Re: Apraxia question from India

[Guest guest]

Hi, I am new too ... but go to http://www.speech411.com   It is the store where

you can buy/look at the ingredients for the supplement ... I hope that helps you

for now!

________________________________

From: Nikunj - Octagon <nikunj@...>

Sent: Wednesday, March 25, 2009 12:59:55 PM

Subject: [ ] Apraxia question from India

Hi,

I am new to this group (just joined today) so let me introduce myself. I am the

father of a 27 month old living in India where unfortunately we do not have much

knowledge/expertise about Apraxia. Based on recommendations of a friend of mine

living in US whose child has been diagnosed with Apraxia, I had ordered the book

" The Late Talker " from Amazon.com

Based on my reading of the book and other Internet articles, I do believe that

my daughter has Apraxia. She was also a late walker and did not start walking /

crawling until she turned 2 years old. She is undergoing speech therapy for the

last 4 months and both my wife and I are " hard at play " with her most of the

time. She seems to respond particularly well to my playing with her and is most

verbal during our time together. From not saying more than " mama " and " papa "

till 2 months ago (that too interchangeably for either of us) to having approx.

50 words in her vocabulary now, she has come a long way.

I was most excited to read the chapter on " nutritional supplements " in the book

" The Late Talker " - fish oil fatty acids and how they might potentially help

(along with speech therapy) in treating Apraxia. I immediately consulted our

Pediatrician here in India who was aware of Omega3 (she studied in UK) but told

me that at one time there was a lot of hype about this treatment but lately, it

has come to light that it does not really help in anyway. Now, the questions

going around in my head are:-

1) What is the latest belief about treatment of Apraxia with such nutritional

supplements? Are there any short-term or long-term side effects?

2) Is the nutritional supplement only meant for kick-starting the speech process

or is it also useful in cases like my daughter's since she has already started

saying words and is increasing her vocabulary everyday?

3) If we were to do a blood test to check whether or not she has a deficiency of

HUFA (highly unsaturated fatty acids), would that be useful?

3) None of the brands mentioned by in the book are available in India, however,

a variety of other brands of fish oil fatty acids are available. How do I choose

what is right for my daughter? Can you please tell me the ingredients /

composition I should look for and the dosage?

I would really appreciate any help /comments with this. It is a doubly difficult

situation for me with not enough expertise available here in India. Furthermore,

if anyone knows of any local resources related to Apraxia in my country, that

would be most useful.

Thank you,

Nikunj

nikunjeOctagon (DOT) com

[Guest guest]

Our daughter was diagnosed with apraxia 3 weeks ago and for two weeks we have

been giving her a moderate dose of fish oil and after about a week we noticed a

great difference in her speech and she has started to " chatter " alot more, I

would suggest ordering over the internet.

Have a nice day, Christian

[ ] Apraxia question from India

Hi,

I am new to this group (just joined today) so let me introduce myself. I am

the father of a 27 month old living in India where unfortunately we do not have

much knowledge/expertise about Apraxia. Based on recommendations of a friend of

mine living in US whose child has been diagnosed with Apraxia, I had ordered the

book " The Late Talker " from Amazon.com

Based on my reading of the book and other Internet articles, I do believe that

my daughter has Apraxia. She was also a late walker and did not start walking /

crawling until she turned 2 years old. She is undergoing speech therapy for the

last 4 months and both my wife and I are " hard at play " with her most of the

time. She seems to respond particularly well to my playing with her and is most

verbal during our time together. From not saying more than " mama " and " papa "

till 2 months ago (that too interchangeably for either of us) to having approx.

50 words in her vocabulary now, she has come a long way.

I was most excited to read the chapter on " nutritional supplements " in the

book " The Late Talker " - fish oil fatty acids and how they might potentially

help (along with speech therapy) in treating Apraxia. I immediately consulted

our Pediatrician here in India who was aware of Omega3 (she studied in UK) but

told me that at one time there was a lot of hype about this treatment but

lately, it has come to light that it does not really help in anyway. Now, the

questions going around in my head are:-

1) What is the latest belief about treatment of Apraxia with such nutritional

supplements? Are there any short-term or long-term side effects?

2) Is the nutritional supplement only meant for kick-starting the speech

process or is it also useful in cases like my daughter's since she has already

started saying words and is increasing her vocabulary everyday?

3) If we were to do a blood test to check whether or not she has a deficiency

of HUFA (highly unsaturated fatty acids), would that be useful?

3) None of the brands mentioned by in the book are available in India,

however, a variety of other brands of fish oil fatty acids are available. How do

I choose what is right for my daughter? Can you please tell me the ingredients /

composition I should look for and the dosage?

I would really appreciate any help /comments with this. It is a doubly

difficult situation for me with not enough expertise available here in India.

Furthermore, if anyone knows of any local resources related to Apraxia in my

country, that would be most useful.

Thank you,

Nikunj

nikunj@...

[Guest guest]

Nikunj,

I think you have a lot of valid questions about fish oil supplements, but I want

to interject and say that I wish I had your speech therapist over here in

Georgia, USA, because that is uncanny progress for a child with true apraxia. By

the age of 3, you should be able to understand a majority and what she says and

by age 4, others should be able to under a majority of what she says. It sounds

like sh is well on her way with accomplishing that.

I really would not complicate things too much by worrying about supplements

because it appears that the route you are taking right now is really working for

your child.

You may receive a differing opinion on this, but this is my honest thoughts.

>

> Hi,

>

>

>

> I am new to this group (just joined today) so let me introduce myself. I am

the father of a 27 month old living in India where unfortunately we do not have

much knowledge/expertise about Apraxia. Based on recommendations of a friend of

mine living in US whose child has been diagnosed with Apraxia, I had ordered the

book " The Late Talker " from Amazon.com

>

>

>

> Based on my reading of the book and other Internet articles, I do believe that

my daughter has Apraxia. She was also a late walker and did not start walking /

crawling until she turned 2 years old. She is undergoing speech therapy for the

last 4 months and both my wife and I are " hard at play " with her most of the

time. She seems to respond particularly well to my playing with her and is most

verbal during our time together. From not saying more than " mama " and " papa "

till 2 months ago (that too interchangeably for either of us) to having approx.

50 words in her vocabulary now, she has come a long way.

>

>

>

> I was most excited to read the chapter on " nutritional supplements " in the

book " The Late Talker " - fish oil fatty acids and how they might potentially

help (along with speech therapy) in treating Apraxia. I immediately consulted

our Pediatrician here in India who was aware of Omega3 (she studied in UK) but

told me that at one time there was a lot of hype about this treatment but

lately, it has come to light that it does not really help in anyway. Now, the

questions going around in my head are:-

>

>

>

> 1) What is the latest belief about treatment of Apraxia with such

nutritional supplements? Are there any short-term or long-term side effects?

>

> 2) Is the nutritional supplement only meant for kick-starting the speech

process or is it also useful in cases like my daughter's since she has already

started saying words and is increasing her vocabulary everyday?

>

> 3) If we were to do a blood test to check whether or not she has a

deficiency of HUFA (highly unsaturated fatty acids), would that be useful?

>

> 3) None of the brands mentioned by in the book are available in India,

however, a variety of other brands of fish oil fatty acids are available. How do

I choose what is right for my daughter? Can you please tell me the ingredients

/ composition I should look for and the dosage?

>

>

>

> I would really appreciate any help /comments with this. It is a doubly

difficult situation for me with not enough expertise available here in India.

Furthermore, if anyone knows of any local resources related to Apraxia in my

country, that would be most useful.

>

>

>

> Thank you,

>

>

>

> Nikunj

>

> nikunj@...

>

>

>

[Guest guest]

Well actually, our speech therapist here in India has not been able to make much

headway with my daughter. She does not co-operate with him. His therapy is

restricted to showing picture cards and trying to get her to say some nouns and

verbs. He refuses to give more than half an hour of time for 2 days in a week as

he is busy. The problem where I stay is that we only have a couple of speech

therapists both of whom have so far worked only with adults - they are not

pediatric speech therapists. My daughter has responded more to me - which is all

based on my research on the Internet and some books I ordered from US.

Again, no one in my city really knows about Apraxia so I have not been able to

get a proper medical opinion. My fear that my daughter has Apraxia is based more

on the milestones mentioned in the " Late Talker Book " towards judging the

difference between " A later talker " and Apraxia.

In this context, can someone please tell me by what age Apraxia can be

definitely diagnosed or ruled out? I have read different opinions on this, some

say 18 months, some say 2 yrs and yet others say 2 yrs and 6 months! Is it

possible that even with the present symptoms (approx. 50-60 words in her vocab,

inarticulate speech, not saying more than two syllable words, no two word

phrases, not a lot of spontaneous speech and some sudden one word utterances

which are then not repeated) my daughter may just be a late talker? She is 2 yrs

and 3 months old.

Thanks.

> >

> > Hi,

> >

> >

> >

> > I am new to this group (just joined today) so let me introduce myself. I am

the father of a 27 month old living in India where unfortunately we do not have

much knowledge/expertise about Apraxia. Based on recommendations of a friend of

mine living in US whose child has been diagnosed with Apraxia, I had ordered the

book " The Late Talker " from Amazon.com

> >

> >

> >

> > Based on my reading of the book and other Internet articles, I do believe

that my daughter has Apraxia. She was also a late walker and did not start

walking / crawling until she turned 2 years old. She is undergoing speech

therapy for the last 4 months and both my wife and I are " hard at play " with her

most of the time. She seems to respond particularly well to my playing with her

and is most verbal during our time together. From not saying more than " mama "

and " papa " till 2 months ago (that too interchangeably for either of us) to

having approx. 50 words in her vocabulary now, she has come a long way.

> >

> >

> >

> > I was most excited to read the chapter on " nutritional supplements " in the

book " The Late Talker " - fish oil fatty acids and how they might potentially

help (along with speech therapy) in treating Apraxia. I immediately consulted

our Pediatrician here in India who was aware of Omega3 (she studied in UK) but

told me that at one time there was a lot of hype about this treatment but

lately, it has come to light that it does not really help in anyway. Now, the

questions going around in my head are:-

> >

> >

> >

> > 1) What is the latest belief about treatment of Apraxia with such

nutritional supplements? Are there any short-term or long-term side effects?

> >

> > 2) Is the nutritional supplement only meant for kick-starting the speech

process or is it also useful in cases like my daughter's since she has already

started saying words and is increasing her vocabulary everyday?

> >

> > 3) If we were to do a blood test to check whether or not she has a

deficiency of HUFA (highly unsaturated fatty acids), would that be useful?

> >

> > 3) None of the brands mentioned by in the book are available in India,

however, a variety of other brands of fish oil fatty acids are available. How do

I choose what is right for my daughter? Can you please tell me the ingredients

/ composition I should look for and the dosage?

