Re: Apraxia question from India

March 31, 2009

, As I said, I do hope to get to read it in the near future.Once found out

the root cause of my son's Apraxia, I found the answer I needed, which is

finding alternate pathways to learn to talk.

I am aware that Doman Sr. is a physical therapit; however, I am aware that a

brain surgeon was also on the original team. But none of that matters, as on my

own (before Doman/Delacato) I discovered the miraculous wonders of neural

pathways. This how how people break addictions, change habits, recover from

strokes, and just plain out change the brain. It took Doman's team 20 years,

lol, it took me 5 years to discover this. I was actually very greatful t have

stumbled upon these readings and the NACD, for this is what I believe. Their

methods do work, as I have been using them somewhat in a lay sense.

I learned more from reading their materials than I have learned from all my

son's doctors including a pediatric neurologist in five years.

I am not knocking your book, as I am a writer, and I believe in writing

wholeheartedly. I never said anything bad about your book. I am sure it is a

great book.

Unknowledgeable specialized doctors misdiagnosed my son at birth, labeled him,

and then told us he would be severely mentally retarded due to their diagnosis,

and they were wrong.I found out they were wrong about a lot of things.

>

> 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.

>

> =====

>

March 31, 2009

Hi again Nikunj!

The one SLP I always highly recommend from India is Vani Rupela. I have her

information below as well as information from another therapist who recently

sent information to me. But first BTW does this list help you (Vani is part of

it too)

http://www.rehabcouncil.nic.in/professionals_search/search_main.php?type=search & \

state= & field=AS%20AN%20AUDIOLOGIST%20AND%20SPEECH%20PATHOLOGIST & name= & exp= & quali\

= & lowerlimit=420

(cut from an archive)

I'm not sure where everybody is in India -but I know someone who will know that

can help you: I 'highly' suggest you contact Vani Rupela CCC SLP from All India

Institute of Speech and Hearing. Vani is a member of this group who reaches out

to help here -but not all are able to read every message so may have missed

yours. Vani just wrote a paper for her PhD

" EFFICACY OF NUTRITIONAL SUPPLEMENTATION ON SPEECH AND LANGUAGE

SKILLS OF CHILDREN WITH DEVELOPMENTAL APRAXIA OF SPEECH "

Rupela, Vani

Junior Research Fellow

All India Institute of Speech and Hearing,

Mysore - 570 006

ISHA life member-L-707

Email: vavaoka@...

