Re: apraxia and phonological skills?

[Guest guest]

Marie from what you wrote it sounds more like a phonological or articulation

issue than apraxia. There are a number of warning signs for apraxia and you

didn't hit on any of them in your email. So here are some questions:

1. Did your child ever say a word or sentence once and never say it again?

2. If your child does say a word and you ask him to repeat it can he?

3. Children with apraxia break down the longer the utterance...so in other

words perhaps in isolation can say " ball " but when he wants to ask " Where is the

ball " even though he may be able to say " where " " is " " the " in isolation may

" block " the syllables for the sentence instead to " ba ba ba ba? " or even " ba ba

ba ball "

4. Apraxia is rarely just a speech impairment as it's neurologically based. It

tends to be multifaceted even though in younger years you may not notice the

mild low tone, sensory issues or fine or gross motor skill issues in the body

without a neuromedical exam to confirm or rule out. Here are too links -does

any of the following ring a bell from the archive " new member archive " ?? Below

that are some things to do at home from an article I wrote for Contemporary

Pediatrics as well as a list of articulation ideas that may help! I can tell

you based on what you wrote that it sounds like if your child is apraxic -based

on what you wrote it's probably very mild

Re: Hi! New and wondering about apraxia.

Hi Mrs Laurie and welcome!

Your son sounds like he has some oral apraxia which would of course

need to be confirmed by professionals. If oral apraxia is present

together with your child's delay he should at least be diagnosed

as " suspected apraxia " and appropriate therapy should be provided.

He is entitled by federal law to a free and appropriate public

education (FAPE) in the least restrictive environment (LRE) which

means that if 5 days of one on one speech therapy is appropriate for

him then that's what he should receive. What type of speech therapy

is he receiving from the school right now when you say " some " ?

Below is a very long archive to help -please know that you don't have

to understand it all at once -we're here as a group to help!

Thanks for sharing. This group has from the start been a group

that's made up of parents and professionals who care for children

with many types of speech and/or language delays and/or disorders.

There are parents here for example with undiagnosed " late talkers "

and we just have not heard from them in awhile. It's actually a

really good thing when there is a mix of us to share because we all

learn from each other as many diagnoses can overlap -or down the road

we learn that our child does have co diagnosis.

While this group is open to parents of all children with

communication impairments -including hearing impaired, autistic etc.

it wasn't that all that posted recently had a child with autism, or

autism and apraxia -but because of society focus on autism -many here

started following an autism approach -including ABA in some cases!

That's understandable if the much more basic approach to apraxia -ST

and OT and EFAs were tried first and didn't work -but some were

trying that to start.

The overwhelming majority (if you check the archives) have success

with the basic approach to apraxia.

On the other hand- most of us are dealing with more than verbal

apraxia.we just don't know that when our child is 2 -and we learn

through professionals and observations as they continue to grow and

more and more is expected of them. This is also why it's important

to take your child for a neurodevelopmental medical exam when your

child is suspected of apraxia to confirm or rule out other diagnosis

such as sensory integration dysfunction etc. The earlier you know -

the sooner to start appropriate therapies to get them up to speed by

kindergarten.

Don't let it overwhelm you -perhaps we aren't meant to know more

than what we have to know at each stage. We'll be here to help along

the way. It's OK to have any type of emotion when we find out our

child has more than a simple delay -or " more " than " just " verbal

apraxia. And it's OK to be completely overwhelmed and saddened to

find out your child has apraxia. And as I was one of those parents

it's never " just " apraxia when you find out!!!

It's OK to be upset " just " because your child is a " late talker " too!

Please know that I too believed Tanner to just have apraxia and have

my first message posted to a grouplist about that below.but down the

road found out he had a few other things we needed to help him

address. The incredible news is that the majority of our children if

you check history are up to speed to be mainstreamed by kindergarten-

and of course many have learned with communication impaired children

that it's best to start kindergarten at 6 vs. 5 to give them that one

extra year of therapy and developmental time.

If you have questions after reading the following please share them.

This group has always been a wealth of information for all of us, no

matter how long we've been here.

Below is a new member archived message to hopefully answer more of

your questions for now (did you read The Late Talker yet?) For updated

information on fish oils and vitamin E and more - please visit the

links section here

/links

What type of apraxic like speech behaviors are you seeing that makes

you and the SLP suspect your child has apraxia vs. a simple delay in

speech? Is your child talking at all yet? At your child's age -

without speech, it's difficult to diagnose verbal apraxia -they

could " suspect " verbal apraxia and begin treatment just in case,

which wouldn't hurt your child if he ended up just having a simple

delay. Just a few questions before we could provide more accurate

answers:

Does your child have signs of oral apraxia? (for example, can he on

command smile, imitate funny faces, blow bubbles...if you put peanut

butter anywhere around his mouth can he lick it off no matter where

it is?)