> >

> >

> >

> > I would really appreciate any help /comments with this. It is a doubly

difficult situation for me with not enough expertise available here in India.

Furthermore, if anyone knows of any local resources related to Apraxia in my

country, that would be most useful.

> >

> >

> >

> > Thank you,

> >

> >

> >

> > Nikunj

> >

> > nikunj@

> >

> >

> >

[Guest guest]

HI,

You might want to check with Kirkman Labs. I put the contact

information and distrubuter for India below:

International Orders:

Including Canada International orders will be shipped out the most cost

efficient way. If you need a quote or would like to have the order sent

by special delivery please call us at 1-503-694-1600. Packages usually

take 1 to 2 weeks to receive depending on customs and method of

shipping.

Shipping charges on the online store are for Continental USA orders

ONLY. All international orders will be shipped out in the most cost

efficient way. Otherwise, please contact the sales department via phone

or email if you need to know international shipping charges or quotes.

To contact our distributor in India:

Contact: D.Y. Bodke

Akhil Health Foods India

E-mail: sales@...

Website: www.akhilhealthfoods.com

Good Luck,

Ketzie

=====================

Posted through Grouply, the better way

to access your like this one.

http://www.grouply.com/?code=post

[Guest guest]

Nikunj,

I may be incorrect, and I do not know what the Late Talker book reads; however,

this does not sound like Apraxia to me. I am not a doctor and I am not a speech

therapist, but I am a nurse whohas done extensive research into speech

disorders. As long as there is a " progression " of sorts, there is no apraxia.

Maybe she as a slight developmental delay, but I am not hearing i from what you

have written. Not all children talkat the same time and if she is progressing

faster in other areas, then give her time to learn more words.

Apraxia has a distinct pattern of errors, omissions, substitutions, and

reversals. Someone who is apraxic (and this age, early on)can not duplicate a

simple word that you say on command; additionally, one day a word like " fish "

may come out ery clearly and the next time your child says the sam word, it

sounds like " fi " (with a short " i " sound).

Children with apraxia are inconsistent in their errors and word pronunciation.

They do not have a progressive sequence of sounds. (i.e. Ba, ba ba, ba do,

bottle). They do not do the ba ba, da da, ga ga and then progress to harder

sounds.

I have a two-year-old boy that does less than what you have said and he is not

apraxic.

By the same token, I have a 5 and a half year-old boy who is profoundly apraxic.

I will say that the " picture thing " that the therapist is doing is similar to

what my son was getting in Pre-K and it is not accepatable. I walked in and not

a word was ever said, only pictures were shown to my son and two other children

simultaneously. One card after another was presented without any utterances from

the teacher.

Just keep working with your daughter; you are doing a great job. I have a

feeling she will amaze you soon.

[Guest guest]

Hi Nikunj and welcome!

I'm one of the co authors of The Late Talker and hope I can answer some of your

questions.

I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia " (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective. Not just because I wrote it -but it's received recommendations

from medical, speech and educational professionals as well as parents and may

help answer more questions about apraxia for your older son)

Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

Do you notice if she breaks down the more she tries to say?

Does she " lose " language?

Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

Verbal apraxia signs

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

Oral apraxia signs

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

Soft signs

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

If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

About the fish oils (also known as EFAs or PUFAs) Most find that the fish oils

jump start and accelerate the progress. Many of us continue with this " therapy "

for years however in some cases parents were able to stop after a year or so and

the child was speaking fine. It is possible of course that some children were

not apraxic and were misdiagnosed. The other thought is that fish oil

supplementation is probably healthy for all children -all adults- speech

impaired or not.

You can look for a high quality oil that has the following dosage

Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

To bad nobody has yet wanted to test the basic formula we know to work

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

(and no thanks to those that want to " fix " the formula!!!!!)

Please get back with any answers. We are all here to help!

=====

[Guest guest]

,

I know several great speech patholigists here in north Ga, tell me what area you

are looking to get therapy and I can give you some names.

PS: I am giving my other son (for attention problems) DHA liquid called added

attention by Buried Treasure, it can be added to juice. We have seen a big

difference since we started it but cannot say it was all due to that or maybe

his maturity. Anyway I am now thinking of trying it on my younger one with the

Apraxia, as I have been reading it helps that too, although I have to check the

dosage and may have to use a different brand...bottom line is the DHA.. I think

that is the clue.

Janine

> >

> > Hi,

> >

> >

> >

> > I am new to this group (just joined today) so let me introduce myself. I am

the father of a 27 month old living in India where unfortunately we do not have

much knowledge/expertise about Apraxia. Based on recommendations of a friend of

mine living in US whose child has been diagnosed with Apraxia, I had ordered the

book " The Late Talker " from Amazon.com

> >

> >

> >

> > Based on my reading of the book and other Internet articles, I do believe

that my daughter has Apraxia. She was also a late walker and did not start

walking / crawling until she turned 2 years old. She is undergoing speech

therapy for the last 4 months and both my wife and I are " hard at play " with her

most of the time. She seems to respond particularly well to my playing with her

and is most verbal during our time together. From not saying more than " mama "

and " papa " till 2 months ago (that too interchangeably for either of us) to

having approx. 50 words in her vocabulary now, she has come a long way.

> >

> >

> >

> > I was most excited to read the chapter on " nutritional supplements " in the

book " The Late Talker " - fish oil fatty acids and how they might potentially

help (along with speech therapy) in treating Apraxia. I immediately consulted

our Pediatrician here in India who was aware of Omega3 (she studied in UK) but

told me that at one time there was a lot of hype about this treatment but

lately, it has come to light that it does not really help in anyway. Now, the

questions going around in my head are:-

> >

> >

> >

> > 1) What is the latest belief about treatment of Apraxia with such

nutritional supplements? Are there any short-term or long-term side effects?

> >

> > 2) Is the nutritional supplement only meant for kick-starting the speech

process or is it also useful in cases like my daughter's since she has already

started saying words and is increasing her vocabulary everyday?

> >

> > 3) If we were to do a blood test to check whether or not she has a

deficiency of HUFA (highly unsaturated fatty acids), would that be useful?

> >

> > 3) None of the brands mentioned by in the book are available in India,

however, a variety of other brands of fish oil fatty acids are available. How do

I choose what is right for my daughter? Can you please tell me the ingredients

/ composition I should look for and the dosage?

> >

> >

> >

> > I would really appreciate any help /comments with this. It is a doubly

difficult situation for me with not enough expertise available here in India.

Furthermore, if anyone knows of any local resources related to Apraxia in my

country, that would be most useful.

> >

> >

> >

> > Thank you,

> >

> >

> >

> > Nikunj

> >

> > nikunj@

> >

> >

> >

[Guest guest]

Hey ,

I have not read " Late Talker " because the " title " of the book impresses me as a

book about " developmental delay " rather than " apraxia " and my focus narrowed to

strictly apraxia when we found that this is what my son has. Most of the books

" I " read are medical textbooks. My main focus now, which has always been an

interest to me, is restructuring the neural pathways in the brain, as this is

what has to happen when apraxia is present; alternate pathways have to be

formed. Right now, Glenn Doman's principles are of high interest to me.

I think you misunderstood when I used the word " progression " . So, please let me

explain. If you look at a developmental chart from birth for pediatrics and

focus your attention in particular on how language develops, you will see a

progression of sorts from nonverbal cues to cooing to babbling to sequencing

sounds to production of intelligible words. Infants/children without apraxia

will typicaly develop or progress in the manner stated on the charts. Some

children will have a deveopmental delay (according to the charts, but not

necessarily delayed in regards to what is normal for the child), which means

that they will be slower (according to someone's chart) at reaching the eventual

goal of intelligible speech; however, if you take note, the child will still be

" progressing " in a somewhat orderly sequence. Once the words are gained, they

are not lost, rather they are built upon to form sentences.

With an apraxic child, you will not have this progressive sequence. Words

produced, if any, are frequently lost and never to be heard again. Most of the

time, there are obvious errors and omissions, some substitutions and reversal as

well, and these errors may not even be predictable (they can change from minute

to minute)and may vary from day to day. Groping, or obvious " odd " mouth shapes

when trying to form words, is a very common sign with apraxia, as the brain is

not giving the correct signal to the oral-motor muscles to form the necessary

words that the child knows he/she wants to say.(the neural pathway is broken).

I hope this better explains what I was trying to tell Nikunj. :0)

P.S. Sorry I have not time to read your book , but I think it is geared more

toward the individual who needs to determine what the speech problem is in their

child, correct? Now that we know what my son has, I am more on the mission of

" fixing " the brain and " repairing " the damage.I do hope that I will have some

time in the near future to read the book so that I can make a recommendation for

those it would help. :0)

>

> Hi Nikunj and welcome!

>

> I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

>

> I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia " (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective. Not just because I wrote it -but it's received recommendations

from medical, speech and educational professionals as well as parents and may

help answer more questions about apraxia for your older son)

>

> Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

>

> Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

>

> Do you notice if she breaks down the more she tries to say?

>

> Does she " lose " language?

>

> Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

>

> Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

> Verbal apraxia signs

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

> Oral apraxia signs

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

> Soft signs

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

>

> If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

>

> About the fish oils (also known as EFAs or PUFAs) Most find that the fish

oils jump start and accelerate the progress. Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine. It is possible of course that some

children were not apraxic and were misdiagnosed. The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

>

> You can look for a high quality oil that has the following dosage

> Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

>

> The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

>

> You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

>

> As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

>

> To bad nobody has yet wanted to test the basic formula we know to work

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

> (and no thanks to those that want to " fix " the formula!!!!!)

>

> Please get back with any answers. We are all here to help!

>

> =====

>

[Guest guest]

Janine,

I have to have an in-home speech therapist. My son has chronic pulmonary

infiltates and cannot go out on a regular basis to receive speech therapy in

order to curb the germs he comes into contact with.(MD orders) Do you know any

in-home therapists?

[Guest guest]

We had an in home patholigist that came here twice a month and he was through

the babies can't wait program (under 3 yrs), why don't you call and see what

they can offer you, and they may know of some others that can help. The one that

came here was Helton. 770-535-6907 is the office number.

>

> Janine,

> I have to have an in-home speech therapist. My son has chronic pulmonary

infiltates and cannot go out on a regular basis to receive speech therapy in

order to curb the germs he comes into contact with.(MD orders) Do you know any

in-home therapists?

>

>

[Guest guest]

- my son had words about six until age 12mon-byebye,baba, mama, dada,baby-

and then lost them and then rambled on with " N " sounds and then completely

stopped the N and now has the D as DaDa and DumDum.

I thought since he HAD words-that maybe I had to believe he wouldn't fit the

apraxia diagnosis.