(her other email is vanirupela@... )

~~~~~~~end of archive

I believe this is more recent contact info for Vani but I copied her on here

just in case. Regardless I googled Vani and it appears she'll be easy enough

for you to find. Now if she's close to you -that I wouldn't know. But I'd

contact her either way as she may be better able to direct you if she is too far

to help -and...she's knowledgeable about not only apraxia -but on the EFAs

effect on it!

I don't know anything about this professional -but here's a message I posted

recently that was sent to me:

A stammering free India

Need To Understand Stammering

First of all, I would like to introduce myself. I am Bhoop Singh

Yadav, director of India Speech Therapy Centre, Amer- Jaipur

(Rajasthan) - India.

I was an acute stammerer since the early days of my childhood.

Therefore, I kept on trying to find the causes of stammering and their

cure. At the age of 20, I completely cured myself of stammering. After

this, I further continued my research on this subject and developed a

foolproof technique to cure the problem of stammering.

Although stammering is not a physical disorder, a stammerer has to

suffer a lot due to this problem as vocal fluency is the most

important aspect of the personality of a person. Knowing the gravity

of this problem, I decided to open an institution with an objective to

cure the speech disorders. India Speech Therapy Centre was established

by me during the year 1979 at Jaipur (India). Since then, I have cured

thousands of persons suffering from stammering, misarticulation and

other speech disorders.

With my experience of more than 28 years, I observed that the root

cause of this problem can be understood only by a speech therapist who

suffered from stammering and cured himself by his own experience.

Hence, its successful treatment can be undertaken only by such a

speech therapist as he can very well understand and relate to the

weaknesses of a stammerer.

I therefore, conclude that the treatment of stammering cannot be

undertaken successfully in any hospital worldwide by any other doctor

and that no medicine or surgery can help cure it.

For more details;

Visit our website www.indiaspeechtherapy.org

Contact me at (E-mail):- info@...

Bhoop Singh Yadav

India Speech Therapy Centre

Amer, Jaipur (RAJASTHAN)

INDIA

> >

> > 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

> >

March 31, 2009

The brain affects everything we do as humans. Apraxia's root problem is in the

brain because there is an interruption in the neural pathway(s) and therefore,

the child cannot speak. Why wouldn't it help?

As with all apraxia, ne must develop new neural pathways for language.

> >

> > 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.

> >

> > =====

> >

March 31, 2009

I think Nikunj was looking for answers and honesty. I do not think Nikunj wants

to be " placated " . I was by no means being rude or sending Nikunj away from the

group at all. I am giving Nikunj encouragement that the situation may be

completely normal. Isn't that what one wishes for anyway? Again, I am not giving

any " false hope " to Nikunj either. Also, I was not putting him off for a " year "

to " wait and see " . I think in a few months time, Nikunj might see a marked

improvement. If Nikunj looks at a developmental chart, I think Nikunj may be

relieved to find that what has been mentioned is a developmental progression. I

was simply giving " my " view and " my " honest opinion, which may differ from

yours.

I do have somewhat of an " idea " what is going on with this child because Nikunj

was very clear in the postings. To say I have no idea also puts down Nikunj that

the postings were not clear and explained well, which they were. I paid close

attention and I really feel like you are insulting me, as well, by saying I

" have no idea " . I must have offended you in some way because of your remarks; if

I have offended you, then I am sorry I did. Placating people is not my thing. I

waste little time getting to the point because time is not on my side.

In my opinion, I really think it is rotten for you to say that what I said was

" just awful " . Your opinion may be different than mine, but I did not say that to

you.

>

> 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.

>

March 31, 2009

yes there appears to be an interruption in the neural pathway that causes

the apraxia -but there is still much we don't know about apraxia in regards to

it's cause. We do however fortunately know what works.

Children with apraxia appear to need specific and at this point pretty well

validated motor planning therapies to stimulate speech. Some of the therapies

such as Prompt have been clinically validated as effective for apraxia.

https://promptinstitute.com/index.php?page=prompt-research and others such a

Kaufman's technique are being studied now but have been found successful

over time by the majority.

These multisensory speech therapies do appear to stimulate new pathways for

speech in theory -but in reality which is what (I suspect should) matter to us

as parents (and professionals) - they work -they bring words to children that

were previously unable to put sounds together.

The brain does respond to multiple stimuli, however the word appropriate can't

be used enough. While all multisensory therapies may stimulate various areas

of the brain -that does not appear to mean that just any multisensory therapy

will stimulate speech to a child who has verbal apraxia. The fish oils for

example are just one aspect to a multiple stimuli approach that have been found

to be appropriate.

If one is a researcher who has theory over individual child's success one may be

open to explore something that may or may not work. As a mother it is our

choice as to what type of therapy/therapies we wish to pursue because we are all

well aware that we have precious little time to get our children up to speed

prior to kindergarten which is the goal for most of us.

However no matter what alternative therapies we try -apraxia still requires

appropriate and traditional speech therapies developed to address motor planning

impairments.

We all can try anything we want in regards to therapy with the limits of safety,

money and time, however I'd stick to what has worked very well for the past

decade in this group as parents report what does and doesn't work. -the

methods that we found effective are not broken -and you won't know what they are

until you read The Late Talker since much of them are in there. The methods we

