Speech Apraxia?

[coinkc]

Does anybody have any experience with this? My nephew was just diagnosed with it. If anybody has any resources, advice, etc. we would very much appreciate them.

 

[elmom]

How old is he? We thought my son might have it but he was too young to diagnose (2 years old). It turned out he was just a late talker with all the symptoms. He is doing really well now.

Its a tough one...I know it needs alot of therapy like 4 or 5 times a week. Its also very very rare and also over diagnosed.

 

[ptmmg]

Does anybody have any experience with this? My nephew was just diagnosed with it. If anybody has any resources, advice, etc. we would very much appreciate them.

my son now 4 was dx with speech apraxia at age 2 by a neurologist at Children's Hosp. in Boston. Treatment is intense speech therapy they recommend 4 times a week but that is almost impossible. My son was involved with early intervention I suggest strongly that if your nephew isn't hooked up with that his parents should look into it. I am not sure if this is how its ran in all states but here in Ma. With early intervention speech therapist came out to my house 1 time a week. He probably should of had more but we worked with him a lot! After age 3 they get involved with the public school system and get put on an IEP (individual education plan) I am lucky the town I live in has an awesome program for kids with disabilities. He now goes to public preschool in an integrated class 4 times a week there are a total of 10 kids in his class with 3 teachers he has speech therapy 3 times a week during school hours.. I don't pay a dime!!

He sees the neurologist every 6 months and has made great progress. he is still very hard to understand especially to people who don't know him, but at least now he is attempting speech because 2 years ago he wasn't saying anything.

good luck

 

[coinkc]

Thank you both.

ptmmg, It's great to hear that your son is starting to talk. I think that is what my sister is most afraid of...that her little boy will never talk.

elmom, I am intrigued by your story as he is also very young. He will not turn 2 until the end of April. He was evaluated by 2 different speech pathologists last week, one for the children's hospital and one from infant/todller services here in our area. They are going to set him up with speech therapy but I think just once a week.

Would either of you recommend she try and set up additional sessions each week as well? Would it be okay if he saw different therapists or is it best to just stick with one even if it meant fewer therapy sessions?

 

[Forevryoung]

Thank you both.

ptmmg, It's great to hear that your son is starting to talk. I think that is what my sister is most afraid of...that her little boy will never talk.

elmom, I am intrigued by your story as he is also very young. He will not turn 2 until the end of April. He was evaluated by 2 different speech pathologists last week, one for the children's hospital and one from infant/todller services here in our area. They are going to set him up with speech therapy but I think just once a week.

Would either of you recommend she try and set up additional sessions each week as well? Would it be okay if he saw different therapists or is it best to just stick with one even if it meant fewer therapy sessions?

Future SLP here (graduating in May! Passed the licensing exams!!! )

I would highly suggest that IF it is possible to have therapy more often than once a week even if it is with 2 different people. Your sister can have them talk and coordinate plans and whatnot so that they use the same method of teaching him. Every little bit will help especially since he is so young.

I would highly suggest taking him to a neurologist (again if possible) because SLPs can not technically diagnose childhood apraxia of speech. We can suspect it though (and are very often right).

FYI Apraxia of speech is a neuro-motor speech disorder in the absence of anything "physically" wrong with the speech mechanisms (muscles, tongue, lips, etc) or the brain signals (there is no identifiable cause for the incordination).

 

[scottsod]

my son is just over 2 and was given the apraxia diagnosis about 4 months ago. he had a feeding issue when he was born. he drooled alot when drinking his bottle and had a hard time learning how to drink from one. by the way he was born 2 months early. at 2 he was not really speaking at all. you should be able to understand about 50% of what a 2 year old says we are at about 25%. my son get early intervention speech 2 times a week and then i take him to a children's hospital 1 time a week, he also gets developmental intervention which sort of helps him understand better. if i could get more speech i would, it has helped so much, he used to get so mad at me when we could not understand him but that is getting better and better.

first get the child to a neurologist. speech therapists are wonderful but a doctor needs to say if the kid has it or not. then get the kid to speech more then 1 time a week with out a doubt. and like the other person said totally get him into early intervention. it makes life much easier when they come to the house to do therapy rather then taking the child out every other day.

apraxia is not just a speech disorder. my son couldn't jump until a few months ago. and still wouldn't even jump off a curb because he cant figure out how to get his body to do it. he had problem walking and still is always falling down. to this day he does not call me mama because he cant figure out how to get his mouth to say it. on the bright side it gets better. it takes alot of therapy but by the age of 6 they tell me my son should be typical.

 

[SandrainNC]

My son has it too. He also has Down syndrome and the two together have made him very very behind in speech. He is trying to talk now, which for a long time he didn't even try. But what happens is if I am working with him I will make the "b" sound. He will copy me and make a "ma" sound and look so proud of himself. So he thinks that he is making the "b" sound. He tries so hard! We are very proud of him. He gets speech twice a week at school and private speech every other week.

