician or pediatric neurologist) is qualified to diagnose

the neuro " soft signs " that may co exist with apraxia. It's best to know

if any other issues are there earlier than later. Most children

with apraxia have normal to even above average IQ and know what is

expected of them so they push themselves to keep up and blend. The

older they are however the more that is expected of them and the

more they'll break down. So in other words signs that may not show

up early, could become apparent at school age.

Yes there is pure apraxia -but yes it's rare. As Clint says " Are

you feeling lucky? " If you aren't 100% feeling lucky and are not

100% sure -If apraxia is suspected -the child should have a thorough

neurodevelopmental exam.

(neurodevelopmental pediatrician or pediatric neurologist)

And as many things as Tanner ended up having (and as any of you that

has been on this list a bit know-I am so anti having any new

diagnosis thrown on him) look what I wrote about him just a few

years ago! Tanner was " just " a late talker! (or so I thought)

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

Date: Mon Jan 26, 2004 2:21 pm

Subject: Re: any pure apraxia children?

....Pure apraxia is a question that comes up often, and as long ago as

when Tanner was first diagnosed. In fact below are two of my

first

ever messages on this where first I question what " pure

apraxia " is

a day or so after Tanner was diagnosed -and then another where

I

sign next to Tanner's name " pure apraxia " (and yes -I too was

wrong)

Interestingly enough in my first messages I describe Tanner's

signs

of oral apraxia and sensory problems and hypotonia which -but

since

nobody including Tanner's pediatrician knew they were warning

signs -

none were addressed until after these " soft signs " were

diagnosed by

the neurodevelopmental MDs.

I'll put my post below, here is just one of the more recent

archives

and then some other comments below that on your direct

question:

" From what I've seen personally and in this group, apraxia,

like

autism, is multifaceted in most cases...meaning it's

not " just " an

impairment of speech. Bilker is one of the only

children I

know who has " pure " apraxia of speech and nothing else.

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

(even though most of us in the early stages also believe

it's " only "

a speech delay as you will even read in my first posts 4 years

ago.) "

Most children with apraxia do not have PDD, however it's not

uncommon for children with PDD to have apraxia. Most children

with

apraxia do have mild low tone (weakness) and/or mild motor

planning

problems in other areas of the body. It's also not uncommon for

a 'typical' apraxic child to have sensory integration

dysfunction,

even if it's mild. Through anecdotal reports apraxic children

are

also late to potty train and may be prone to constipation.

(and if

asked to blow their nose into a tissue they will breath in

instead

of blow out!)

Original email about Tanner from 1999:

Subject:

Thanks for the talking kids page!

Date:

Wed, 10 Mar 1999 11:03:00 -0500

From:

& Glenn <shop-in-service@...>

To:

pressone@...

Hi ,

Our 2 3/4 year old son Tanner was diagnosed yesterday with

apraxia.

However, as I'm sure you are well aware, we have been dealing

with

his

non speech for much longer. (You may have read my e-mail about

Tanner.) Tanner looks like a cherub-strangers say that all the

time.

So we call him " the cherub boy " .

It was wonderful to hear your adorable sons, and the other

children

speak. It really does help. At this point our son sounds the

most

like

when the father says " 1, 2, 3, a, b, c, " . Without much

prompting

he is non verbal. Also, most of the time, when my husband and I

try

to ask Tanner questions where he would have to try to answer,

my

older

son, who is four, talks for him. Like your son, Tanner looks

and

acts

normal. Actually outside of expressive speech, Tanner tests on

every

other area above average. This was unfortunately the reason our

pediatrician was never concerned. We had to push to get his

hearing

and

speech evaluation.

If you could tell us some background on your son it would be

appreciated. When did he first get diagnosed? How many days of

therapy

a week does he receive? When did you see the greatest

improvement?

Like Tanner, was there a time he didn't really talk? What

is " pure

apraxia " ? Even though he is a perfect weight now, I have been

concerned with the way he sometimes shoves large amounts of

food in

his

mouth. Is apraxia a rare condition? I've spent the morning

trying

to

find a local support group where I could receive the answers

to some

of

these questions. Even Tanner's speech therapist said there is

not

much

known about it because it is pretty rare. I did find a world

wide

support group for apraxia in Greenbay Wisconsin called MUMS

with 20

to

40 members.

