Re: Need some apraxia insight please...(help)

[Guest guest]

Kate it sounds like it's possible your daughter is one of the 75% and

that's awesome! 75% of late talkers just have simple delays in

speech and need a bit more time. Even if she did have apraxia -it

would be very mild. Listen to the Talking Page and let us know if

Kate sounds like anyone there. http://www.debtsmart.com/talk

Then again I know from my own history what we say are " words "

or " sentences " may or may not be to others. I'm thinking this isn't

the case since you didn't get the diagnosis from anyone but that one

SLP however. Do the professionals you took your child to for

evaluations know about apraxia -see it in other children? Read this

archive which includes why some go through stages like jargon a bit

later - and see if you relate to any of this and just one other

thought I have below:

It's hard to say whether or not this is what Tanner went through

because we all have our own way of deciding what counts as words or

sentences. So that's the first question -how clear are all 150+

words to strangers? How complex are the words? I do know that

Tanner's ability to speak was not only limited to food and drink.

In fact his first word other than " ma " and " mmm " (which stood for

everything!) was the color " lellow " !

(From the LCP Solution book) Then again if your child is

only asking for food... you are probably a much better cook than I

am!

How long has your child been in therapy and how quick was the

surge? Did you start all/or any of the traditional and alternative

interventions simultaneously -or just about all at the same time? I

tried to spread things out by at least a few months so to know which

is working and which we can forget about.

Another big question is are you sure your child isn't doing sentence

attempts? What are you counting as a sentence? Tanner went to

sentence attempts quickly.

For Tanner as I've posted before - " Da da Daddy? " said while putting

his both hands palm up by his head, cocking his head to one side was

a three word sentence attempt of " Where is Daddy? " If we broke down

these sentence attempts as we did into " Where...is...Daddy? " he

would try to repeat as best he could, and would always be much more

clear this way.

When your child does say a word like " Juice " is it ever said with

any sounds in front of 'Juice' with or without inflection? Is it

possible if that's so that it's sentence attempts? Or, do you believe

it's just a stutter of the same word? As the parents that live with

her and love her most I believe you can answer that question just as

well as any expert -perhaps even more accurately in some instances.

Tanner's SLP at the time, Ortega, told us that prior to

being able to say complete sentences that children learn to block

out sentences much in the way Tanner did at three years old. Some of

our children didn't go through the developmental stages of babbling

or jargon -even teething! And when they go through these stages as

an older child it concerns us, when instead we could appreciate that

this too may be a positive sign.

We worked with horns too. We would at home for therapy toot long

and short on a horn and Tanner needed to copy it back. I was told

that if Tanner could not imitate 3 toots on a horn he didn't have

the breath control yet for a 3 word sentence. Some of this is in

The Late Talker book.

Frustration? I don't view that as necessarily a bad thing either.