So he still CAN be apraxic? We don't have and eval for months still!! It is

killing me! Btw he also has low muscle tone....

Sent from my BlackBerry® smartphone with SprintSpeed

[ ] Re: Apraxia question from India

Hey ,

I have not read " Late Talker " because the " title " of the book impresses me as a

book about " developmental delay " rather than " apraxia " and my focus narrowed to

strictly apraxia when we found that this is what my son has. Most of the books

" I " read are medical textbooks. My main focus now, which has always been an

interest to me, is restructuring the neural pathways in the brain, as this is

what has to happen when apraxia is present; alternate pathways have to be

formed. Right now, Glenn Doman's principles are of high interest to me.

I think you misunderstood when I used the word " progression " . So, please let me

explain. If you look at a developmental chart from birth for pediatrics and

focus your attention in particular on how language develops, you will see a

progression of sorts from nonverbal cues to cooing to babbling to sequencing

sounds to production of intelligible words. Infants/children without apraxia

will typicaly develop or progress in the manner stated on the charts. Some

children will have a deveopmental delay (according to the charts, but not

necessarily delayed in regards to what is normal for the child), which means

that they will be slower (according to someone's chart) at reaching the eventual

goal of intelligible speech; however, if you take note, the child will still be

" progressing " in a somewhat orderly sequence. Once the words are gained, they

are not lost, rather they are built upon to form sentences.

With an apraxic child, you will not have this progressive sequence. Words

produced, if any, are frequently lost and never to be heard again. Most of the

time, there are obvious errors and omissions, some substitutions and reversal as

well, and these errors may not even be predictable (they can change from minute

to minute)and may vary from day to day. Groping, or obvious " odd " mouth shapes

when trying to form words, is a very common sign with apraxia, as the brain is

not giving the correct signal to the oral-motor muscles to form the necessary

words that the child knows he/she wants to say.(the neural pathway is broken).

I hope this better explains what I was trying to tell Nikunj. :0)

P.S. Sorry I have not time to read your book , but I think it is geared more

toward the individual who needs to determine what the speech problem is in their

child, correct? Now that we know what my son has, I am more on the mission of

" fixing " the brain and " repairing " the damage.I do hope that I will have some

time in the near future to read the book so that I can make a recommendation for

those it would help. :0)

>

> Hi Nikunj and welcome!

>

> I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

>

> I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia " (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective. Not just because I wrote it -but it's received recommendations

from medical, speech and educational professionals as well as parents and may

help answer more questions about apraxia for your older son)

>

> Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

>

> Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

>

> Do you notice if she breaks down the more she tries to say?

>

> Does she " lose " language?

>

> Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

>

> Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

> Verbal apraxia signs

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

> Oral apraxia signs

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

> Soft signs

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

>

> If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

>

> About the fish oils (also known as EFAs or PUFAs) Most find that the fish

oils jump start and accelerate the progress. Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine. It is possible of course that some

children were not apraxic and were misdiagnosed. The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

>

> You can look for a high quality oil that has the following dosage

> Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

>

> The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

>

> You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

>

> As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

>

> To bad nobody has yet wanted to test the basic formula we know to work

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

> (and no thanks to those that want to " fix " the formula!!!!!)

>

> Please get back with any answers. We are all here to help!

>

> =====

>

[Guest guest]

Actually that sounds like apraxia to me ... My son said Mama very clearly at 14

months old .. and then nothing. Took me a long to even notice it either (he was

my second child, people say 2nd children sometimes don't talk as early as the

oldest, etc.) But apraxic children do LOSE speech. they can say it one day,

but not again and lose the ability to say it again.

Someone else can probably explain it better than I can though.

________________________________

From: " lucy2max@... " <lucy2max@...>

Sent: Sunday, March 29, 2009 3:25:27 AM

Subject: Re: [ ] Re: Apraxia question from India

- my son had words about six until age 12mon-byebye,baba, mama, dada,baby-

and then lost them and then rambled on with " N " sounds and then completely

stopped the N and now has the D as DaDa and DumDum.

I thought since he HAD words-that maybe I had to believe he wouldn't fit the

apraxia diagnosis.

So he still CAN be apraxic? We don't have and eval for months still!! It is

killing me! Btw he also has low muscle tone....

Sent from my BlackBerry® smartphone with SprintSpeed

[ ] Re: Apraxia question from India

Hey ,

I have not read " Late Talker " because the " title " of the book impresses me as a

book about " developmental delay " rather than " apraxia " and my focus narrowed to

strictly apraxia when we found that this is what my son has. Most of the books

" I " read are medical textbooks. My main focus now, which has always been an

interest to me, is restructuring the neural pathways in the brain, as this is

what has to happen when apraxia is present; alternate pathways have to be

formed. Right now, Glenn Doman's principles are of high interest to me.

I think you misunderstood when I used the word " progression " . So, please let me

explain. If you look at a developmental chart from birth for pediatrics and

focus your attention in particular on how language develops, you will see a

progression of sorts from nonverbal cues to cooing to babbling to sequencing

sounds to production of intelligible words. Infants/children without apraxia

will typicaly develop or progress in the manner stated on the charts. Some

children will have a deveopmental delay (according to the charts, but not

necessarily delayed in regards to what is normal for the child), which means

that they will be slower (according to someone's chart) at reaching the eventual

goal of intelligible speech; however, if you take note, the child will still be

" progressing " in a somewhat orderly sequence. Once the words are gained, they

are not lost, rather they are built upon to form sentences.

With an apraxic child, you will not have this progressive sequence. Words

produced, if any, are frequently lost and never to be heard again. Most of the

time, there are obvious errors and omissions, some substitutions and reversal as

well, and these errors may not even be predictable (they can change from minute

to minute)and may vary from day to day. Groping, or obvious " odd " mouth shapes

when trying to form words, is a very common sign with apraxia, as the brain is

not giving the correct signal to the oral-motor muscles to form the necessary

words that the child knows he/she wants to say.(the neural pathway is broken).

I hope this better explains what I was trying to tell Nikunj. :0)

P.S. Sorry I have not time to read your book , but I think it is geared more

toward the individual who needs to determine what the speech problem is in their

child, correct? Now that we know what my son has, I am more on the mission of

" fixing " the brain and " repairing " the damage.I do hope that I will have some

time in the near future to read the book so that I can make a recommendation for

those it would help. :0)

>

> Hi Nikunj and welcome!

>

> I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

>

> I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia " (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective. Not just because I wrote it -but it's received recommendations

from medical, speech and educational professionals as well as parents and may

help answer more questions about apraxia for your older son)

>

> Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

>

> Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

>

> Do you notice if she breaks down the more she tries to say?

>

> Does she " lose " language?

>

> Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

>

> Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

> Verbal apraxia signs

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

> Oral apraxia signs

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

> Soft signs

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

>

> If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

>

> About the fish oils (also known as EFAs or PUFAs) Most find that the fish

oils jump start and accelerate the progress. Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine. It is possible of course that some

children were not apraxic and were misdiagnosed. The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

>

> You can look for a high quality oil that has the following dosage

> Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

>

> The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

>

> You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

>

> As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

>

> To bad nobody has yet wanted to test the basic formula we know to work

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

> (and no thanks to those that want to " fix " the formula!!!!!)

>

> Please get back with any answers. We are all here to help!

>

> =====

>

[Guest guest]

-you made me feel better- getting closer to a diagnosis I hope.

Do you think apraxia more than dysarthia or hypotonia?

If he can't use tongue too well, nor stick it out-i saw it a couple times a

teeny bit come out, can't really laugh, can smile, has to shove food into

mouth-evan over stuff...still looking like apraxia?

Will a developmental pediatrician be able to diagnose? I have to wait 8weeks for

that appt- so it is killing me.

Did you have tons of medical testing done?

Are a lot of kids here positive for mito disease?

Iveta

Sent from my BlackBerry® smartphone with SprintSpeed

[ ] Re: Apraxia question from India

Hey ,

I have not read " Late Talker " because the " title " of the book impresses me as a

book about " developmental delay " rather than " apraxia " and my focus narrowed to

strictly apraxia when we found that this is what my son has. Most of the books

" I " read are medical textbooks. My main focus now, which has always been an

interest to me, is restructuring the neural pathways in the brain, as this is

what has to happen when apraxia is present; alternate pathways have to be

formed. Right now, Glenn Doman's principles are of high interest to me.

I think you misunderstood when I used the word " progression " . So, please let me

explain. If you look at a developmental chart from birth for pediatrics and

focus your attention in particular on how language develops, you will see a

progression of sorts from nonverbal cues to cooing to babbling to sequencing

sounds to production of intelligible words. Infants/children without apraxia

will typicaly develop or progress in the manner stated on the charts. Some

children will have a deveopmental delay (according to the charts, but not

necessarily delayed in regards to what is normal for the child), which means

that they will be slower (according to someone's chart) at reaching the eventual

goal of intelligible speech; however, if you take note, the child will still be

" progressing " in a somewhat orderly sequence. Once the words are gained, they

are not lost, rather they are built upon to form sentences.

With an apraxic child, you will not have this progressive sequence. Words

produced, if any, are frequently lost and never to be heard again. Most of the

time, there are obvious errors and omissions, some substitutions and reversal as

well, and these errors may not even be predictable (they can change from minute

to minute)and may vary from day to day. Groping, or obvious " odd " mouth shapes

when trying to form words, is a very common sign with apraxia, as the brain is

not giving the correct signal to the oral-motor muscles to form the necessary

words that the child knows he/she wants to say.(the neural pathway is broken).

I hope this better explains what I was trying to tell Nikunj. :0)

P.S. Sorry I have not time to read your book , but I think it is geared more

toward the individual who needs to determine what the speech problem is in their

child, correct? Now that we know what my son has, I am more on the mission of

" fixing " the brain and " repairing " the damage.I do hope that I will have some

time in the near future to read the book so that I can make a recommendation for

those it would help. :0)

>

> Hi Nikunj and welcome!

>

> I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

>

> I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia " (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective. Not just because I wrote it -but it's received recommendations

from medical, speech and educational professionals as well as parents and may

help answer more questions about apraxia for your older son)

>

> Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

>

> Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

>

> Do you notice if she breaks down the more she tries to say?

>

> Does she " lose " language?

>

> Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

>

> Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

> Verbal apraxia signs

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

> Oral apraxia signs

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

> Soft signs

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

>

> If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

>

> About the fish oils (also known as EFAs or PUFAs) Most find that the fish

oils jump start and accelerate the progress. Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine. It is possible of course that some

children were not apraxic and were misdiagnosed. The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

>

> You can look for a high quality oil that has the following dosage

> Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

>

> The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

>

> You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

>

> As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

>

> To bad nobody has yet wanted to test the basic formula we know to work

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

> (and no thanks to those that want to " fix " the formula!!!!!)