Well again, thanks for putting the talking kids page together.

Let

me

know what you need, and my husband and I can send you a tape

and

picture

of Tanner.

Best,

[Guest guest]

Just a comment on the tone issue, for example - as part of the " apraxia

syndrome " . I did not think my son had low tone, and neither did his

pediatrician (although the developmental ped picked it up right away). It

was subtle, only in his upper extremities, and mainly at his trunk, but

definitely there and manifected in things like delayed sitting, delayed

walking (though he seemed " strong " ) etc. Definitely getting better with OT.

My son's SID issues are also mild in comparison to other kids, but present

nevertheless, and improving with OT techniques. -

Thanks for the talking kids page!

Date:

Wed, 10 Mar 1999 11:03:00 -0500

From:

& Glenn <shop-in-service@...>

To:

pressone@...

Hi ,

Our 2 3/4 year old son Tanner was diagnosed yesterday with

apraxia.

However, as I'm sure you are well aware, we have been dealing

with

his

non speech for much longer. (You may have read my e-mail about

Tanner.) Tanner looks like a cherub-strangers say that all the

time.

So we call him " the cherub boy " .

It was wonderful to hear your adorable sons, and the other

children

speak. It really does help. At this point our son sounds the

most

like

when the father says " 1, 2, 3, a, b, c, " . Without much

prompting

he is non verbal. Also, most of the time, when my husband and I

try

to ask Tanner questions where he would have to try to answer,

my

older

son, who is four, talks for him. Like your son, Tanner looks

and

acts

normal. Actually outside of expressive speech, Tanner tests on

every

other area above average. This was unfortunately the reason our

pediatrician was never concerned. We had to push to get his

hearing

and

speech evaluation.

If you could tell us some background on your son it would be

appreciated. When did he first get diagnosed? How many days of

therapy

a week does he receive? When did you see the greatest

improvement?

Like Tanner, was there a time he didn't really talk? What

is " pure

apraxia " ? Even though he is a perfect weight now, I have been

concerned with the way he sometimes shoves large amounts of

food in

his

mouth. Is apraxia a rare condition? I've spent the morning

trying

to

find a local support group where I could receive the answers

to some

of

these questions. Even Tanner's speech therapist said there is

not

much

known about it because it is pretty rare. I did find a world

wide

support group for apraxia in Greenbay Wisconsin called MUMS

with 20

to

40 members.

Well again, thanks for putting the talking kids page together.

Let

me

know what you need, and my husband and I can send you a tape

and

picture

of Tanner.

Best,

[Guest guest]

Here's another message which contains a " first message I ever sent

to a grouplist " about Tanner as well as more about apraxia from the

perspective of being on the other side now. This message may be

better than the last archive. They have a new search function with

and I'm trying to get the hang of it.

Hurray Zimet!!!!

Thu Feb 3, 2005 2:38 pm

" kiddietalk " <kiddietalk@...>

Many of you may have read 's post and not given it a thought.

Just wanted to once again brag about Zimet, Tanner's Early

Intervention therapist. used to work for Early Intervention

out of Children's Specialized Hospital in Mountainside, NJ. She is

now working for EI in Georgia -and I'm hoping she moves a bit

further south (and ask her to all the time!) Tanner is so fortunate

that he got to work with early on but he almost didn't.

Because nobody but Glenn and I took Tanner's " not talking yet "

seriously -like pulling teeth to get him in speech therapy as it

says in The Late Talker book, Tanner who was nonverbal only had

about 6

weeks of Early Intervention therapy because nobody told us he

qualified for it. In fact we were told to " wait until he's three

and then if he's still not talking we'll send him for a speech and

hearing evaluation " by his pediatrician. Tanner passed all

developmental milestones on time or early, so as far as his doctor

and the world was concerned 'there was nothing to worry about'. Not

that Tanner wasn't in therapy privately which we got to pay out of

pocket for -Tanner had been in speech therapy from around the age of

2 for around 5 months, 2-3 x a week for 30-45 minute one on one

sessions with little change. he had more facial movements -but his

only word was " ma " or " mmm " . (see first post ever I sent to another

Internet grouplist below from 1999)