as parents try are those that are recommended to us by professionals or even

experts in the field of apraxia who we respect. The methods we as parents try

are also those that have positive reports in this group. The method you wish to

try has to my best knowledge -neither.

=====

March 31, 2009

My mother was a CCU Nurse -coronary care- for 30 years. my sister is a NICU

nurse that can put an IV in a baby that weighs 1-3lbs---but none of that

qualifies them to diagnose any of the issues that the doctors have confirmed in

my daughter, and they dont use their job title to sound more authoritative.I can

bet that the wife of my neurosurgeon does not diagnose hydrocephalus simply

because she lives with a doctor!! reading medical textbooks does not qualify

anyone here to dissuade any parent here from asking for help.A diagnosis of

Apraxia is not necessary in this group when looking for tips and ideas as to

where to get help for a child.

on the dynavox---I would not take no for an answer to a rep who said the

distance was too much to come and help me learn to use an $8000 device that was

purchased for MY child. they are a rep for a specific area- than that is what

they should be covering!! I have not the slightest clue what Kiddos means? this

is a big country and names of agencies that we dont have here should be

clarified.

March 31, 2009

In using the mulitsensory approach, you are using the methods of Doman/Delacato.

Are you offended? (That is the way I took it.)

I never said one method was better than another. It is a combination of the

right methods that work for each child is what works.

I appears that those I have offended in some way, by my expressing a " like " for

the NACD ad The Institutes methods do not know what methds we are using for my

son or what we have tried.

If you are interested, then I will tell you. But please do not attack me, as I

have attacked none of you.

I have only offered responses to questions posed. I expect that Nikunj will

absorb " all " the answers given and not just one.

>

> yes there appears to be an interruption in the neural pathway that

causes the apraxia -but there is still much we don't know about apraxia in

regards to it's cause. We do however fortunately know what works.

>

> Children with apraxia appear to need specific and at this point pretty well

validated motor planning therapies to stimulate speech. Some of the therapies

such as Prompt have been clinically validated as effective for apraxia.

> https://promptinstitute.com/index.php?page=prompt-research and others such a

Kaufman's technique are being studied now but have been found successful

over time by the majority.

>

> These multisensory speech therapies do appear to stimulate new pathways for

speech in theory -but in reality which is what (I suspect should) matter to us

as parents (and professionals) - they work -they bring words to children that

were previously unable to put sounds together.

>

> The brain does respond to multiple stimuli, however the word appropriate can't

be used enough. While all multisensory therapies may stimulate various areas

of the brain -that does not appear to mean that just any multisensory therapy

will stimulate speech to a child who has verbal apraxia. The fish oils for

example are just one aspect to a multiple stimuli approach that have been found

to be appropriate.

>

> If one is a researcher who has theory over individual child's success one may

be open to explore something that may or may not work. As a mother it is our

choice as to what type of therapy/therapies we wish to pursue because we are all

well aware that we have precious little time to get our children up to speed

prior to kindergarten which is the goal for most of us.

>

> However no matter what alternative therapies we try -apraxia still requires

appropriate and traditional speech therapies developed to address motor planning

impairments.

>

> We all can try anything we want in regards to therapy with the limits of

safety, money and time, however I'd stick to what has worked very well for the

past decade in this group as parents report what does and doesn't work.

-the methods that we found effective are not broken -and you won't know what

they are until you read The Late Talker since much of them are in there. The

methods we as parents try are those that are recommended to us by professionals

or even experts in the field of apraxia who we respect. The methods we as

parents try are also those that have positive reports in this group. The method

you wish to try has to my best knowledge -neither.

>

> =====

>

March 31, 2009

I do not diagnose, and I do not use my " title " as an authoritative figure, by no

means. I have learned much aboutApraxia in a very little time due to necessity.

Someone asked the group for answers and I gave my opinion (just as every else

does on a forum) based on what I know, what I have learned, and my experience as

a mom. Why is everyone so mad?

I have 5 kids. One talked in complete intelligible sentences at one year (now

11), one talked little at 4 and half years old (now 10), one will be two

tomorrow and talks less than Nikunj's child, one is apraxic (5), and the eldest

I truly cannot recall

without looking at her 22 year-old baby journal.

Carson is the rep for my area and he won't come to Toccoa. I can locate the

e-mail and post it if you like or if there are disbelievers. I have no reason to

lie about it. For me, DynaVox was a wrong choice (insurance paid $10,580)and I

do not think they offer good follow-up care for everyone. Someone else may have

a differing opinion. I am in the country, not the in town Metro area and it

makes a difference. We having online streaming problems and repeated efforts to

take the courses online for free were fatal and I did this during the months I

was waitng for approval from insurance, contacting DynaVox every step of the

way.

My son is homebound per dr. order and needs homebound services for this item,

among other tings he needs like therapyists in home.

Sorry for the abbreviation on Kiddos' Clubhouse Foundation. That is where my son

won a scholarship for in-home therapy supplies; he was able to get vestibular

equipment like swings, Kaufman Praxis materials, z-vibe and other speech stuff.

I just cannot understand why everyone is so angry about what I said to Nikunj?

My thought (opinion) is that his kid, at this point, is developing somewhat

normally (in a progressive sequence); every kid is different.

Your opinion differs and I am not mad at you.

>

> 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.