Sandra

 

[belle&beast]

Thank you both.

ptmmg, It's great to hear that your son is starting to talk. I think that is what my sister is most afraid of...that her little boy will never talk.

elmom, I am intrigued by your story as he is also very young. He will not turn 2 until the end of April. He was evaluated by 2 different speech pathologists last week, one for the children's hospital and one from infant/todller services here in our area. They are going to set him up with speech therapy but I think just once a week.

Would either of you recommend she try and set up additional sessions each week as well? Would it be okay if he saw different therapists or is it best to just stick with one even if it meant fewer therapy sessions?

I am a speech pathologist and work with preschoolers right now. When I worked in early intervention, we typically visited families one time per week, but trained the parents or caregivers to complete a home program on the days we were not there. So, if your sister can practice what the therapist teaches her, she will be doing the exercises daily and that will be extremely beneficial. If she does decide to work with different therapists, be sure that they are in contact and are on the same page about the treatment prescribed.

 

[Kriii]

Not to argue w/a future SLP, but we SLPs CAN diagnose apraxia of speech (unless of course there are different laws in your state). The OP's child is on the young side for diagnosing it but since I didn't do the evaluating I can't offer an opinion on the diagnosis. OP might want to check out the apraxia kids website for good information. Frequent treatment is best. 3-4 times per week is not overdoing it for severe cases of apraxia. Hope everything goes well for the child!

 

[Kriii]

I thought I'd better clarify my reply - I didn't mean to imply that the child was too young to diagnose. There are different opinions on the earliest age to diagnose (around 2 to 4) and two is towards the earlier side. I am also talking about VERBAL/SPEECH apraxia not apraxias affecting other parts of the body. I am an SLP and do have experience w/apraxia. I would politely (really not a flame) ask that the future SLP read up more on apraxia before posting that we aren't qualified to dx verbal apraxia (check out the ASHA website or apraxia-kids.org). This does a disservice to the rest of us.

 

[OneLittleSpark]

I know very little about the subject of speech difficulties etc, but wanted to offer you a little bit of hope on the subject. One of my best friends, apparently hardly spoke until he was about four, or possible even older. He only had a few words, one of which I know was Beena (Ribena) which meant a drink (though apparently somehow his sister could tell exactly which drink it was he wanted, just from this one word) and, as other people have reported, got very frustrated when people didn't understand him. No one knew why he wasn't speaking and, though he was trying, all of his therapies etc seemed not to be doing that much for him. Then I think he just had a break through. The way he tells it, he had a fairly rapid up-turn from a small handful of words, to fairly comprehensive language in a surprisingly short space of time. He graduated last year with a degree in Engineering and is currently working on his Masters. Nowadays, far from being quiet, it's getting him to shut up that's the trick!

So, basically, don't give up hope, some people seem to just take longer than others to get there.

 

[Forevryoung]

I thought I'd better clarify my reply - I didn't mean to imply that the child was too young to diagnose. There are different opinions on the earliest age to diagnose (around 2 to 4) and two is towards the earlier side. I am also talking about VERBAL/SPEECH apraxia not apraxias affecting other parts of the body. I am an SLP and do have experience w/apraxia. I would politely (really not a flame) ask that the future SLP read up more on apraxia before posting that we aren't qualified to dx verbal apraxia (check out the ASHA website or apraxia-kids.org). This does a disservice to the rest of us.

I apologize. I should have clarified.

http://www.apraxia-kids.org/atf/cf/{145BA46F-29A0-4D12-8214-8327DCBAF0A4}/CAS_Position_statement.pdf

"differential diagnosis of CAS in very young children and in the context of neurological and
complex neurobehavioral disorders may require provisional diagnostic classifications, such as
CAS cannot be ruled out, signs are consistent with CAS, or suspected to have CAS. "

 

[coinkc]

Thank you everyone for your replies and stories. I will pass them on to my sister. He is such a smart little guy (already knows his letters and even some sounds. he can say the sounds, just not words ) It's just heartbreaking to think he may not ever talk clearly. But from the stories that have been posted here, it's great to be given some hope!

 

[elmom]

I was told by our ped, 3 SLPs. ECI and a Neuro that diagnosis of apraxia should not really happen until children are older (like 4 years), and have had at least 6 months of intensive therapy. Many of them expressed that there is an over-diagnosis of this condition cause late talking can present the same way.

My son had major symptoms of verbal apraxia. I was sure he had it and was devastated. We went to one SLP that he didn't *click* with but she said she was watching for it cause she agreed he had the symptoms. The new one he clicked quite well with and she agreed that he had many symptoms and she was going to watch him but it would be at least 6 months before she had an opinion if he might have it.

At 25 months, when he started therapy, he had 10 words, he had only a few sounds even. MMM, daa, ne and ya was just about it. He learned some animal sounds (moo, naa, baa, doo) and then how to say "dubba dubba" and "aaaaaa-PLE" and it snow balled from there. He is now (4 months later of twice a week therapy) speaking in sentences and has hundreds and hundreds of words, can count to 10, knows many of his letters, shapes, colors. He still has a ways to go on articulation, but he isn't apraxic and that is good news. Yesterday he talked to a complete strange in detail about his car and her dogs...and she understood. woohoo!