>

> Please get back with any answers. We are all here to help!

>

> =====

>

[Guest guest]

you may not be aware that this group is owned by me -and I co authored The

Late Talker book. I was mearly asking you that if you did extensive research

why you wouldn't have read the book that has been one of the best selling books

for apraxia since it came out in 2003 -and it doesn't take any searching at all

to learn that if you do a quick search for books on apraxia in children!

We named the book The Late Talker because most don't know what apraxia is and

one only knows that their child isn't speaking yet. Children that are not

speaking yet as a whole are all in fact " late talkers " whether their diagnosis

of why they aren't speaking is accurate or not. As we know -there are many

autistic children that are misdiagnosed and are actually apraxic. But apraxia

asides-the book is geared not only for apraxia but for any child who is not

talking yet...which is why the full name of the book is 'The Late Talker What to

Do If Your Child Isn't Talking Yet " There are strategies for both the child as

well as the parent.

You speak much about medical references. Again my one co author is a

neurodevelopmental pediatrician and from memory right now I don't recall any

other book on verbal apraxia written by a medical doctor. In addition there was

this article

http://contemporarypediatrics.modernmedicine.com/contpeds/author/authorInfo.jsp?\

id=18406

I wrote the parent " to do at home part for this "

http://www.contemporarypediatrics.com/contpeds/data/articlestandard/contpeds/492\

004/136315/article.pdf

But then you also make me wonder why you bring up Doman when from what I read

he's the last person a medical person would recommend.

As you probably know he's also not a doctor - in the 50s he was a physical

therapist. In regards to apraxia I know many professionals I'd recommend before

him; actually unless there's something about him other than what I just posted

I'd probably never recommend him. The Late Talker does cover multisensory

therapies and approaches to apraxia in addition to the traditional -but we only

included those that we know to have worked in this group over the years.

We all are here to help our child diagnosed with whatever communication

impairment or delay they may have and I'm here to help whether you ever find the

time to read my book or not -whether you like it or not. I'm just saying if I

were you I'd find the time to read it -and read it before Doman's. Good luck

with your son.

=====

[Guest guest]

+

I would like to add to this discussion. As I have mentioned on another post,for

the past year plus,I have done the type of therapy that Bob Doman uses for my

son, although I go through a different group. I think it is important to

mention that this therapy has helped my son with his many sensory, vestibular,

and proprioceptive issues, but it has NOT helped him to talk. I have recently,

for the past 3 weeks or so, started my son with speech therapy with a therapist

that works with apraxia. He is now starting to say some words spontaneously. I

do believe that the neurodevelopmental therapy is excellent and I have seen

miracles happen and maybe because of this therapy my son's speech may come along

faster now that I have the appropriate speech therapist. This therapy did not

help my child to talk. Will I continue with this type of therapy? Yes because

it will help his other issues but this method did not help him to talk. I truly

wish that I had heard about the book The Late Talker 3 years ago because it has

been such an education for me and the puzzle pieces are coming together. I have

been a victim of the " just wait and see " or " I know kids that didn't talk

until... " . I happened to fall upon this group by accident or I should say by

Divine Providence. From this group I found out about the book.

Just a note, I don't recall that neurodevelopmental therapy directly addresses

apraxia.

I hope this a helps and I want to thank you again, , for this group and your

book. God has blessed you.

Jane

www.KidsHealthNaturally.com

www.HealthyChatter.com

>

> you may not be aware that this group is owned by me -and I co authored

The Late Talker book. I was mearly asking you that if you did extensive

research why you wouldn't have read the book that has been one of the best

selling books for apraxia since it came out in 2003 -and it doesn't take any

searching at all to learn that if you do a quick search for books on apraxia in

children!

>

> We named the book The Late Talker because most don't know what apraxia is and

one only knows that their child isn't speaking yet. Children that are not

speaking yet as a whole are all in fact " late talkers " whether their diagnosis

of why they aren't speaking is accurate or not. As we know -there are many

autistic children that are misdiagnosed and are actually apraxic. But apraxia

asides-the book is geared not only for apraxia but for any child who is not

talking yet...which is why the full name of the book is 'The Late Talker What to

Do If Your Child Isn't Talking Yet " There are strategies for both the child as

well as the parent.

>

> You speak much about medical references. Again my one co author is a

neurodevelopmental pediatrician and from memory right now I don't recall any

other book on verbal apraxia written by a medical doctor. In addition there was

this article

>

http://contemporarypediatrics.modernmedicine.com/contpeds/author/authorInfo.jsp?\

id=18406

>

> I wrote the parent " to do at home part for this "

>

http://www.contemporarypediatrics.com/contpeds/data/articlestandard/contpeds/492\

004/136315/article.pdf

>

> But then you also make me wonder why you bring up Doman when from what I read

he's the last person a medical person would recommend.

> As you probably know he's also not a doctor - in the 50s he was a physical

therapist. In regards to apraxia I know many professionals I'd recommend before

him; actually unless there's something about him other than what I just posted

I'd probably never recommend him. The Late Talker does cover multisensory

therapies and approaches to apraxia in addition to the traditional -but we only

included those that we know to have worked in this group over the years.

>

> We all are here to help our child diagnosed with whatever communication

impairment or delay they may have and I'm here to help whether you ever find the

time to read my book or not -whether you like it or not. I'm just saying if I

were you I'd find the time to read it -and read it before Doman's. Good luck

with your son.

>

> =====

>

[Guest guest]

- I am sorry to interupt this conversation..I was reading your book for the

first time tonight and got to the neurodevelopmental ped section. Finally! I had

no idea what everyone is talking about...can I ask my ped to write referral to

one if one is not in my insurance plan..will my child be ok just going thru

mainstream channels such as a d

[Guest guest]

Hi,

Thanks for all your postings / replies. I will try to answer everything to the

best of my abilities. To begin with, I would just like to clarify that my

daughter is actually 2 yrs and 3 months old (not 2 yrs old). The 50 - odd words

she has in her vocab have been picked up in the last 2 months. She says some

words very clearly and they are easily understandable to anyone (including

strangers), for eg. mama, papa, hi, bye, up, on, tie, doll, baby, boat, hot,

auto, tall, home, boy, toy, bird, happy, etc.

Other words in her vocab are not so correct - she says ball as just " bouu " , was

saying door closely resembling to the correct sound till a few days ago but

lately suddenly door has become " doul " , she says apple correctly at times and at

other times it's just " appaa " , she says birthday sometimes clearly and sometimes

without the " r " sound, " open " is always " auto " , etc.

She seems to have difficulty saying back of the tongue sounds like " k " and " g "

sounds. For eg. she knows how to say " do " (pronounced as " dou " in Indian

language - meaning " give " ) but whenever we try to teach her to say " go " she

still says " do " every single time. Sit is " tit " , girl is " tirl " , cat is " tat " ,

book is just " boo " , done is " none " , " gaadi " (meaning car in Indian language) is

" daadi " (meaning grandmom in Indian language - another word which she knows

well). So on and so forth.

She seems to be unable to say blended words like " play " , " box " , " help " , etc. She

had said " light " and " catch " once very clearly when she was between 6-12 months

old but then did not repeat. Even till 2 months ago, she would say a few words

just once and then not repeat. For eg. papa for a few days and then only mama

for next few (no papa at all) and similarily, few other words that were said

just 1 or 2 times and then not repeated. However, thank god, this has not been

happening for the last couple of months, touch wood!

Also, for the last 2 months or so we have trying some oromotor exercises with

her - some of which she was able to do immediately when we tried and others

which she has started doing now. For eg. she would lick chocolate off the side

of her mouth and below but not from just above the upper lip. She still does not

lick things off from just above her upper lip. She used to hate having her teeth

brushed but is now okay with it. We tried getting her to blow match-sticks,

initially, she would suck in her breath but then started blowing out the match

sticks (still with some breathing in). Now, she is able to blow candles as well.

She is also able to make the clucking sound by touching the tip of her tongue to

the top of the inside of her mouth now. We had been trying to get her to pucker

her lips and give a kiss since she was very young but she did not start doing it

up until a couple of days ago.

She does swallow some types of food without chewing but chews other types of

food specially crunchy ones like chips, etc. She does grind her teeth during the

day even in normal course. While speaking into a mic, she puts it inside her

mouth as far as it will go even though we have taught her many times to hold it

just an inch away from her mouth. Her receptive and cognitive skills have been

found to be appropriate for her age and in some cases, even better than her age.

She does not like anyone touching her hair and is very fussy about cleanliness

and hygiene, all of which she might well have picked up from me! She is also bit

of a fussy eater.. not overly fond of food as such. She does not like any kind

of a sudden noise and jumps and gets scared whenever something like this happens

though it's less now compared to earlier.

She likes making puzzles, playing with all kinds of toys and doing pretend play.

While her gross motor skills are fine (she started climbing up and down the

staircase on her own by holding the railing just 2 days ago), however, we are

not able to judge her fine motor skills very well. She does seem to have some

problem in this regard but we are not sure whether or not it's apt for her age,

for eg. putting a hollow ring into a fine lace is a bit of a struggle, fitting

in fine puzzle pieces are sometimes a trial and error, etc.

I have tried to put in everything I could think of and be as objective in my

assessment as I could. I would really appreciate some inputs on whether this

looks like apraxia or just delayed speech. Thanks so much to everyone for their

help!

Best,

Nikunj

>

> Hi Nikunj and welcome!

>

> I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

>

> I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia " (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective. Not just because I wrote it -but it's received recommendations

from medical, speech and educational professionals as well as parents and may

help answer more questions about apraxia for your older son)

>

> Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

>

> Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

>

> Do you notice if she breaks down the more she tries to say?

>

> Does she " lose " language?

>

> Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

>

> Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

> Verbal apraxia signs

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

> Oral apraxia signs

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

> Soft signs

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

>

> If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

>

> About the fish oils (also known as EFAs or PUFAs) Most find that the fish

oils jump start and accelerate the progress. Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine. It is possible of course that some

children were not apraxic and were misdiagnosed. The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

>

> You can look for a high quality oil that has the following dosage

> Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

>

> The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

>

> You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

>

> As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

>

> To bad nobody has yet wanted to test the basic formula we know to work

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

> (and no thanks to those that want to " fix " the formula!!!!!)

>

> Please get back with any answers. We are all here to help!

>

> =====

>

[Guest guest]

I can comment on a few things (until someone more qualified can!)  My son also

loses words .. though less now (he was diagnosed with apraxia at 2 and is now

3.5).  The 'g' and 'k' sounds are very problematic

My guess is your daughter does have apraxia ... but YOU are a fantastic

therapist!  I mean, wow!  So you are doing what you should be doing. 