I was concerned -but deep down I kept believing that Tanner would

fool everyone and " just start talking " like everyone kept telling us

he would. So as lame as Tanner's EI goal is going to sound -the

magic age for me would be 3. That was the age everyone kept

bringing up. I figured at 3 he would just start. We only had about

6 weeks of Early Intervention. Our EI goal -in writing -which was

considered a good goal by all -was that " by the time Tanner was

three -he would point to a ball and say " ba " instead of " mmm " A

week or so prior to starting the EI therapy was when we started

using an EFA formula called Efalex (ProEFA wasn't even around then)

In the LCP Solution is said the first word was after 3 weeks -but

going over old emails -it was actually 2 weeks till " lellow " When

Tanner graduated from EI, -he was doing much more than saying " ba "

when pointing to a ball -he was saying " lellow " on command to any

yellow object he could find in the house or yard -and 20 other words

too including " purple " .!!! (I remember thinking he was like Bambi

when he first learned to talk and called everything " flower " )

is " the " professional that first had witnessed Tanner's

amazing surges when put on EFAs, and dramatic regression when taken

off (because he was going to be tested for the school program and I

thought he was doing too good to get the 1/1 therapy)

This was written about in The LCP Solution as the first

story under apraxia -read it online here (third story)

http://www.drstordy.com/stories.html

is also the one that encouraged me to start the support group

that became a nonprofit Children's Apraxia Network. She helped me

find a room to have meetings at the Children's Specialized Hospital

in Mountainside, NJ Our first meeting and just about all of them

were off the charts huge!

http://www.cherab.org/news/childrenshospitalarticle.html

http://www.cherab.org/information/dietaryeffects/StarLedgerarticle.ht

ml

And now there is CHERAB -and The Late Talker book -and

Speechville...thanks to Zimet who is just awesome, as we

credit her in The Late Talker (paperback edition)

is now helping as Robin just posted -how cool is

that?!

http://www.cherab.org/news/.html

Since there is much talk about newly diagnosed -misdiagnosis.

Please know there are many knowledgeable professionals out there -

like . Make sure your child is evaluated with an appropriate

diagnosis so that your child can receive appropriate therapies. And

for anyone who hasn't read it yet -below the following archive is my

first post ever. Tanner was a child diagnosed by many as " severe to

profound " apraxia. He is doing so amazing today -that he brings

hope that all can do this great. And you know the good news -most

are!

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

Date: Tue Jan 6, 2004 9:56 pm

Subject: Re: Are these new developments typical of verbal apraxia?

Hi Kim!

In the early days many of us think our child is " just " a late talker-

as you can see in my first email to a grouplist below -I too thought

this of Tanner. Archives and emails are great because they give us

a timeline. When you archive Kim you will not only see how you

learned about new conditions faces -but how far he has come!

The thing about most apraxic (or communication impaired or delayed

for those who have children not diagnosed at all or as something

else) is that most have average to above average intelligence. In

other words kids like know what is expected of them and they

push themselves to do it. As they get older however, more and more

is expected of them independently, and when they can't keep up -they

begin to break down. This is why it is so important to see

knowledgeable neuroMDs when your child is young -and a good one can

diagnose young. And as I covered the other day -there are more

advanced neuroimaging techniques -so between that and genetic

testing -perhaps definitive diagnosis won't remain the crapshoot it

is today for too much longer.

I can tell you as a parent of an older apraxic child (Tanner turned

7 June 11th) that he was late to do a few things other than speech -

like potty train. Lots of parents here also stress out about late

potty training -and it was more than one neuroMD that told me that

Tanner's working hard on other issues -and may not have the muscle

control due to the hypotonia -so " give him a bit more time " Wise

advice -he potty trained late at four...but 20 years from now will

anyone care?

Please don't stress about a 5 year old who has sloppy handwriting.

