Seeking Advice on Apraxia

I think I'd put him in preschool with regular kids. Then he'll have more stimulation. Just a thought.
A. G

Wow, i've never talked to another mom who's kid has apraxia. My daughter had apraxia too. She's five now and doing great! She talks so much, loves to sing and is rarely quiet. I love hearing what she has to say. Although, sometimes, she repeats herself often, I have to remind her that I heard her the first 100 times. LOL. Is your son getting OT also? That's what kick-starting talking for my girl, lots of physical movement with a Physical Therapist. Where is your son going for therapy? We went to Hand in Hand in Encino and love them. All the different therepists there are terrific. The best advice is to just repeat the lessons at home your son is getting from his therepists. We also learned sign language which helped with communication until she could talk. When he starts talking up a storm, you'll wonder "what was he waiting for." He'll have a lot to say.
M.

Be Patient. Since you said that your son in getting Speech Therapy, the words will come. My daughter is 31 months old and is in Speech Therapy too. She continues to struggle with words but is steadily improving, though it has been a very long and slow road. I have to keep reminding myself to not compare my daughter to other children. She does things on her own time. Your son will too.

Hi K.! I've read the other posts and I would agree with the SLP who wrote questioning the diagnosis. Apraxia is fairly rare and can be hard to diagnose. On the flip side, there are some older SLP's who don't even believe the diagnosis exists! My almost 5 year old daughter (4th child for me) was diagnosed when she was three. Our insurance (thank God!) covered therapy for her and I enrolled her at the Cal State LA Speech CLinic ###-###-####). She has had exceptional services and therapy. In the Pasadena area, however, I would wholeheartedly recommend Justine Sherman & Associates in Sierra Madre ###-###-####). These ladies are exceptional, caring, and very knowledgeable about apraxia as well as other speech disorders if you wanted a second opinion. In the meantime, have your child watch your mouth as you say words that he would commonly say. He needs to see how your mouth looks when you're making proper sounds. Also, lots and lots of repetition of common words said properly are very important as well. God bless you! It's been a long journey, but worth it. L.

I think you're doing everything right - now its just about time. My 3-yr. old was a "late talker" - his babbling had conversational qualities, but was still babbling. At 26-months he began a weekly one-on-one speech therapy program. After four months, I enrolled him in a fantastic 3x per week program at Providence Speech and Hearing (Orange, CA). WOW! The children learned basic signing (American Sign Language)so that they can have their needs met (i.e. more juice, tired, etc). After five months, he graduated from the program; I marvel at his progress. For my son, signing was a lifeline...

Making language fun is key - I learned from his speech pathologist how to make funny faces and tell stories to encourage sounds and words. Keep a journal to record his progress - it will help to read through the entries during those moments when you wonder where the words are. One day (soon), when you least expect it, you'll hear your son say the most beautiful words "Mommy, I love you"...

Hi there!! This sounds exactly like my son. He is currently 4 1/2 years old and went through the early preschool and in home speech therapy. I take my son to an MD in Fountain Valley that has a more alternative approach to medicine. He suggested removing the gluten from his diet because he felt it caused his hyperactivity which was a big problem in getting him to focus and increase his attention span. This was around 3 years of age. Within 2 weeks we noticed a big change!!
It seemed as if he retained more of the things we worked on with him and the speech therapists felt the same. Hope this helps!!

Dear K.,

I have three sons - and the middle one was severely speech delayed - he is now 21. He received speech services from about 3 years old through elementary school. The speech services in one district (from 3-8 years) were wonderful - summers when he didn't have the services it really showed. When he was 8 moved. The new school district wasn't very good about providing the services he needed and his teachers weren't very educated about the effected and consequences of delayed speech patterns. Because he was gifted it was very hard to convince them to work with him differently than their regular students. I finally pulled him from the program altogether because they weren't addressing his needs and it became disruptive to leave class for services.

In his "old district" his tests showed that his expressive speech was at least 3 standard deviations below his peers, but his cognitive vocabulary was 2 SD ABOVE his peers. The "old" speech services concentrated on "expressive" speech - an area largely ignored by his new school. I tried to educate the teachers and even volunteered in many classes rooms. Being a constant volunteer at the school helped me to see how things worked and I realized that changes couldn't happen soon enough for my boy. I probably should have sought private services, but by the time we worked some of this our my boy was 12 and making friends was more important than continuing to fight with the school about speech......Several years later a couple of his teachers apologized to me for not listening to me and doing more - they had been to some district classes and realized how to help better so my unsuccessful attempts did have an affect on making some district changes....

He is now 21. As an opinionated young man he is frustrated that he can't make eloquent political arguments in his head come out his mouth.

So whats my point? If speech services make a difference - PUSH for them throughout his ENTIRE SCHOOL career.