Good luck ... and you and she are doing great!

________________________________

From: nickoct1979 <nikunj@...>

Sent: Monday, March 30, 2009 2:41:08 AM

Subject: [ ] Re: Apraxia question from India

Hi,

Thanks for all your postings / replies. I will try to answer everything to the

best of my abilities. To begin with, I would just like to clarify that my

daughter is actually 2 yrs and 3 months old (not 2 yrs old). The 50 - odd words

she has in her vocab have been picked up in the last 2 months. She says some

words very clearly and they are easily understandable to anyone (including

strangers), for eg. mama, papa, hi, bye, up, on, tie, doll, baby, boat, hot,

auto, tall, home, boy, toy, bird, happy, etc.

Other words in her vocab are not so correct - she says ball as just " bouu " , was

saying door closely resembling to the correct sound till a few days ago but

lately suddenly door has become " doul " , she says apple correctly at times and at

other times it's just " appaa " , she says birthday sometimes clearly and sometimes

without the " r " sound, " open " is always " auto " , etc.

She seems to have difficulty saying back of the tongue sounds like " k " and " g "

sounds. For eg. she knows how to say " do " (pronounced as " dou " in Indian

language - meaning " give " ) but whenever we try to teach her to say " go " she

still says " do " every single time. Sit is " tit " , girl is " tirl " , cat is " tat " ,

book is just " boo " , done is " none " , " gaadi " (meaning car in Indian language) is

" daadi " (meaning grandmom in Indian language - another word which she knows

well). So on and so forth.

She seems to be unable to say blended words like " play " , " box " , " help " , etc. She

had said " light " and " catch " once very clearly when she was between 6-12 months

old but then did not repeat. Even till 2 months ago, she would say a few words

just once and then not repeat. For eg. papa for a few days and then only mama

for next few (no papa at all) and similarily, few other words that were said

just 1 or 2 times and then not repeated. However, thank god, this has not been

happening for the last couple of months, touch wood!

Also, for the last 2 months or so we have trying some oromotor exercises with

her - some of which she was able to do immediately when we tried and others

which she has started doing now. For eg. she would lick chocolate off the side

of her mouth and below but not from just above the upper lip. She still does not

lick things off from just above her upper lip. She used to hate having her teeth

brushed but is now okay with it. We tried getting her to blow match-sticks,

initially, she would suck in her breath but then started blowing out the match

sticks (still with some breathing in). Now, she is able to blow candles as well.

She is also able to make the clucking sound by touching the tip of her tongue to

the top of the inside of her mouth now. We had been trying to get her to pucker

her lips and give a kiss since she was very young but she did not start doing it

up until a couple of days ago.

She does swallow some types of food without chewing but chews other types of

food specially crunchy ones like chips, etc. She does grind her teeth during the

day even in normal course. While speaking into a mic, she puts it inside her

mouth as far as it will go even though we have taught her many times to hold it

just an inch away from her mouth. Her receptive and cognitive skills have been

found to be appropriate for her age and in some cases, even better than her age.

She does not like anyone touching her hair and is very fussy about cleanliness

and hygiene, all of which she might well have picked up from me! She is also bit

of a fussy eater.. not overly fond of food as such. She does not like any kind

of a sudden noise and jumps and gets scared whenever something like this happens

though it's less now compared to earlier.

She likes making puzzles, playing with all kinds of toys and doing pretend play.

While her gross motor skills are fine (she started climbing up and down the

staircase on her own by holding the railing just 2 days ago), however, we are

not able to judge her fine motor skills very well. She does seem to have some

problem in this regard but we are not sure whether or not it's apt for her age,

for eg. putting a hollow ring into a fine lace is a bit of a struggle, fitting

in fine puzzle pieces are sometimes a trial and error, etc.

I have tried to put in everything I could think of and be as objective in my

assessment as I could. I would really appreciate some inputs on whether this

looks like apraxia or just delayed speech. Thanks so much to everyone for their

help!

Best,

Nikunj

>

> Hi Nikunj and welcome!

>

> I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

>

> I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia " (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective. Not just because I wrote it -but it's received recommendations from

medical, speech and educational professionals as well as parents and may help

answer more questions about apraxia for your older son)

>

> Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

>

> Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

>

> Do you notice if she breaks down the more she tries to say?

>

> Does she " lose " language?

>

> Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

>

> Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

> Verbal apraxia signs

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

> Oral apraxia signs

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

> Soft signs

> http://www.cherab. org/information/ speechlanguage/ parentfriendlyso

ftsigns.html

>

> If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

>

> About the fish oils (also known as EFAs or PUFAs) Most find that the fish oils

jump start and accelerate the progress. Many of us continue with this " therapy "

for years however in some cases parents were able to stop after a year or so and

the child was speaking fine. It is possible of course that some children were

not apraxic and were misdiagnosed. The other thought is that fish oil

supplementation is probably healthy for all children -all adults- speech

impaired or not.

>

> You can look for a high quality oil that has the following dosage

> Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

>

> The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

>

> You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

>

> As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

>

> To bad nobody has yet wanted to test the basic formula we know to work

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

> (and no thanks to those that want to " fix " the formula!!!!! )

>

> Please get back with any answers. We are all here to help!

>

> =====

>

[Guest guest]

, I didn't even connect that you were one of the authors ... I want to

quickly say thank you for that book.  In the first chapter, you so accurately

described my son to me.  Things I didn't even notice that he was doing to

overcome his speech delay/disorder.  Or were related to the apraxia.  THANK YOU

for writing it!

________________________________

From: kiddietalk <kiddietalk@...>

Sent: Sunday, March 29, 2009 11:53:01 PM

Subject: [ ] Re: Apraxia question from India

you may not be aware that this group is owned by me -and I co authored The

Late Talker book. I was mearly asking you that if you did extensive research why

you wouldn't have read the book that has been one of the best selling books for

apraxia since it came out in 2003 -and it doesn't take any searching at all to

learn that if you do a quick search for books on apraxia in children!

We named the book The Late Talker because most don't know what apraxia is and

one only knows that their child isn't speaking yet. Children that are not

speaking yet as a whole are all in fact " late talkers " whether their diagnosis

of why they aren't speaking is accurate or not. As we know -there are many

autistic children that are misdiagnosed and are actually apraxic. But apraxia

asides-the book is geared not only for apraxia but for any child who is not

talking yet...which is why the full name of the book is 'The Late Talker What to

Do If Your Child Isn't Talking Yet " There are strategies for both the child as

well as the parent.

You speak much about medical references. Again my one co author is a

neurodevelopmental pediatrician and from memory right now I don't recall any

other book on verbal apraxia written by a medical doctor. In addition there was

this article

http://contemporary pediatrics. modernmedicine. com/contpeds/ author/authorInf

o.jsp?id= 18406

I wrote the parent " to do at home part for this "

http://www.contempo rarypediatrics. com/contpeds/ data/articlestan

dard/contpeds/ 492004/136315/ article.pdf

But then you also make me wonder why you bring up Doman when from what I read

he's the last person a medical person would recommend.

As you probably know he's also not a doctor - in the 50s he was a physical

therapist. In regards to apraxia I know many professionals I'd recommend before

him; actually unless there's something about him other than what I just posted

I'd probably never recommend him. The Late Talker does cover multisensory

therapies and approaches to apraxia in addition to the traditional -but we only

included those that we know to have worked in this group over the years.

We all are here to help our child diagnosed with whatever communication

impairment or delay they may have and I'm here to help whether you ever find the

time to read my book or not -whether you like it or not. I'm just saying if I

were you I'd find the time to read it -and read it before Doman's. Good luck

with your son.

=====

[Guest guest]

Hi, I am not a medical doctor!  I have just really learned about the hypotonia

myself.  Thinking back, my son did not stick his tongue out (we thought he was

tongue tied, but he wasn't) but not really knowing what to look for, I didn't

think too much about it.  When he would lick icecream, it was very 'forced'

looking, moving his head, not his tongue  ... not natural, but again, I didn't

think too much about it. 

The (sad) fact, we had him in a private speech therapy for 6 months, then he

qualified for free state services.  It was at that time, the Child Development

Coordinator informed us that the private therapist had diagnosed him with

apraxia! 

So a lot of his tongue issues seem to be resolved now ... though again, it just

happened (I am sure with a lot of help in therapy). 

My husband and I have been way too 'carefree' about Liam's apraxia.  I am just

now coming out of the denial state and starting to realize the impact it will

have on Liam.  And I am getting scared. 

Anyway, I hope my ramblings helped you some ... but yes, tongue issues are

symptoms of apraxia also ... that I do know! 

melanie

________________________________

From: " lucy2max@... " <lucy2max@...>

Sent: Sunday, March 29, 2009 10:33:33 PM

Subject: Re: [ ] Re: Apraxia question from India

-you made me feel better- getting closer to a diagnosis I hope.

Do you think apraxia more than dysarthia or hypotonia?

If he can't use tongue too well, nor stick it out-i saw it a couple times a

teeny bit come out, can't really laugh, can smile, has to shove food into

mouth-evan over stuff...still looking like apraxia?

Will a developmental pediatrician be able to diagnose? I have to wait 8weeks for

that appt- so it is killing me.

Did you have tons of medical testing done?

Are a lot of kids here positive for mito disease?

Iveta

Sent from my BlackBerry® smartphone with SprintSpeed

[ ] Re: Apraxia question from India

Hey ,

I have not read " Late Talker " because the " title " of the book impresses me as a

book about " developmental delay " rather than " apraxia " and my focus narrowed to

strictly apraxia when we found that this is what my son has. Most of the books

" I " read are medical textbooks. My main focus now, which has always been an

interest to me, is restructuring the neural pathways in the brain, as this is

what has to happen when apraxia is present; alternate pathways have to be

formed. Right now, Glenn Doman's principles are of high interest to me.

I think you misunderstood when I used the word " progression " . So, please let me

explain. If you look at a developmental chart from birth for pediatrics and

focus your attention in particular on how language develops, you will see a

progression of sorts from nonverbal cues to cooing to babbling to sequencing

sounds to production of intelligible words. Infants/children without apraxia

will typicaly develop or progress in the manner stated on the charts. Some

children will have a deveopmental delay (according to the charts, but not

necessarily delayed in regards to what is normal for the child), which means

that they will be slower (according to someone's chart) at reaching the eventual

goal of intelligible speech; however, if you take note, the child will still be

" progressing " in a somewhat orderly sequence. Once the words are gained, they

are not lost, rather they are built upon to form sentences.