He is smart, there is no doubt. He has a mechanical mind really and he is a perfectionist (something his SLP sees in alot of her late talkers). It is something else that just makes him a late talker. I don't know what.

I am sort of...well skeptical about the diagnosis of apraxia when it is given right away without at least 6 months of therapy, because I think some people would have diagnosed my son with it. But the important thing is he is getting therapy. The more the better. If he has apraxia, he is going to need it. If he doesn't and is a late talker, he will catch up soon and will benefit from the therapy. The sooner the better to get started.

 

[benjackal]

Agree with the above statements made by SLPs - I am an SLP and have seen a lot of children with this condition. I actually like it when there is another therapist involved (usually private services), as we are restricted to the number of times we can see clients for publicly funded services. We rely on the parents and caregivers a lot and have very detailed home treatment plans. Having another therapist involved provides variety to the child and parents and can offer a different point of view. It is really important to have the communication amongst therapists to ensure that they are both on the same page.

Also, I have found that the biggest factor in progress in therapy is the motivation of the child. The support system and follow through at home are a very close second, but having a child who is self-motivated to improve consistently exceeds my expectations.

Best of luck!

 

[KirstenB]

I'm glad I found this thread. Our 2 1/2 yr old Zoe has had EI services since she was 11 mths old, first for low muscle tone, then she started ST at 18 mths. I asked her speech therapist what she thought was causing Zoe's not talking when she first started working with us. At the time Zoe had no words, and we had just started introducing sign language. Zoe had been dx'd with autism spectrum disorder. Her speech therapist said she was convinced Zoe had "way too much communicative intent" to meet the autism criteria. She also had consistent "gaze shift", like she was trying to talk to us with her eyes and gestures.

Interestingly enough, the speech therapist also said she wasn't seeing signs of apraxia either. In the last year Zoe's changed a lot. Her speech therapist initially thought she had sensory processing disorder. Once we were able to help her manage A LOT of the sensory issues, she became more interactive and outgoing. She responds very quickly to any verbal command, so we're not seeing a processing delay anymore. She will use a word out of the blue, then it disappears for weeks or months, and then she use it again out of nowhere. She sometimes trembles several times a day when she tries to reach for something.

Now her speech therapist said it's starting to look more like apraxia. She's developed a huge gap between her receptive and expressive language. Her therapist said it's very hard to reach an apraxia diagnosis in someone so young. Now that her sensory issues aren't interfering, I'm starting to think apraxia too, maybe with something else going on.

I find all these different issues really complex. I give her therapist credit for taking a second look at apraxia after initially ruling it out. Anyway, regardless of what she has, Zoe's making great progress, and I've been really happy with our EI team.

 

[breezy1077]

Our son was "diagnosed" with apraxia when he was 2 1/2. He couldn't talk, never babbled and would only grunt or use the aaaaaa sound a lot. He was also bright (could pick out correct colors, letters and shapes by age 2 - just couldn't talk). He was later diagnosed with pdd nos at 4 and while we're still dealing with many issues, the talking is sooo much better (we still have language barriers ie he can say words but has a difficult time formulating what he wants to say ie -again- you can understand him but he has a hard time just telling you about his day). Anyway, enough about us -my point is hang in there - it's frustrating but with early intervention it can get much better.

My suggestion to you, start teaching sign language! what a tremendous help this was to us (and him). It will help with the frustration levels (the parents and the childs) and may actually facilitate speech. Hope this helps.

 

[ecki]

I've been asking Kayla's therapists and my SIL (who is an SLP) about apraxia for a year now and really can't seem to get a clear apraxia diagnosis. Kayla had about 50 words and a dozen signs at age 2 and by age 3 it was ALL gone due to the regressive form of autism. Now she has one word (done) and basically one sign (cookie).

She did see a neurologist, but doesn't see him anymore because he did a 24 hour EEG, didn't see anything wrong so he said we didn't need to see him anymore.

Anyway, I've been told that since she is completely nonverbal, they can't actually say it's apraxia. Back when she could talk, it was discussed, because half the time she could say a word well but the other half it was like it was in her head but she couldn't get it out. Or she would pop out with a word perfectly and then we'd never hear it again.

She does have a developmental pediatrician appointment later this month. Maybe I'll bring it up with him and see what he has to say. Of course, this is the guy who gave her an autism diagnosis after asking me 10 questions, so I'm curious how many questions it will take him to come up with an apraxia diagnosis.

 

[Forevryoung]

Of course, this is the guy who gave her an autism diagnosis after asking me 10 questions, so I'm curious how many questions it will take him to come up with an apraxia diagnosis.

I hope you sought a second opinion on that one... 10 questions???


PS I know a child who has been diagnosed with Down Syndrome and "autism"- the child does not really have autism. Same child was diagnosed with apraxia of speech but doesn't have any of the signs either... (not saying that is the case with your daughter, just be careful)

 

[ecki]

LOL, yep 10 questions! I'm actually trying to get off my lazy butt and get an appointment with Dr. Capone at Kennedy Kreiger in Baltimore since he's the authority on Down syndrome/autism. But we're pretty sure Kayla's autistic. I went to the Autism Speaks website and watched all their videos and Kayla does ALL of them.