Who knows where Tanner's self esteem and thus academic work and

social skills would be if he felt there was something wrong with him

because he took a bit longer to learn to write. A child in

kindergarten isn't expected to be sitting at a desk writing

sentences anyway...that isn't until first grade.

Tanner's handwriting started off early in the year horrible, but he

was just learning then. In kindergarten did I care that Tanner was

still learning how to draw lines and circles and hold a pencil

correctly? No -we and the professionals just kept working with

him.

Tanner transitioned out of OT at the end of kindergarten last year

at 6. Up till 6 years old he was still working on holding a pencil

correctly and writing with his OT due to his motor planning

problems. This was one of the main reasons that I also say there is

no way Tanner would have been ready to start kindergarten at 5 -he

would not have been ready for first grade at 6! Starting Tanner at

6 in kindergarten he was one of the top in the class...and no matter

how hard the spelling words and school assignments are each week -

Tanner is still getting straight A's in every subject -and now with

neat handwriting too.

Glenn and I never worried about Tanner catching up -he always does.

And many times Tanner doesn't just catch up -he passes others!

Tanner is a child that pushes himself and works hard to do what

others do not only when others ask him to -but because he so badly

wants to. The teacher told me early in the year that there was a

contest for children that knew how to read chapter books...this is

when Tanner was just learning to read books like Dr. Seuss Hop on

Pop. Tanner came home to me to tell me about this contest and how

much he wanted to do this. In speaking with his teacher -she too

knew how much he wanted to be part of this contest -but he wasn't

advanced enough of a reader. Tanner's going to be able to be part

of it next year -he's not yet quite up to chapter books -but coming

closer every week. And you know what -he may be behind a few others

in his advanced class -but he is doing far better than many in

public schools in first grade at this point.

Tanner takes pride in how neat his handwriting is now. I sometimes

can't even believe he wrote what he wrote it's so perfect!

As I always say in the long run is what matters. Nobody will care

twenty years from now if had neat handwriting in

preschool or it took till first or even second grade -you can always

teach those with sloppy handwriting like me to become doctors

(someone needs to write prescriptions) -or how to type. But if you

shatter a child's self esteem that's something that's hard to teach.

My suggestions other than to not worry about it? Buy things that

are fun that at the same time help with strength and motor

planning. Chunky pencils, markers and crayons are great. Don't

forget the pencil grips to help too. Clay is always

good not just for motor planning -but for working out feelings,

developing creativity. You can even get a PlayDoh Game Pen!

Last time I was in Toys R Us I think I even saw a game for younger

kids that had clay or playdoh. Or just make up your own games. Here

is a cute home game for " Playdough Pictionary " you can age down or

up.

http://lds.about.com/library/bl/games/blplaydough.htm

(the one I have may be too old for -but my boys (7 and 9)

love Cranium Cadoo where they get to make things with clay -act

things out -draw etc. Tanner is finally old enough to read some of

what he needs to with the magic glasses by himself!)

Buy arts and crafts things like SpectraColor Image Pad or even plain

old finger paints where he needs to use his fingers. And if you are

around to supervise -Shrinky Dinks is great for helping with fine

motor skills too -all the coloring and cutting and pasting etc.

Dr. Agin through her keen eye diagnosed Tanner when he was three

years old with sensory integration dysfunction, mild hypotonia, mild

motor planning issues in his body -and of course oral apraxia. His

verbal apraxia was not diagnosed until he was a bit older and

actually started to talk. Now that you know this -read the post

below which was prior to Tanner being diagnosed by Dr. Agin. In

hindsight the signs of other issues were there even when he was

younger -even the reasons why we called him " cherub boy " and " the

serious baby " -we just excused the signs away.

Here is proof you are not at all the only one that thought your child

was " just " a late talker!

Subject: Help for Tanner!

Date: Wed, 10 Mar 1999 01:52:42 -0500

From: & Glenn <shop-in-service@...>

apraxia-kids@...

References: 1

Other Parents:

Help! Our two year old son Tanner, who was born July 11, 1996, was

diagnosed today with apraxia after 4 months of speech therapy at a

hospital.