With an apraxic child, you will not have this progressive sequence. Words

produced, if any, are frequently lost and never to be heard again. Most of the

time, there are obvious errors and omissions, some substitutions and reversal as

well, and these errors may not even be predictable (they can change from minute

to minute)and may vary from day to day. Groping, or obvious " odd " mouth shapes

when trying to form words, is a very common sign with apraxia, as the brain is

not giving the correct signal to the oral-motor muscles to form the necessary

words that the child knows he/she wants to say.(the neural pathway is broken).

I hope this better explains what I was trying to tell Nikunj. :0)

P.S. Sorry I have not time to read your book , but I think it is geared more

toward the individual who needs to determine what the speech problem is in their

child, correct? Now that we know what my son has, I am more on the mission of

" fixing " the brain and " repairing " the damage.I do hope that I will have some

time in the near future to read the book so that I can make a recommendation for

those it would help. :0)

>

> Hi Nikunj and welcome!

>

> I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

>

> I do agree with in that it is possible that your little one has a simple

delay in speech since she is just 2 years old and already has 50 words -however

I don't agree with 's statement " As long as there is a " progression " of

sorts, there is no apraxia "   (and -with your extensive research on speech

impairments -just curious why you haven't read The Late Talker book as it's

written by a neurodevelopmental pediatrician and parent of 2 " late talkers "

perspective.  Not just because I wrote it -but it's received  recommendations

from medical, speech and educational professionals as well as parents and may

help answer more questions about apraxia for your older son)

>

> Like any condition there are degrees of severity with apraxia as well.  There

are also subjective ways of looking at the " words " our 2 year old has.  So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

>

> Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

>

> Do you notice if she breaks down the more she tries to say?

>

> Does she " lose " language?

>

> Do you notice any " soft signs " such as low tone, motor planning issues in the

body or any signs of oral apraxia?

>

> Here's some parent friendly signs of verbal and oral apraxia -as well as " soft

signs "

> Verbal apraxia signs

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

> Oral apraxia signs

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

> Soft signs

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

>

> If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

>

> About the fish oils (also known as EFAs or PUFAs)  Most find that the fish

oils jump start and accelerate the progress.  Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine.  It is possible of course that some

children were not apraxic and were misdiagnosed.  The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

>

> You can look for a high quality oil that has the following dosage

> Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

>

> The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA is

from either primrose or borage seed oil and it's the small amount of Omega 6. 

You can mix oils together to create the above formula if you can't find one near

you that has it.

>

> You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere.  Did you check in your stores

for the brand Eye Q?  It's a UK brand that is similar to the ProEFA and also a

good starting formula.

>

> As far as is it hype?  I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that.  If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

>

> To bad nobody has yet wanted to test the basic formula we know to work

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

> (and no thanks to those that want to " fix " the formula!!!!!)

>

> Please get back with any answers.  We are all here to help!

>

> =====

>

[Guest guest]

This may not be the answer you are searching for and I a not a doctor nor a

speech therapist, but I am a nurse.

Omissions at the end of words are a normal thing in learning to talk, initially.

It seems like the omissions are fairly consistent, which at this time, makes me

elieve that your childhas neithrdevelopmental delay nor apraxia. (This is just

an opinion,though, and should by no means be construed as a diagnosis for your

child.) See what happens in the near future.

> >

> > Hi Nikunj and welcome!

> >

> > I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

> >

> > I do agree with in that it is possible that your little one has a

simple delay in speech since she is just 2 years old and already has 50 words

-however I don't agree with 's statement " As long as there is a

" progression " of sorts, there is no apraxia " (and -with your extensive

research on speech impairments -just curious why you haven't read The Late

Talker book as it's written by a neurodevelopmental pediatrician and parent of 2

" late talkers " perspective. Not just because I wrote it -but it's received

recommendations from medical, speech and educational professionals as well as

parents and may help answer more questions about apraxia for your older son)

> >

> > Like any condition there are degrees of severity with apraxia as well.

There are also subjective ways of looking at the " words " our 2 year old has. So

the question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

> >

> > Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

> >

> > Do you notice if she breaks down the more she tries to say?

> >

> > Does she " lose " language?

> >

> > Do you notice any " soft signs " such as low tone, motor planning issues in

the body or any signs of oral apraxia?

> >

> > Here's some parent friendly signs of verbal and oral apraxia -as well as

" soft signs "

> > Verbal apraxia signs

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

> > Oral apraxia signs

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

> > Soft signs

> >

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

> >

> > If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

> >

> > About the fish oils (also known as EFAs or PUFAs) Most find that the fish

oils jump start and accelerate the progress. Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine. It is possible of course that some

children were not apraxic and were misdiagnosed. The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

> >

> > You can look for a high quality oil that has the following dosage

> > Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

> >

> > The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA

is from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

> >

> > You can order from some sites that ship internationally like

http://www.speech411.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

> >

> > As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

> >

> > To bad nobody has yet wanted to test the basic formula we know to work

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

> > (and no thanks to those that want to " fix " the formula!!!!!)

> >

> > Please get back with any answers. We are all here to help!

> >

> > =====

> >

[Guest guest]

People visit this group looking for encouragement, support, and reassurance.  We

all know parents of apraxic children battle insurance companies, schools,

medical community, and even other family members.  Please do not make this group

another place to have to defend out children.  You have no idea what is going on

with this child and it is irresponsible (and just plain awful) of you to say

this.   

From: <agirlnamedsuess@...>

Subject: [ ] Re: Apraxia question from India

Date: Monday, March 30, 2009, 12:19 PM

This may not be the answer you are searching for and I a not a doctor nor a

speech therapist, but I am a nurse.

Omissions at the end of words are a normal thing in learning to talk, initially.

It seems like the omissions are fairly consistent, which at this time, makes me

elieve that your childhas neithrdevelopmental delay nor apraxia. (This is just

an opinion,though, and should by no means be construed as a diagnosis for your

child.) See what happens in the near future.

> >

> > Hi Nikunj and welcome!

> >

> > I'm one of the co authors of The Late Talker and hope I can answer some of

your questions.

> >

> > I do agree with in that it is possible that your little one has a

simple delay in speech since she is just 2 years old and already has 50 words

-however I don't agree with 's statement " As long as there is a

" progression " of sorts, there is no apraxia " (and -with your extensive

research on speech impairments -just curious why you haven't read The Late

Talker book as it's written by a neurodevelopmental pediatrician and parent of 2

" late talkers " perspective. Not just because I wrote it -but it's received

recommendations from medical, speech and educational professionals as well as

parents and may help answer more questions about apraxia for your older son)

> >

> > Like any condition there are degrees of severity with apraxia as well. There

are also subjective ways of looking at the " words " our 2 year old has. So the

question to you is how clear are your daughter's 50 words and are they

understandable to strangers?

> >

> > Can you provide some examples of her current vocabulary (try to write out

exactly how she says some of the words)

> >

> > Do you notice if she breaks down the more she tries to say?

> >

> > Does she " lose " language?

> >

> > Do you notice any " soft signs " such as low tone, motor planning issues in

the body or any signs of oral apraxia?

> >

> > Here's some parent friendly signs of verbal and oral apraxia -as well as

" soft signs "

> > Verbal apraxia signs

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

> > Oral apraxia signs

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

> > Soft signs

> > http://www.cherab. org/information/ speechlanguage/ parentfriendlyso

ftsigns.html

> >

> > If you notice any of the " soft signs " it would be a good idea to make an

appointment with either a neurodevelopmental medical doctor (such as a pediatric

neurologist or developmental pediatrician) to confirm or rule out.

> >

> > About the fish oils (also known as EFAs or PUFAs) Most find that the fish

oils jump start and accelerate the progress. Many of us continue with this

" therapy " for years however in some cases parents were able to stop after a year

or so and the child was speaking fine. It is possible of course that some

children were not apraxic and were misdiagnosed. The other thought is that fish

oil supplementation is probably healthy for all children -all adults- speech

impaired or not.

> >

> > You can look for a high quality oil that has the following dosage

> > Around 100 DHA, 150 to 250 of EPA, 30-50 of GLA to start.

> >

> > The DHA and EPA are from the fish oils and they are the Omega 3 and the GLA

is from either primrose or borage seed oil and it's the small amount of Omega 6.

You can mix oils together to create the above formula if you can't find one near

you that has it.

> >

> > You can order from some sites that ship internationally like

http://www.speech41 1.com however with shipping costs US to India it's probably

best to see if you can find it locally somewhere. Did you check in your stores

for the brand Eye Q? It's a UK brand that is similar to the ProEFA and also a

good starting formula.

> >

> > As far as is it hype? I'd say no way- but fish oil formulas are not all the

same and some researchers don't seem to appreciate that. If you use the wrong

formula -we have found in this group for the past decade with thousands that it

didn't work.

> >

> > To bad nobody has yet wanted to test the basic formula we know to work

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

> > (and no thanks to those that want to " fix " the formula!!!!! )

> >

> > Please get back with any answers. We are all here to help!

> >

> > =====

> >

[Guest guest]

Hi Nikunj and thank you so much for taking the time to answer my questions so

comprehensibly. Based on some of your reported symptoms to me it does sound

like you need to seek diagnosis at least of suspected apraxia to secure

appropriate therapies. Over the years we've had a few wonderful professionals

from India post however I'm not sure what facilities you are near to take your

child for evaluations. The lack of some of the sounds may still be

developmental at this point as she's only 2.3 years old -but here are the

warning signs of apraxia that stand out to me:

1. She can say a word correct -but inconsistently.

2. She has said a few words once never to say them again.

3. She has some signs of oral apraxia (which can be diagnosed much earlier than

verbal apraxia and if there almost guarantees verbal apraxia) Even though she

is starting to learn some of the actions this is a huge red flag.

4. She has some signs of sensory issues (touch/auditory) keep in mind if she

does have a diagnosis of sensory dysfunction something that means nothing to us

can actually be painful for her- so it's good to know.

You don't mention anything to make me think there are any tonal issues.

I know I posted the links for you prior -but here they are again.

Signs of oral apraxia

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

Signs of " soft signs "

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

Now we need to help you find a professional/s in your area for neuromedical

exam. No harm in a second opinion by a speech pathologist in your area who is

very knowledgeable about apraxia as well.

Also thought the following may be helpful for you. Below is a " Late Talker "

handout which we put together to raise awareness about warning signs for any

" late talker " :

Is Your Child A Late Talker?

· Are they quiet? · Seem shy? · Not talking like their peers?

· Allow you or siblings to speak for them? · Do you wonder why?

Your baby's babbling and toddlers first words can be music to your ears.

When faced with a child who doesn't speak or seems to have difficulty with words

parents are often told that their child is " just a late-talker. " Unfortunately,

all too often, that is not the case. The American Speech and Hearing Association

(ASHA) estimates that 16 million Americans under the age of eighteen have a

chronic speech-language disorder and that some 45 million Americans are affected

by communication disorders of one kind or another which was announded by

Congresswoman Carolyn McCarthy during the kick-off of the Better Hearing and

Speech Month Health Fair in Washington, DC on May 8, 2002 .