FOR NOW:
**if you can get services over summer - go for it;

**if your son does not like his therapist - get another (speech is very personal - if your son does not trust the therapist or feels no connection, he will not do as well);

**try to work with the teachers; my first therapist went to my son's preschool so she would know what to discuss with him; later this is really important - have the therapist use his spelling words in their sessions or discuss books that the class has read

**facilitate meeting other child with the same intellectual and emotional levels; if others are making fun of his speech, he will need a buddy who will stand by; my son was fortunate enough to meet a boy who didn't make fun of his speech and is still is best friend; they were both very intense and met digging in the sand box at recess.

FOR LATER:
**Give your son coping skills - in case others make fun of his speech (actually everyone needs to do this on some level, as boys will make fun of each other... make sure the skills are "boy" skills....)

**when your son starts to write, notice his spelling, it is revealing of areas that need work (my son would spell CAT as "TAT" which reflected his inability to distinguish C and T; or potato as botato)

**Ask how his speech may be reflected in the standardized testing that is so popular (my son always scored VERY low in spelling, but very high in reading comprehension - showing an unusual combination - so we had to fight for him to be in honors classes....);

** Affirm his ideas and personage

** Realize your other children might modeling their speech after his - so providing experiences with children/families who do not have this issue is important. At the suggestion of the school district, I actually started my third son in preschool a little earlier than I expected so he would hear his peers, not just his brother! While my third son showed none of the signs of his brother, the school district actually put my third son in speech his first year in Kind. just to make sure he was on target - I was surprised at how much clearer his speech was after a year and how he continued to speak more clearly than ANY of his older brothers. I'm very thankful for the "old" district and their individualized attention shown to ALL my sons.

Don't blame yourself!! Hopefully this will be a "stage" that can be resolved during your son's first few years before school starts - if not, realize that help is there and it does make a difference.

Enjoy your boy!!

S.

K.,

My 4.5 y.o. is very language delayed. We've had him in a mix of public and private services. We did early intervention, now we are in the school district's program. My son now has an autism diagnosis. Some things you can do to help your son with his language skills - read to him, talk to him constantly, name everything you do, everything you see. Use sign language. I highly recommend the www.signingtime.com videos. My son did really well. When he was first getting started the visual representation of words really helped him. He's often learn a sign and a verbal word at the same time. It also helped him get his point across when we couldn't understand him. The DVDs are pricey so I recommend only buying volumes 1-3 to get started. Those are first signs, everyday signs and playtime signs (if I remember the titles correctly). They have plenty of basic, useful signs to get you started. Other than that, ask your speech therapist what she recommends. Mine is really good about telling us what we should do as "homework." If I remember correctly apraxia has a lot to do with muscle tone and motor planning. You may want to look into occupational or physical therapy to help with those issues.

I'm all for taking whatever public (i.e. free) services you can get. But don't be shy about hiring private services too. I've found there can be a huge difference in how they approach a problem (and there can be a huge difference when the folks doing the therapy are depending on how well they do to continue getting paychecks!). I really think if we hadn't hired a private speech therapist when we did, my son would likely have never started talking. My husband and I had to refinance our house and totally rearrange our lives (we don't eat out, we don't do vacations, etc) to be able to afford some private services but they have really, really helped our son's development and they are very worth it. We joke that our son is more expensive than our house payment and that isn't far off (our house is still slightly more expensive each month but not by much!). My son has come a long, long way. We anticipate he'll be in regular kindergarten next year. Anything is possible so do as much as you can do. The earlier you start and the more intensive the services, the better your outcomes will be.

Good luck!
T.

What a good mother you are and I am glad that you are able to be home to focus on your son. My son is 15 months and I don't have any advice, but wondered what type of business you are able to do at home? I too am waiting to get over to my husband's insurance in September and be able to do something from home. Did you take the kind of work you were doing previously and work it into a home business? Any advice would be appreciated. Thanks K.
email: ____@____.com

You may want to take a look at the website at Apraxia Kids (http://www.apraxia-kids.org)...it's an excellent place for information. They have a couple of events you might want to try to get to. Also, there is a very active Yahoo group here:

http://health.groups.yahoo.com/group/childrensapraxianet/

Tons of information from the been there, done that crowd as well as professionals.

To all those that doubt that Apraxia can be diagnosed early- here is my daughter's story. She had lots of motor delays- rolled over at 6 months, sat at 8, didn't crawl until 12 months...and she had no speech. We knew she wasn't deaf- she could pinpoint a sound like you wouldn't believe!!

When she was just over a year we began therapy through what in CA is called Regional Center (if you are in need of services but don't know where to start- start here). By the time she was 2 Apraxia/Dysparaxia was mentioned more and more by the staff. When she was 2 1/2 I had one of the therapist told me she thought she was severely Dyspraxic. There really is no "cure" for it so I never gave it much thought. That is until she turned 3 and went into the school district system. I mentioned that my daughter was Dyspraxic to her Special Day Class teacher and she went off on me!!! Telling me there is no way to diagnosis such a thing until she is at least 7- she was not very nice about it.