To me frustration is a sign that your child expects more from him or

herself. As parents we can support, encourage, and teach it's OK to

fall down. When we teach our kids certain sports like roller

blading, skiing, etc. that is one of the most important things to

teach first.

~~~~~~~~~~~

Even if she is apraxic -and clearly it is mild -it would even be

harder to secure that diagnosis because she's on EFAs. Even children

with severe apraxia no longer present as classic apraxic once on

EFAs. They can repeat on demand -surge much faster than

they " should " (apraxic children not on EFAs are studied to need 81%

more speech therapy for the same results as those with simple

phonological disorders)

Research Project By Dr.

" In stark contrast, the children with apraxia of speech whose parent

stated that three quarters of their child's speech could be

understood following treatment, required 151 individual sessions

(ranging from 144-168). In other words, the children with apraxia of

speech required 81% more individual treatment sessions than the

children with severe phonological disorders in order to achieve a

similar function outcome. " Functional treatment outcomes for young

children with motor-speech disorders by in Clinical

Management of Motor Speech Disorders A.J. Caruso and E.A. Strand

1999.

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

The EFAs you are giving her will be healthy no matter what -but if

she does have just a simple delay in speech that's awesome and you

probably don't have to do larger dosages -you could just do one

capsule a day. What dosage is she on now? (did you follow this?)

/message/77247

Please continue to share with us here. We haven't heard much from

those of you with " just " late talkers (like my older son Dakota)

Whether your child has a delay or a disorder- there's information

here to help!

=====

[Guest guest]

,

The therapists/dr.'s I've seen say at a young age it's hard to truly

diagnosis a child with apraxia. However, over the summer my son (who

is now 3) was potentially diagnosed with dyspraxia/apraxia. The

developmental pediatrician said he sees signs of dyspraxia. However

his EI speech therapist said she thought he might but that in the end

she didn't think he did have it. Before he aged out of EI I took him

to a highly reccommended private therapist for an evaluation and to

start therapy with them in addition to his preschool program and she

confirmed the diagnosis of apraxia. I was really frustrated b/c who

did you believe the therapist who worked with your kid for over a

year or these other professionals?

I recently was lead to the book The Late Talker and after reading

that I was convinced that this is what my son has. I wish I had the

book a year ago b/c my son responds really well to the PROMPT

therapy. I guess what I'm trying to get at is at this young age it's

tough for them to tell exactly what it is and that is super

frustrating as a parent. Just keep doing what your doing and try to

find a professional who is very knowledgable about the different

forms of apraxia and talk to them.

Also, how are the omega 3 pills working? I just got them and I plan

to try them out on my son? Good luck with everything and it sounds

like your daughter is doing great.

>

> Any insight?

>

> My daughter was diagnosed with apraxia by a therapist (SLP) who

saw her six months ago. After that, I took her to 2 other

therapists, a ped neuro, 2 peds visits, and the school district. All

of which said she didn't have it. I had her seen by so many b/c when

I looked it up on the web, it is very clear that the treatment is

very different for apraxia as opposed to a speech/language delay.

> I didn't take her back to the girl who diagnosed her with apraxia

b/c she really rubbed me the wrong way in general (telling me

condescendingly that I wasn't 'talking to her right', that she

is 'definitely way behind her peers', and she told me she had apraxia

like it was nothing and sent me on my way to look it up online. Her

tone was hopeless...)

> She has been in therapy with a therapist recommended by all the

docs, who still says it is just a delay-- and seems happy with her

progress. She has made tremendous progress. six months ago she

didn't understand much detail, didn't say more than one word at a

time, was harder to understand... Now she uses more action words,

pronouns , etc... and is speaking in 3-7 word sentences.

> BUT ... she still uses alot of jargon. The therapist thinks this

is a 'filler' for her as she is learning more words, thinking quicker

to put them together, and as she is becoming more clear. But I still

have in the back of my mind that this may be an apraxia thing for

some reason. Is that something that kids with apraxia do? An

example is... Mommy, can we watch gdgdgd movie gdgd tonight? She

talks fast and there's kindove a babbling thing between some of her

words. And some of her words are out of sequence as well... Got

hurt, fall down a Kate. Which means 'I fell down and got hurt " (her