Most parents, and even most pediatricians, are not concerned when faced with

a two-year-old who passes all of his developmental milestones on time - except

speech and language. However, they should be. It is vitally important to

identify and treat speech and language challenges as early as possible in a

child's life, with a strong emphasis on the early intervention years of birth to

three. At this age the brain is undergoing the most rapid development. No harm

will come from therapeutic services. " Early intervention services are benign in

their delivery but can be extremely beneficial. Don't wait. Six months for a 2

year old is equivalent to a quarter of their lifetime developmentally " as Dr.

Judy Flax says, who is a Research Coordinator of the Tallal Lab and a Senior

Research Speech Pathologist for the Infancy Studies Laboratory at the Center for

Molecular and Behavioral Neuroscience (CMBN) of Rutgers University, Newark, NJ

To find out about your nearest Early Intervention program you should call

your local school district, they will be able to refer you to the program

appropriate for your child's age. Waiting to refer is a loss of precious time

that may impact on the child's learning ability and social-emotional well being

in later years. Pediatricians and parents should insist on a speech and hearing

evaluation as soon as there is a real concern about a child's early language

development. Early referral is endorsed by the American Academy of Pediatrics,

and the American Academy of Neurology. In addition, " any child with a severe

speech/language delay should have a comprehensive health and neurologic

assessment to look for medical conditions that may be causing or contributing to

the delay " as Dr.Marilyn Agin says, a developmental pediatrician who is the

Medical Director for Early Intervention for NYC.

CHERAB is a non-profit foundation that focuses on raising awareness of

Apraxia and other speech and language delays, and the importance of early

intervention. Working with developmental pediatricians, speech pathologists,

neuroscientists and major hospitals the CHERAB Foundation is working towards

research on therapies which may help late talkers with Apraxia, Dysarthria,

delayed language development, Autism and other speech and language impairments.

A list-serv overseen by pediatricians, speech-language pathologists, and

educational consultants is run by CHERAB and can be found at their web-site.

Through the list you can connect to many other parents who have children who

have speech or language delays, and find out what they have been able to do to

help their child.

Some speech disorders can overlap, or be misdiagnosed. For example, " Verbal

apraxia, a disorder of central nervous system (CNS) processing, and dysarthria,

a disorder of output, are commonly confused " , says Dr. , chief of

child development at the Chicago College of Medicine. " Experts are able to

differentiate between these two disorders by listening carefully to a child's

speech and by identifying certain physical clues " , says Dr. , but adds,

" These disorders are poorly understood by physicians and by a lot of speech

therapists as well. " It is possible for phonological disorders, apraxia and

dysarthria to all occur together in the same child. Speech Language Impairments,

which is connected to language based learning difficulties may also be present.

And the severity of each may vary.

Apraxia is perhaps the most misunderstood of all the speech disorders. So,

what is apraxia? Verbal Apraxia is a neurological motor speech impairment that

involves a breakdown in the transmission of messages from the brain to the

muscles in the jaw, cheeks, lips, tongue and palate that facilitate speech.

There is no obvious weakness in these muscles and the child may well be able to

move them quite happily when not trying to speak. Apraxic children, who are

usually seen as " just late talkers " when young, are able to comprehend language

at an age appropriate level, however have difficulty expressing themselves using

speech. With apraxia, a child knows what he wants to say but there is a road

block obstructing the signal from the brain to the mouth. For any child with a

speech disorder, but especially with apraxia, the earlier therapy is begun, the

better the results for your child and their social-emotional development.

Your Child's Language Development

So how do you know when your child is having problems with speaking? When is

a good time to seek out help? Being aware of average speech milestones can also

help you decide whether or not to speak to your doctor. Some guidelines are

provided here for your information, but if you have concerns about your child's

speech or language development, or any other developmental issue, make an

appointment with your pediatrician so you can discuss these issues. While the

average milestones are a good way to measure development, every child develops

at their own pace, and this overview should not be used to diagnose a specific

problem.

Normal Language Milestones - Clues of a Possible Problem

Typically seen in first 6 months

· Responds to name by looking for voice · Can regularly find speaker or

source of sound · Cooing, gurgling, chuckling, laughing ·Imitates sounds and

actions · Enjoys social games (peek-a-boo, pat-a-cake) · Babbling (bababa,

mamama)

Cause for concern in first 6 months

· Cannot focus, easily over-stimulated · Seems unaware of sound, Cannot find

source of sound · Seems unaware of people and objects in environment · Does not

seem to understand or enjoy imitating · Lack of connection (eye contact, vocal

turn-taking)

· No babbling, or babbling with few consonants

Typically seen in first 9-12 months

· Attracts attention by vocalizing · Waves bye · Vocalizations that sound

like first words (mama,dada) · Clearly indicates desire for objects · Imitates

new sounds and actions

Cause for concern in first 9-12 months

· Easily upset by sounds that would not upset others · Lack of response

indicating comprehension of words · Lack of consistent patterns of babbling ·

Does not clearly indicate desire for objects

Typically seen in first 12-18 months

· Single word production begins · Requests objects: points, vocalizes, word

approximations · Gets attention vocally or physically (mommy) · Knows adult can

do things for them (wind up a toy) · Uses " ritual " words (bye, hi, please,

thank-you)

Protests: Says no, shakes head, moves away etc) · Comments: Points and

vocalizes or uses word approximations) · Acknowledges: Eye contact, vocal

response, repetition of word

Cause for concern in first 12-18 months

· Lack of communicative gestures · Does not attempt to imitate or produce

single words

· Does not persist in communication (may hold hand up for help, but gives up

if adult does not respond immediately) · Limited comprehension (understands less

than 50 words) · Limited vocabulary (speaks less than 10 words) · Lack of new

words between the age of 12-18 months

Typically seen in first 18-24 months

· Uses mostly words to communicate · Begins to use two word combinations

(more cookie etc) · By 24 months has more than 50 words, or word approximations

Cause for concern in first 18-24 months

· Relies on gestures to communicate · Limited vocabulary (speaks less than

50 words)

· Does not use any two word combinations · Limited consonant production ·

Mostly unintelligible speech · Regresses in language development: Stops talking,

repeats phrases inappropriately

Typically seen in first 24-36 months

· Engages in short dialogues · Expresses emotions · Begins using language in

imaginative ways · Begins providing descriptive details when speaking · Begins

to use articles and word endings (a, the, ing,) uses plurals (cats)

Cause for concern in first 24-36 months

· Words limited to single syllable and no final consonants · Few or no

multiword utterances · Does not demand a response from a listener · Asks no

questions · Speech difficult to understand · Tantrums when frustrated · Echoing

of speech without communicative intent

Adapted from Clinical Practice Guidelines Communication Disorders III 22-25

In addition, the policy statement from the neurology journal Neurology,

(August, 2000), states that Absolute Indications for Immediate Evaluation

include,

· No babbling or pointing or other gestures by twelve months · No single

words by sixteen months · No two-word spontaneous phrases by twenty-four months

· Any loss of any language or social skills at any age.

Oral-Motor Problems

Early feeding problems could be a sign of later speech challenges. The same

muscles that are used for eating are used for speaking. A baby that has trouble

nursing could be a early sign that the baby has muscle weakness in the oral

motor area for example. If oral-motor difficulties are present your child should

have an evaluation by a pediatric medical and oral motor speech expert to

determine the cause and best therapy to possibly prevent some future speech

problems. A few possible signs of oral-motor problems are outlined next.

Does your child have difficulties with any of the following?

· Blowing (unable to blow out birthday candles, or blow bubbles by one year)

· Kissing or making a kiss face · Licking his lips · Imitating facial

expressions such as smiling · Chewing or transitioning to solid foods ·

Excessive drooling

When trying to speak does your child?

· Display groping behaviors, searching for proper mouth position, silent

posturing, dysfluencies · Show expressive language disturbances: limited

vocabulary, grammatical

errors, disordered syntax · Make up sign language, or show frustrations when

not understood?

It is important to note that some children have no difficulty with

oral-motor movements, and may also pronounce speech clearly, but still may have

difficulty learning language. There are many different types of speech and

language problems, which together represent the number one learning disabiltiy

in schools today. That is why again it is important to seek an assessment if a

child is not attaining the language milestones at the expected age. Early

intervention is key to your child's development. If you have any concerns about

your child's speech or language development be sure to express them to your

child's doctor. If you want to find out more about early speech and language

development and CHERAB's efforts to help children with speech and language

delays you can contact the group or visit the web-site at:

Cherab Foundation, Inc.,

Communication Help, Education, Research, Apraxia Base

Web: http://www.cherab.org

Grouplist:

PO Box 8524

PSL, Florida 34952

772-335-5135

Speechville Express

Web: http://www.speechville.com

To find a Speech Language Pathologist near you:

American Speech-Language-Hearing Association (ASHA)

10801 Rockville Pike

Rockville, MD 20852

Phone: 1-900-638-8255

301-897-8682 (Voice or TTY)

Web: www.asha.org

Acknowledgements:

Marilyn Agin MD

Medical Director NYC Early Intervention, Advisor CherabFoundation

[Guest guest]

Hi ,

Thank you for your reply. We have been unable to find anyone in India with

specific expertise about Apraxia. We have got to the point where we have applied

for our American Visas and starting to think about coming there to seek help.

Still not absolutely decided but we are discussing it. Another thing which we

thought of doing is sending in a DVD of our daughter to Kaufman - her

website says they also do consultations this way for foreigners.

However, if you know of any Apraxia experts in my country, that would certainly

make things a lot easier for us. We live in Kolkata (previously known as

Calcutta) but we can pretty much go to any place in India to get a correct

diagnosis and proper advice on what needs to be done.

Thanks,

Nikunj

>

> Hi Nikunj and thank you so much for taking the time to answer my questions so

comprehensibly. Based on some of your reported symptoms to me it does sound

like you need to seek diagnosis at least of suspected apraxia to secure

appropriate therapies. Over the years we've had a few wonderful professionals

from India post however I'm not sure what facilities you are near to take your

child for evaluations. The lack of some of the sounds may still be

developmental at this point as she's only 2.3 years old -but here are the

warning signs of apraxia that stand out to me:

>

> 1. She can say a word correct -but inconsistently.

> 2. She has said a few words once never to say them again.

> 3. She has some signs of oral apraxia (which can be diagnosed much earlier

than verbal apraxia and if there almost guarantees verbal apraxia) Even though

she is starting to learn some of the actions this is a huge red flag.

> 4. She has some signs of sensory issues (touch/auditory) keep in mind if she

does have a diagnosis of sensory dysfunction something that means nothing to us

can actually be painful for her- so it's good to know.