I sort of let it go- like I said, there is no "cure" so I just dismissed her comments. That is until about a year later, we were in the neurologist's office and he looked at me and said something link "Oh, that is typical for someone with Dyspraxia like her". Come to find out, he knew she was dyspraxic and just assumed I knew (she was about 4 at the time).

And there is a difference if you have the diagnosis! Better speech therapy. I learned that the best thing for Dyspraxics is lots of short therapy session- not long ones.
And I will agree with whom ever said put your child in regular preschool. We did this for half a day (special ed preschool in the AM, regular in the afternoon) for less then a year and she went from 4 words to 50 in that time!

It's a long road!! She is 7 now and still has a really hard time! We were at the neurologist just the other day and she was having problems following directions (do this, then this, then this) and he said those are all Apraxic things. What to do...he told me coloring and cutting with scissors for these issues.

It's frustrating for both her and me! She gets so mad sometimes when we don't understand her!! And we get so frustrated when she doesn't talk "normal". My advise- read everything you can about the condition and try all the crazy things- as long as they are safe! (some people have GREAT success with things like EFAs, acupuncture helped us some), but don't forget to enjoy them for who they are!

Whew, that was long!

I don't know anything about apraxia, but I can tell you that speech therapists were thrilled when my daughter helped a child with speech delays. All my DD did was talk to this little girl...ALL DAY LONG. My DD is a talker LOL. My advice is to surround your son with other children that are talking. Arrange playdates as much as possible, go to the park, sign up for anything and everything that exposes him to other children. As adults we can talk to children all day long, but the voice of another child is ten times more powerful. Our little friend's vocabulary dramatically increased because she wanted to talk/respond to my daughter.

Try incorporating sign language into your speaking with him. If you use the wors momma, dada, bottle, sleep , play ..Common words sign them as you are saying them. Sign language has been shown to aid in speech development. Also this will decrease frustration at not being able to communicate , for you and your son.

Good luck !!!
J.

How did they base their diagnosis of Apraxia? I am an SLP and it seems hard to believe they could make that diagnosis if he is only producing those 2 words. Apraxia is a motor planning problem, characterized by INCONSISTENT sound errors. Does he attempt to produce other sounds/words? If so, what did he do when trying to attempt those words?
If they diagnosed it soley on the fact that he only had 2 words, I'd be less than certain that is a correct diagnosis. Apraxia is a really TOUGH thing to diagnos and in my experience if often diagnosed incorrectly. I'm not saying that's the case with your son, but something to consider.

Either way, talk, talk, talk!! Label everything. Read books. Model correct language. Expand on what he does say. If he says, "daddy", say, "Yes, daddy is ____" (whatever he is doing). Do ryhming activities, peek a boo, things like that. Practice "up and down", "on and off" doing an activity. Sing songs!! Happy Birthday, nursery rhymes, etc.

Feel free to send me a private message if you have more questions.

First off all, don't worry about the words. The words will come in due time after they work on his oral motor planning issues and oral weakness. My son had similar issues and his private speech therapist went through this entire protocol of exercizes that he did with her and with us at home. They were exercizes like having my son perse his lips down on a tongue depressor for a count of 5 to strengthen his lips, having him blow on bubbles to work on this exhalation skills for the "f" sound. I'm sure that your speech therapist is doing exercizes like this for your son now so ask her for a list of homework for you to do with your son and try to make what you are doing as fun as possible because, it may not sound like it, but this stuff is real work for him.

Like I said, the words will come as his oral motor planning issues and mouth strengthens up. Once he has mastered all of the sounds ("f", "th", "z") that are appropriate for his age, you may want to see if your speech therapist is familiar with the Lindamood phonics awareness system. That works on oral motor planning as well and has been a tremendous benefit to our 4-year old. Lindamood does have a website for you to check out. The whole thing sounds complex but it's really not once you get started on it and it is well worth the effort.

Good luck!

My son was diagnosed with apraxia when he was 30 months old. He didn't start talking until he was 36 months old but once he did the language came quickly. He's 4 1/2 now and still delayed but is 95% intelligable. Continue to model language as your child is understanding and picking up what you are saying but hasn't quite figured out how to form the words yet. Remember to be patient although it is hard at times. Continue to go to speech - my son went to LA Speech and Language and also to Therapy West - a special education preschool. I also recommend the books The Late Talker by Marilyn C. Agin, et al. which has lots of info on apraxia. Also, my son's speech therapist recommended Childhood Speech, Language & Listening Problems by Patricia McAleer Hamaguchi.
Childhood Apraxia of Speech - google it - they have a website that is very helpful in explaining the difference between a speech delay and a speech disorder. Please feel free to contact me if you have more specific questions as I haven't run into very many parents with children with apraxia and it's nice to have someone to talk to about it!
M.