name is Kate).

> If anyone has any insight, could you please share? I just want

to make sure I am getting the right therapy for her, but am

established with our person and wouldn't know where to start since I

am just kindove wondering more than anything. Any suggestions would

be greatly appreciated. She is such a joy, and I want to do

everything in my power to make sure she is happy and that I do my

part to getting her the help she needs. What do you think I should

do??

> I have her on Vitamins and Omega 3's. Her name is Kate, and she

turned 3 October.

> Thank you,

>

>

> ---------------------------------

> Never miss a thing. Make your homepage.

>

>

[Guest guest]

Therapists cannot give a diagnosis, not one that will get you any

services in the schools. A true diagnosis has to come from the

Developmental Pediatrican or a Ped. Neuroligist.

[Guest guest]

As a parent of two late talkers –years ago I too didn't understand the

difference between an inclusive placement and inclusive therapy. I

have some very close friends and advisors in the educational field

but rule of thumb is…don't trust all you hear. It's your child's

future and don't leave it up to them to evaluate and decide what

therapy and amount of therapy is appropriate without an outside

expert to oversee 3 and 6 month written IEP goals.

It may be an awesome program and they are providing the appropriate

amount of one on one services…but as someone who's been here for a

few years…I'd say check it out and know for sure from someone who's

only vested interest is your child.

Why do I have my doubts? You say " social, emotional and adaptive

delays (but well below Asperger scale). I'd rather have a label of

ADHD then social, emotional and adaptive delays if one had to guess

why a 3 year old was a but hyper....but of course I wouldn't sign any

IEP until I agreed with it with my children's outside professionals.

" with their evaluations, none of them formal diagnoses, he was placed

in special ed

preschool (3 yr olds) for 3 days a week. "

You say " no formal diagnosis " almost as if that's a good thing! And

with that huge mish mash of problems they are placing on your 3 year

old's back?!!! And did I get this right -your child is not yet

getting 'any' speech therapy? Where would he fall on this chart?

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

Of course you would need someone (I'd say outside) to evaluate to

know.

Are you really happy with this?!! Please just say " Noooooooooo! "

Remember that old robot from Lost in Space –right about now you'd

here " Danger Will " . Your child is 3 years old –there are

many reasons for why he tested to have social emotional and adaptive

delays but my first thought would be that they didn't test him

appropriately. If you secure an outside evaluation you want in

writing that his testing and classification was inappropriate. On

top of that …only 3 days a week? And classified as verbal

apraxic?!! My son's preschool was 4 days a week and proved it

inappropriate for his needs and got him into out of district

placement –and that was a day more than your school. Please –if you

can afford to or have insurance to pay for it –one way or the other –

you have to check what's going on at the door. If they pegged your

child like this at 3 years old –you just don't know what you don't

know. And of course they paint the picture bright for kindergarten –

they have a few years to do whatever they do –and to them it's clear

that your happy. To me it's clear you are happy. But you won't be

if 2 or 3 years from now he's made little progress and you find out

that they haven't been providing the appropriate therapies or

placement. FAPE in the LRE –no matter where you are in the US your

child is entitled to it! At least they are providing ESY...but

thanks for the head's up about your school district so we can warn

others!

In most cases:

inclusive classroom =good/inclusive therapy =not good

Below are two archives –one on inclusive therapy and one on what has

happened to far too many:

Inclusive therapy archive

Re: Classroom teacher a SLP and " language based preschool " vs SLP

Shilo perhaps the teacher 'can' be an SLP, a " Sweet Likable Person " -

but what does that have to do with appropriate professional speech

therapy?

And Kim -you mean to tell me they are 'still' saying that same old

line, don't tell me let me guess something like:

" It's a language based program so it's hard to say just how much

speech therapy he will be receiving per day or week because (insert

wool over eyes here) he will be receiving therapy throughout the day

incorporated and reinforced in all activities all day long by the

teacher and aids in the classroom... so... in fact it's actually if

you think about it more speech therapy than what you were asking us

for because since the therapy is all day long incorporated and

carried out by the teacher and aids in the classroom and because the

SLP is there to oversee and show the teacher what needs to be done

speech