>

> You don't mention anything to make me think there are any tonal issues.

>

> I know I posted the links for you prior -but here they are again.

>

> Signs of oral apraxia

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

>

> Signs of " soft signs "

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

>

>

> Now we need to help you find a professional/s in your area for neuromedical

exam. No harm in a second opinion by a speech pathologist in your area who is

very knowledgeable about apraxia as well.

>

> Also thought the following may be helpful for you. Below is a " Late Talker "

handout which we put together to raise awareness about warning signs for any

" late talker " :

>

> Is Your Child A Late Talker?

>

> · Are they quiet? · Seem shy? · Not talking like their peers?

>

> · Allow you or siblings to speak for them? · Do you wonder why?

>

>

> Your baby's babbling and toddlers first words can be music to your ears.

When faced with a child who doesn't speak or seems to have difficulty with words

parents are often told that their child is " just a late-talker. " Unfortunately,

all too often, that is not the case. The American Speech and Hearing Association

(ASHA) estimates that 16 million Americans under the age of eighteen have a

chronic speech-language disorder and that some 45 million Americans are affected

by communication disorders of one kind or another which was announded by

Congresswoman Carolyn McCarthy during the kick-off of the Better Hearing and

Speech Month Health Fair in Washington, DC on May 8, 2002 .

>

> Most parents, and even most pediatricians, are not concerned when faced

with a two-year-old who passes all of his developmental milestones on time -

except speech and language. However, they should be. It is vitally important to

identify and treat speech and language challenges as early as possible in a

child's life, with a strong emphasis on the early intervention years of birth to

three. At this age the brain is undergoing the most rapid development. No harm

will come from therapeutic services. " Early intervention services are benign in

their delivery but can be extremely beneficial. Don't wait. Six months for a 2

year old is equivalent to a quarter of their lifetime developmentally " as Dr.

Judy Flax says, who is a Research Coordinator of the Tallal Lab and a Senior

Research Speech Pathologist for the Infancy Studies Laboratory at the Center for

Molecular and Behavioral Neuroscience (CMBN) of Rutgers University, Newark, NJ

>

> To find out about your nearest Early Intervention program you should call

your local school district, they will be able to refer you to the program

appropriate for your child's age. Waiting to refer is a loss of precious time

that may impact on the child's learning ability and social-emotional well being

in later years. Pediatricians and parents should insist on a speech and hearing

evaluation as soon as there is a real concern about a child's early language

development. Early referral is endorsed by the American Academy of Pediatrics,

and the American Academy of Neurology. In addition, " any child with a severe

speech/language delay should have a comprehensive health and neurologic

assessment to look for medical conditions that may be causing or contributing to

the delay " as Dr.Marilyn Agin says, a developmental pediatrician who is the

Medical Director for Early Intervention for NYC.

>

> CHERAB is a non-profit foundation that focuses on raising awareness of

Apraxia and other speech and language delays, and the importance of early

intervention. Working with developmental pediatricians, speech pathologists,

neuroscientists and major hospitals the CHERAB Foundation is working towards

research on therapies which may help late talkers with Apraxia, Dysarthria,

delayed language development, Autism and other speech and language impairments.

A list-serv overseen by pediatricians, speech-language pathologists, and

educational consultants is run by CHERAB and can be found at their web-site.

Through the list you can connect to many other parents who have children who

have speech or language delays, and find out what they have been able to do to

help their child.

>

> Some speech disorders can overlap, or be misdiagnosed. For example,

" Verbal apraxia, a disorder of central nervous system (CNS) processing, and

dysarthria, a disorder of output, are commonly confused " , says Dr.

, chief of child development at the Chicago College of Medicine. " Experts

are able to differentiate between these two disorders by listening carefully to

a child's speech and by identifying certain physical clues " , says Dr. ,

but adds, " These disorders are poorly understood by physicians and by a lot of

speech therapists as well. " It is possible for phonological disorders, apraxia

and dysarthria to all occur together in the same child. Speech Language

Impairments, which is connected to language based learning difficulties may also

be present. And the severity of each may vary.

>

> Apraxia is perhaps the most misunderstood of all the speech disorders. So,

what is apraxia? Verbal Apraxia is a neurological motor speech impairment that

involves a breakdown in the transmission of messages from the brain to the

muscles in the jaw, cheeks, lips, tongue and palate that facilitate speech.

There is no obvious weakness in these muscles and the child may well be able to

move them quite happily when not trying to speak. Apraxic children, who are

usually seen as " just late talkers " when young, are able to comprehend language

at an age appropriate level, however have difficulty expressing themselves using

speech. With apraxia, a child knows what he wants to say but there is a road

block obstructing the signal from the brain to the mouth. For any child with a

speech disorder, but especially with apraxia, the earlier therapy is begun, the

better the results for your child and their social-emotional development.

>

> Your Child's Language Development

>

> So how do you know when your child is having problems with speaking? When

is a good time to seek out help? Being aware of average speech milestones can

also help you decide whether or not to speak to your doctor. Some guidelines are

provided here for your information, but if you have concerns about your child's

speech or language development, or any other developmental issue, make an

appointment with your pediatrician so you can discuss these issues. While the

average milestones are a good way to measure development, every child develops

at their own pace, and this overview should not be used to diagnose a specific

problem.

>

> Normal Language Milestones - Clues of a Possible Problem

>

>

> Typically seen in first 6 months

> · Responds to name by looking for voice · Can regularly find speaker or

source of sound · Cooing, gurgling, chuckling, laughing ·Imitates sounds and

actions · Enjoys social games (peek-a-boo, pat-a-cake) · Babbling (bababa,

mamama)

>

> Cause for concern in first 6 months

> · Cannot focus, easily over-stimulated · Seems unaware of sound, Cannot

find source of sound · Seems unaware of people and objects in environment · Does

not seem to understand or enjoy imitating · Lack of connection (eye contact,

vocal turn-taking)

> · No babbling, or babbling with few consonants

>

> Typically seen in first 9-12 months

> · Attracts attention by vocalizing · Waves bye · Vocalizations that sound

like first words (mama,dada) · Clearly indicates desire for objects · Imitates

new sounds and actions

>

> Cause for concern in first 9-12 months

> · Easily upset by sounds that would not upset others · Lack of response

indicating comprehension of words · Lack of consistent patterns of babbling ·

Does not clearly indicate desire for objects

>

> Typically seen in first 12-18 months

> · Single word production begins · Requests objects: points, vocalizes,

word approximations · Gets attention vocally or physically (mommy) · Knows adult

can do things for them (wind up a toy) · Uses " ritual " words (bye, hi, please,

thank-you)

> Protests: Says no, shakes head, moves away etc) · Comments: Points and

vocalizes or uses word approximations) · Acknowledges: Eye contact, vocal

response, repetition of word

>

> Cause for concern in first 12-18 months

> · Lack of communicative gestures · Does not attempt to imitate or produce

single words

> · Does not persist in communication (may hold hand up for help, but gives

up if adult does not respond immediately) · Limited comprehension (understands

less than 50 words) · Limited vocabulary (speaks less than 10 words) · Lack of

new words between the age of 12-18 months

>

> Typically seen in first 18-24 months

> · Uses mostly words to communicate · Begins to use two word combinations

(more cookie etc) · By 24 months has more than 50 words, or word approximations

>

> Cause for concern in first 18-24 months

> · Relies on gestures to communicate · Limited vocabulary (speaks less than

50 words)

> · Does not use any two word combinations · Limited consonant production ·

Mostly unintelligible speech · Regresses in language development: Stops talking,

repeats phrases inappropriately

>

> Typically seen in first 24-36 months

> · Engages in short dialogues · Expresses emotions · Begins using language

in imaginative ways · Begins providing descriptive details when speaking ·

Begins to use articles and word endings (a, the, ing,) uses plurals (cats)

>

> Cause for concern in first 24-36 months

> · Words limited to single syllable and no final consonants · Few or no

multiword utterances · Does not demand a response from a listener · Asks no

questions · Speech difficult to understand · Tantrums when frustrated · Echoing

of speech without communicative intent

>

> Adapted from Clinical Practice Guidelines Communication Disorders III

22-25

> In addition, the policy statement from the neurology journal Neurology,

(August, 2000), states that Absolute Indications for Immediate Evaluation

include,

> · No babbling or pointing or other gestures by twelve months · No single

words by sixteen months · No two-word spontaneous phrases by twenty-four months

· Any loss of any language or social skills at any age.

>

> Oral-Motor Problems

>

> Early feeding problems could be a sign of later speech challenges. The

same muscles that are used for eating are used for speaking. A baby that has

trouble nursing could be a early sign that the baby has muscle weakness in the

oral motor area for example. If oral-motor difficulties are present your child

should have an evaluation by a pediatric medical and oral motor speech expert to

determine the cause and best therapy to possibly prevent some future speech

problems. A few possible signs of oral-motor problems are outlined next.

>

> Does your child have difficulties with any of the following?

> · Blowing (unable to blow out birthday candles, or blow bubbles by one

year) · Kissing or making a kiss face · Licking his lips · Imitating facial

expressions such as smiling · Chewing or transitioning to solid foods ·

Excessive drooling

>

> When trying to speak does your child?

> · Display groping behaviors, searching for proper mouth position, silent

posturing, dysfluencies · Show expressive language disturbances: limited

vocabulary, grammatical

> errors, disordered syntax · Make up sign language, or show frustrations

when not understood?

>

> It is important to note that some children have no difficulty with

oral-motor movements, and may also pronounce speech clearly, but still may have

difficulty learning language. There are many different types of speech and

language problems, which together represent the number one learning disabiltiy

in schools today. That is why again it is important to seek an assessment if a

child is not attaining the language milestones at the expected age. Early

intervention is key to your child's development. If you have any concerns about

your child's speech or language development be sure to express them to your

child's doctor. If you want to find out more about early speech and language

development and CHERAB's efforts to help children with speech and language

delays you can contact the group or visit the web-site at:

>

>

>

> Cherab Foundation, Inc.,

> Communication Help, Education, Research, Apraxia Base

> Web: http://www.cherab.org

> Grouplist:

> PO Box 8524

> PSL, Florida 34952

> 772-335-5135

>

> Speechville Express

> Web: http://www.speechville.com

>

> To find a Speech Language Pathologist near you:

>

> American Speech-Language-Hearing Association (ASHA)

> 10801 Rockville Pike

> Rockville, MD 20852

> Phone: 1-900-638-8255

> 301-897-8682 (Voice or TTY)

> Web: www.asha.org

>

> Acknowledgements:

>

> Marilyn Agin MD

> Medical Director NYC Early Intervention, Advisor CherabFoundation

>