Unfortunately, before Tanner was 2, when my husband and I were

concerned about how quiet he was, our pediatrician wasn't. She

didn't see any reason for concern at that time since he was always

very bright and his comprehension was excellent. Undaunted, we

pushed to get a hearing and speech evaluation done anyway. It was

like pulling teeth! On a suggestion from Tanner's speech therapist

to get him evaluated, Tanner was also just recently accepted into the

early intervention program in our state of NJ. Tanner (whose knick

name is " Cherub Boy " since that is what he looks like) in every

other way, looks and acts normal (and has tested above average.)

Since Tanner has been going to speech therapy twice a week, he has

made great improvements on imitating basic simple sounds.

Unfortunately, other than some basic sounds he will now mimic if

prompted, he is not attempting to say words yet. For the most part

he is quiet and observant. If you say " 1, 2, 3, a, b, c " to Tanner,

he may try to imitate you, but it will be the inflection of the word

with the sound " mmmm " . Basically that and pointing is how Tanner

communicates all the time.

From the time he was a baby, and up until recently, he rarely showed

any facial expressions. Now, with the small amount of therapy he

has had, he noticeably smiles frequently and can for the first time

blow bubbles!

Around the age of one, Tanner had two episodes of Roseola with a

very high fever each time. Is there any evidence that a high fever

may cause apraxia?

Even though his hearing is normal, would a school for the deaf which

is able to teach speech to deaf children be useful to him in

addition to his other therapies?

We are new to the network and we were wondering if any other parents

or professionals in this network have any words of wisdom. We e-

mailed a local support group. It's comforting to know that this

condition has been resolved successfully by others. From what we've

read on the subject, most of the children at Tanner's age at least

try to talk, does Tanner's condition sound severe? Or, maybe a

better question, was your child, or those you work with, similar at

some point?

Just one other thing, how many e-mails can one expect to get a day

with being on the regular list?

Thanks in advance for being out there and sharing! Out of

curiosity, does

anyone know how many children have aprixia? Tanner's therapist said

it's not that common.

Best!

and Glenn "

See -so don't feel bad!

=====

(archive queen) Geng

President CHERAB Foundation

Communication Help, Education, Research, Apraxia Base

http://www.cherab.org

http://www.speech-express.com/boards

cherab

Co Founder Speechville

http://www.speechville.com

772-335-5135

" Help give our cherubs a smile and a voice "

>

> RE: Giving ProEFA to Toddler

>

> Hi Sheila,

> I puncture the soft gel and squeeze the lemony flavored oil

> into a small bowl (2 tbs) of strawberry-bannanna yogurt.

> My daughter thinks it's yummy. (I don't use the whole container

> of yogurt, so I know she eats the entire spiked amount).

> Pudding also works. Good luck!

>

> Zimet, M.S.,CCC/SLP

=====

[Guest guest]

This is the confusion for me as well. My 4 year old

son has no soft signs. He did everything on time:

sit, crawl, walk, blew out his birthday candles. He

has been playing ice hockey for over a year now. He

eats great, and always has. The only thing was

constant ear infections which led to us having tubes

put in and his tonsils and adnoids removed. He's

talking but not clearly. Is he apraxic? They say he

is, but I don't know. . .

--- kiddietalk <kiddietalk@...> wrote:

> Who diagnosed it's just apraxia?

>

> It's clear that nobody but a neuroMD

> (neurodevelopmental

> pediatrician or pediatric neurologist) is qualified

> to diagnose

> the neuro " soft signs " that may co exist with

> apraxia. It's best to know

> if any other issues are there earlier than later.

> Most children

> with apraxia have normal to even above average IQ

> and know what is

> expected of them so they push themselves to keep up

> and blend. The

> older they are however the more that is expected of

> them and the

> more they'll break down. So in other words signs

> that may not show

> up early, could become apparent at school age.

>

> Yes there is pure apraxia -but yes it's rare. As

> Clint says " Are

> you feeling lucky? " If you aren't 100% feeling

> lucky and are not

> 100% sure -If apraxia is suspected -the child should

> have a thorough

> neurodevelopmental exam.

> (neurodevelopmental pediatrician or pediatric

> neurologist)