therapy outside of this program by the SLP is no longer necessary

because again the speech therapy is all day long and incorporated

into all we do which is why this program is called a language based

program "

Oh....K some like to hear that -personally I like the story about

the Tooth Fairy better.

Don't confuse the words language based, inclusive and group

therapy since they all 'can' be different -but in most preschools in

most cases they all mean the same thing -less or no one on one

appropriate

therapy when appropriate. Don't let the school get away with talking

you into something that is not appropriate for your child. Ten

years from now you may never see them again -ten years from now

however your child will still be your child -stand up and fight to

secure appropriate therapy now for his/her future.

A language based classroom also referred to by some as an inclusive

classroom is typically wonderful, inclusive therapy is different.

Inclusive (group) therapy does not replace individual therapy, and a

teacher's follow through does not replace an SLP working with your

child anymore than you doing follow through at home does. Neither

alone is appropriate for children that require 'individual' or 'one on

one' speech and/or occupational therapy.

Best possible world is when the school offers both the inclusive

classroom together with the individual therapy if that is

appropriate for the child. The Summit Speech School for the hearing

impaired and deaf is a perfect example of such a preschool. It's

where my son Tanner, and many other's children here went to preschool.

In general inclusive therapy (again not to be confused with an

inclusive

classroom which could be great for almost all) is wonderful only for

those children with mild or simple delays in speech. As far as I

know to date there are no experts who will recommend inclusive

therapy 'alone' for a child with moderate to especially severe

impairments of speech that require individual therapy (such as

apraxic children) at best they will say " it's yet to be determined " -

and many others state that inclusive therapy for a child with a

severe impairment of speech 'can' be detrimental. All this can be

found under lock and key at the ASHA site. This article on

inclusive therapy used to be available to the public to help the

children and the families and back when I needed it to help advocate

for my son Tanner I printed it out -and was able to use that to help

secure out of district placement (which is why he is excelling today)

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

In a quick search for a website that appreciates that information out

there

helps the children -I found these quotes on inclusive therapy:

" With more children in inclusive settings, we are finding ourselves

with more training of regular education /paraprofessional staff

needed and less time to manage it. I feel important carry-over is

neglected due to our lack of time to contact parents, support staff,

etc. This has been professionally very frustrating for me. "

" It is difficult to develop necessary time to consult with teachers

on work more inclusively when running to three buildings a day. "

" My caseload for 98-99 was great. I was primarily at 1 school. I did

not have a COTA and saw approximately 20 students. Had excellent

inclusive therapy with time to discuss weekly inclusive therapy, so,

when I was in the classroom I was NOT an aide. Was able to carryout

ALL IEP objectives as time was allotted for collaboration and travel

time was minimal. Not the case this year! At 4 schools and have a

COTA. Have noticed a significant decrease in ability to carryout IEP

objectives, not in 1 place long enough to be part of collaborative

meetings - miss all my schools scheduled collaboration meetings

which are critical to attend to get carryover of goals - In and out

method of therapy - not good. Need to limit amount of travel and

allow time at each school to become " part " of the program. 94 - The

98-99 school year was somewhat atypical with a caseload of 45.

Typically I am over but last year was excessive. At 45 it is

impossible to do more than the basics. I may have met the IEP but

not in a way that was most beneficial to the child. For example, if

I missed a child due to a meeting I would try to make up the time

but the child would be often inappropriately grouped. The high

numbers also affected my ability to consult with

teachers/staff/parents. There were several children on my caseload

whose time could have been cut down this year if I could have spent

more 1:1 time with them in and out of the classroom last year. "

http://idea.uwosh.edu/sped/yeartwo/surveys/occ/returns/therapy.pdf

And...just to show you as well that you are not the only one in this

situation -here is another off the web which was from a thread you

may find interesting with comments from Kathleen Whitmire PhD, an ASHA

professional (and with her email address):

" I am in a situation where the principal has decided that ALL

