Confused about oral apraxia/oral motor issues - can or an SLP help?

July 19, 2010

My son's EI OT indicated on her notes for a recent session that my son attempted

to imitate different lip formations; however, he mostly displayed open mouth (he

does not widen/narrow - close teeth - curl lips - etc.). When I followed up

with her, she indicated she thought this was due to " motor planning " and some

low muscle tone, but this was something that fell more under ST.

I've brought this up to 3 of his 4 SLPs with varying reactions:

SLP #1 (outpatient) indicated it was probably a motor planning issue, which

she's already addressing. Just this past week, she started more of a play

therapy approach, using PROMPT when appropriate but not all the time. She feels

his apraxia has a very strong sensory component to it, which is very possible -

he's been found have body awareness issues, which has been helped tremendously

through 2 1/2 months of OT and PT.

SLP #2 (EI) said she was taught to focus on getting him to make sounds, not

facial imitations, etc.

SLP #3 (outpaitent) said she didn't think he had oral apraxia, but since we

talked about this at the end of his session, indicated she'd need to think about

this.

No one at this point has diagnosed him with oral apraxia or oral motor issues.

Based on what I've read though, he seems to have some signs but maybe not be a

clear cut case? At least based on the questions I've been asked, he doesn't have

a history of feeding issues. He can stick out his tongue on command. He also

smiles a lot. But blowing out a candle is a bit of a challenge (he can blow out

of his mouth, though sometimes it seems like he's blowing upward). He can't

kiss by puckering up - it's an open mouth kiss or he moves his hand to an open

mouth and throws the kiss. He doesn't seem to notice food left on his lips. He

has learned to blow his nose on command - at least 50% of the time. He drooled

a lot as an infant, but that has largely disappeared - or did until when we

started or increased fish oils (heavy drooling usually lasted a week to 10 days

and then decreased) or now give him a chewy tube.

Where do I go from here? Am I correct in thinking it's important to address any

oral apraxia and/or oral motor issues, in addition to the verbal apraxia and

sensory issues? Maybe even address these first?

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