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

Does your child have any neurological " soft signs " such as hypotonia

or sensory integration dysfunction?

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

Who else evaluated your child? Was it only the SLP through your

town school or was he also in Early Intervention through the state?

(birth to three) Was he evaluated by both a speech pathologist as

well as an occupational therapist? Was/were they knowledgeable

about apraxia? (If your child wasn't diagnosed by an occupational

therapist as well and professionals suspect apraxia -I highly

recommend you request that too either through both the school as

well as private through insurance for many reasons)

To answer any questions you may have about taking your child to see a

neurodevelopmental MD if he has not yet been to one and apraxia is

suspected... in one word - " Yes!!! " I would have your child diagnosed

(private) by a neurodevelopmental medical doctor (developmental

pediatrician or pediatric neurologist) who is knowledgeable about

apraxia and other neurologically based multi-faceted communication

impairments for numerous reasons. Reasons include (but not limited

to)

*having a " hero " on the outside of the school who can assist in a

therapeutic plan and oversee your child's development over the years

*advocacy support with the insurance company

* ruling out or confirming any neurological soft signs or any other

reasons for the delay in speech

*help those that ask " why isn't he talking yet " understand this is a

medical condition -and has nothing to do with your child's cognitive

ability. (if in your child's case it doesn't. Apraxia in itself

does not affect a child's cognitive ability -and speaking early or

late is no indication of a child's intelligence. Also contrary to

popular belief -most who have speech impairments have average to

above average intelligence)

Hi Barbara!

Did you read The Late Talker book? My co author is a

neurodevelopmental pediatrician and she wrote that book with me to

educate pediatric medical professionals. We also had a cover article

in Contemporary Pediatrics which is the trade magazine for hundreds

of thousands of pediatric medical professionals Nationwide. You

could share this too:

" The " late talker " -when silence isn't golden

Not all children with delayed speech are " little Einsteins " or garden

variety " late bloomers. " Some have a speech-language disorder that

will persist unless warning signs are recognized and intervention

comes early. Includes a Guide for Parents. "

Podcast interview with Dr. Marilyn Agin from Contemporary Pediatrics

http://contemporarypediatrics.modernmedicine.com/radio_peds4

Actual article (where you can read it for free)

http://drgreene.mediwire.com/main/Default.aspx?P=Content & ArticleID=132720

http://opsc.mediwire.com/main/Default.aspx?P=Content & ArticleID=132720

There are also many activities parents can do at home with their

child to promote the development of speech. These are detailed in the Guide

for Parents written by

[Guest guest]

Hi ,

Thanks so much for your reply!

> 1. Did your child ever say a word or sentence once and never say it again?

> 2. If your child does say a word and you ask him to repeat it can he?

> 3. Children with apraxia break down the longer the utterance...so in other

words perhaps in isolation can say " ball " but when he wants to ask " Where is the

ball " even though he may be able to say " where " " is " " the " in isolation may

" block " the syllables for the sentence instead to " ba ba ba ba? " or even " ba ba

ba ball "

No, she has never really hit on any of these. She can repeat a word, but with

phonological difficulty ( " toy " is " boy " , but " too-too " is " too-too " ). Many

sounds she can say in isolation, it's just when she puts them in a word they

change to the sounds she's more comfortable with.

> 4. Apraxia is rarely just a speech impairment as it's neurologically based.

It tends to be multifaceted even though in younger years you may not notice the

mild low tone, sensory issues or fine or gross motor skill issues in the body

without a neuromedical exam to confirm or rule out.

We're working with LAUSD as she turns three soon and they've said they'd like to

have her evaluated by an OT for some sensory issues. She doesn't like getting

" dirty " - the feeling of something sticky or slimy on her hands drives her crazy

(not the kid who likes playing in the mud or sand too often!); she also often

has a hard time using both hands at the same time. Usually one or the other.

Thank you for all the archive information! It is really helpful. I'll look into

the other fish oil. Would you suggest trying Nutriveda if she does just have a

phonological disorder?

Again, I really appreciate the help! It is so overwhelming to know where to look

for information and this is very helpful.

Take care,

Marie