special education classes including speech therapy to be performed

in the classroom. Although inclusion has it's merit,and ultimately

you want your student/client to generalize in the community setting,

inclusion may not be appropriate. How would you suggest to approach

this individual, who by the way, refuses to listen to any and all

recommendations that pull-out is necessary, including quoting

the " law " . Thank you for your response. "

http://cahn.mnsu.edu/5whitmire/_disc25/0000001b.htm

" Although " quoting the law " hasn't been too helpful in the past, this

will be

your best approach. IDEA does require that a full continuum of

services be

considered for each child. You may want to mention that individual

services may

result in faster progress for some kids, allowing you to dismiss

those kids

earlier and thus save the district money in the long run. It sounds

as though

the administrator is concerned about budget, so try to come from that

perspective. Good luck. "

http://cahn.mnsu.edu/5whitmire/_disc25/00000025.htm

Why to seek outside evals for appropriate diagnosis

Re: Who else would understand, but all of you

Pat we hear your pain! At least I do. " speech

delay secondary to hypotonia " So sad. Most likely the hypotonia is

secondary to a speech disorder if this child is 4. At what age

would the professional that diagnosed this child stop calling it

a " delay " ? At 5? 6? 7? What?

Here's the way I see it with late talkers and the average parent.

(you are all above average!)

Age 2. Possibly a bit concerned -but if they are concerned at all

and let just about anyone know they'll get the advice that it's best

to wait and see and not put pressure on the child because he'll talk

when he is ready. All here heard that too -but unlike the average

parent -we pushed on for more answers anyway.

Age 3. The late talker has now missed Early Intervention through

the State. The parents, now a bit more concerned that their child

still is not talking possibly enroll their child in the preschool

disabled child through their town's school (EI for 3 and up) At

worst -the child still receives no therapy still either through the

school EI or private. If in the school program, the school provides

this undiagnosed late talker with the cookie cutter " inclusive

language based " preschool class where the child will " actually be

getting so many hours of speech therapy a day because the therapy is

integrated into every activity they do that it's hard to even say

how many hours a day it will be! " (in fact the child will probably

at best get two fifteen minutes to one half hour sessions a week of

group speech therapy, possibly the same amount of group OT. Group

therapy/inclusive therapy -same thing - is pretty much useless for

an apraxic child since they require one on one therapy. It may be

good to have inclusive therapy with the private therapy a week

depending on the class) Inclusive therapy is great for a child who

has just a simple delay in speech. It's not appropriate for a child

with a severe impairment of speech like apraxia.

The child is still essentially nonverbal at 3 in spite of " all " the

therapy he's getting a week. All wonder why (outside of this group

that is) Then again -at 3 most are still saying to the parents that

they are wasting their time because the child is just a late talker,

and most people can think of at least one family member that spoke

late, and if not -there's always Einstein, he was a late talker,

right?

Age 4. The " he'll talk when he's ready " virtually overnight turns

instead to these parents hearing from all " what's wrong with him? "

Ouch. The school, the parents, the lady at the supermarket that

packs the bags -all are now greatly concerned about this nonverbal 4

year old. The school ups the child's therapy to one or two days a

week of individual therapy at best. Does nothing different at

worst. Nobody knows what's wrong, but some still trust that their

pediatrician, SLP, preschool teacher, or some other lame

professional, who diagnosis their essentially nonverbal 4 year old

(four year old!) as having a " speech delay secondary to hypotonia)

OK -that's not even the average parent -even an average parent would

question speech delay secondary to hypotonia in their four year

old. Apparently this parent is blindly following this professionals

advice -and the child is still not progressing. There should be

clear set goals and progress to map. Without progress either the

diagnosis or therapy or therapist should be examined -changed. All

in this group have heard from professionals that our child is ___

(something that is outrageously wrong) -but in contrast -we know

that most don't understand the new epidemic of apraxic or otherwise

speech impaired children -and how to advocate for them to get them

the appropriate therapy they need to give them the brightest hope

for a verbal future. Key word that's missing in the vocabulary -

advocate. Most of us didn't have it in our own vocabulary either

prior to our children being late talkers -but we learned it's what's

needed.

Age 5-7 " learning disabilities, cognitive delays, special ed

classes, perhaps even life skills classes " -that's what this child

is dealing with as per the advice of the school professionals. Even

if the parents had hope in their child before -it's fading quick -I

mean, " he would never make it in a mainstream class. " (he's never

been given the chance, is he behind due to that?! Talk about Duh!)

Age 9 Nobody blinks or is at all shocked with this same little

child is placed in a TMR class. Nobody thinks it's horrible that

the child is taught how to sweep floors and other life skills.

Therapy is either greatly reduced (from the 2 days a week) or just

stopped. After all, the issue isn't a speech impairment, it's

cognitive, right? That's what the school says -must be right, right?

By the Grace of God the children in this group are not the above

child. I read all the time how parents come so close who have

children that were misdiagnosed. We also all know 's sad

tragic story which may after all have a Happy Ending for our Little

Mermaid! (I hear she's doing well according to Zimet CCC SLP)

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

This is why it's important to follow your gut -and follow it early.

First the school gives up on the child. Then the parents give up on

the child. Then the child gives up. Don't let it happen.

As far as what can you do when you are dealing with a parent who is

letting their child slip through the cracks in front of your eyes?

It depends on how close you are to them. Seems like you did all you

could do for the person you don't know that well. My husband upset

about this situation in a friend's child, just showed up with a

bottle of ProEFA. (but it was a very good friend and the husband is

an attorney and the wife is a pediatric nurse that worked in a large

LI hospital) The child was not diagnosed at that point -he was 4.

This story is in the archives and it was prior to me writing The

Late Talker book, or he would have brought them that book too.

Prior to starting the EFAs as per my advice (or it's hard to

diagnose what it really is) they finally then took their (also 4

year old) son for a private eval where he was diagnosed as apraxic.

They started the EFAs and the child started talking. I saw this

little boy about two years ago when he was around 7 and he was

talking -but clearly had speech problems. Another friend of

Glenn's, more casual, also from LI but moved to NJ -the mom didn't

want to get a diagnosis or even an evaluation from EI because she

wanted to just " give him time " But they did start the EFAs and her

child also started talking -and that was around the age of three.

EFAs or not -if a child is apraxic their best odds are with therapy

too.

Just the other day Glenn came home and said to me " Where's a new

bottle of ProEFA? " When I asked him why -it was because he ran into

an adult with severe stuttering and told this person about the fish

oils and wanted to just give them a bottle.

How to deal with the mom your talking about? I don't know what to

say. I still don't get it how an adult would accept a diagnosis if

you want to call it that of speech delay secondary to hypotonia.

In a four year old!

=====

[Guest guest]

Thank you Alan and hoping to hear more input from you! How's it

going with the feedback? I would have answered you as well but my

son is now 11.

You are correct in that an SLP can diagnosed the oral or verbal

apraxia or any other co existing conditions of speech –but they are

not qualified to diagnose the neurodevelopmental " soft signs " that

typically accompany the apraxia diagnosis such as hypotonia. Perhaps

that is what Maureen meant? Also not sure if this is still the case

but in Canada it used to be that only pediatricians could diagnose

apraxia. As we wrote in The Late Talker book –if apraxia is

suspected –a neurodevelopmental medical exam is highly recommended to

confirm or rule out soft signs. Early intervention is the best time

to address any and all issues that child may be dealing with.

Oh and one other pet peeve of mine -as an SLP working on his PhD –

please try to not use the term " childhood apraxia of speech " We have

members here who have children that were diagnosed as apraxic as

children that are now teens or adults. While many learn to overcome

apraxia and become mainstreamed in school and life –it doesn't go

away and when dealing with complex thoughts and words even later in

life it shows itself. It's as Earl once said " Once a

stutterer, always a stutterer " As you know –like stuttering, apraxia

is also a motor planning disorder. While I understand ASHA adapted

using it just a few years ago –they have not been the best advocacy

group around to protect the interests of those who have actual

impairments. Someone wasn't thinking of the craziness of the name

for 2 reasons –the longer the utterance the more one breaks down and

it's the longest diagnosis name ever…and more important -the name

becomes an insult after a certain age –say 9. What's a teenager to

say if his speech messes up as they probably are already well aware

that there will be times it will " I have apraxia' And the teacher

thinking the teenager can't say the entire diagnosis says it for

him " You mean you have " childhood apraxia of speech? " Oh that would

be horrible!!!!!!!

Fortunately my son was diagnosed in 1999 many years before apraxia

was even recognized by ASHA while some were still arguing if it

existed in pediatrics –so he was fortunate to be diagnosed with

just " apraxia " I'm raising awareness for those in this group with 3

and 4 year olds because they don't see down the road yet. I'm

looking out for them.

While it is difficult to diganose verbal apraxia in a 2 year old or a

3 year old child that is nonverbal -you can diagnose oral apraxia and

if there is a late talker with signs of apraxia who has co existing hypotonia

for example

they could be given a diagnosis of " suspected apraxia " to begin

appropriate therapies just in case.

=====

[Guest guest]

The Therapist cannot write a prescription for services. You still

needed to follow up with the doctor to get those. Thats all I was

referring to.

>

[Guest guest]

Hi Azami,

Is it only once a week he get's therapy? Is the speech therapy your

son gets 1 on 1 or in group? How long is the therapy for? I don't

know if your son is apraxic but I was told that most children with

apraxia need at least 3 days of 1 on 1 speech therapy a week.

Kate

>

He gets speech and occupational therapy once a week in his program

[Guest guest]

--I was not trying to debate anything, not with all the well-wishes I

have gotten! What I was referring to and if your situation or state is

different- this is a big country. Tara has been out of preschool for

almost 3 yrs, but even than I needed a script from a Pediatrician or

Physiatrist or a Neurologist for services for the school year. It never

said " Apraxia " on it- it just said SP, OT PT as needed. But if even

one doctor decided she did not need speech anymore- I could safely

assume the school district would have a problem with that. That would

mean she did not have a diagnosis anymore? We have lots of good SLP in

NY and our EI program is one of the best in the country- but by the

time most children start Speech with EI, its almost time to age out?

isn't that correct? Most parents don't get an evaluation till after the

age of 1 or 2. That leaves barely a year to work on speech and it just

seems difficult for a speech therapist to diagnose apraxia before the

child ages out of Early Intervention.

gotta go...baby is crying.

[Guest guest]

Becky you are probably correct- an SLP first. But others add more

to help see other sides. All views help.

The blind men and the elephant:

http://www.noogenesis.com/pineapple/blind_men_elephant.html

I don't believe it's a choice of an SLP `or' a neuroMD

(neurodevelopmental pediatrician or pediatric neurologist) as who to

diagnosis apraxia. Apraxia today is multifaceted so you should seek

diagnosis from an SLP, neuroMD and OT.

No matter which you start with you should seek opinions from

knowledgeable professionals. Most likely your " late talker " child

will be seen by an SLP first because your child's pediatrician may

recognize a speech delay, or you may point our your concern. The

pediatrician may notice even some early warning signs of apraxia

since more are becoming aware –but most likely even then would refer

your child for a speech and hearing evaluation first. If you happen

to live around an apraxia expert like neurodevelopmental pediatrician

Dr. Agin someone like that may see a child even before an SLP -but in

most cases that isn't the norm. No matter what a neuroMDs would work

together with the SLPs and OTs reports -and in some cases work

together in the same office or hospital which is becoming more the

norm.

I just wanted to post the following just in case anywhere in the

world there is a situation where an SLP can't diagnose as it has been

stated here before in the archives. In Canada it's been stated both

ways. Which is true I can't confirm -but probably best to be aware

that we are dealing with parents from all over the world so to share

all options.

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

Subject: re: help in Canada

" Apraxia is a very controversial diagnosis here in Canada, and in

most cases, >the best you will get is a diagnosis of " suspected

apraxic "

, it's even more than raising awareness. There is a real

reluctance to diagnose, in fact, I just found out that SLP's are not

allowed to make the diagnosis here. So who can? I don't know and am

going to find out. Pediatricians are rarely aware of Apraxia - we

have to educate them. So who else could possibly diagnose --

developmental pediatricians? Neurologists?

In Canada, it is usually an SLP, developmental pediatrician or

pediatric neurologist that will dx apraxia of speech. An OT would dx

global apraxia.

~~~~~~~~~~~~~~~~~~~~~end of archives

=====