expressive language delay vs apraxia?

[LES Bear]

Hi all. 

My daughter is 2.5 years old and has a significant expressive language delay.  She has probably about 10 words she says clearly and another 10 that DH and I can understand.  She understands everything and manages to make herself pretty understood with gestures etc.  I so regret that we did not introduce more signing when she was younger but we're doing that now.  We've just completed a second round of EI evals (she was denied services at 2 yo even though they said that she clearly needed them) and are waiting to hear if she is eligible.  We've been in speech therapy with a private therapist for the last 2 months and, while she is nice and DD likes her, I'm not particularly confident that it's making a difference.  

I guess I have a couple questions:

How to integrate the speech therapy exercises/homework into play so she enjoys them and does them?  I don't want to get into a coercive parenting style (and I think it will backfire) but I'm at a loss for how to get her to practice speaking when she generally tends to avoid it.  Any games parents out there have developed?  

How to differentiate between expressive language delays and apraxia and does it matter?  DD did not babble much as an infant (sign of apraxia) but does not make inconsistent errors in speech (if she days something wrong it is always wrong in the same way) and doesn't drool etc or have feeding problems.  

Also just eager to tap into a community like this.  This is my first post about DD's speech issues.  I struggle with seeing her struggle and how to find the balance between accessing services and also continuing to see/celebrate/support all her strengths.  It is also so painful to see her struggling to communicate.  She is a very robust and confident kid - usually a leader in groups, but I see her starting to become more clingy and withdraw. 

Thanks for listening and your help!

[FarmerBeth]

My son was identified as having an expressive language delay at an older age than your daughter, so I know more about older guidelines.  My DS at your daughter's age didn't make inconsistent errors or drool or have feeding problems.  While he also had articulation problems. the expressive language problem was clearly the larger issue due to problems coming up with words independently, but being capable of repeating words when shown.  I'm not sure if this is technically how to differentiate, I have no expertise, just a child with an expressive language delay.

What really helped encourage speaking, for us, was lots of games, especially singing.  DS was much more comfortable with singing than talking.  We kept on making conversation whenever we could, and didn't put him on the spot or make him uncomfortable.  I wasn't comfortable with the coercive style of parenting, either (I'm guessing you're referring to not providing things unless you are verbally asked.  I couldn't stomach it either) unless I was very sure he could comfortable handle saying something.  We read a lot, too, and now that he's 7, I can see how reading has really brought along speaking.  We were (and still are) strict with our other children to give him time to formulate his thoughts and speak without interruption.

Just don't give up!  2.5 is very young, Your daughter has lots of time to improve, and just plain talking together can do so much.  Even when my son was 5, I can remember feeling like he would never really talk like everyone else, and now his language differences aren't very obvious.  Things can change very quickly.

[Linda on the move]

  Welcome to mothering and especially to the special needs board at mothering!

Our speech therapist was great at giving me specific suggestions for "home work."  You might talk to your DD's therapist for targeted ideas. My DD wasn't really into moving her lips or pushing air out through them at all, so we did things like blow pens, blowing bubbles, and making faces in a hand mirror. We would practice different sounds while looking in the mirror, and I would let her touche my lips while I made a sound to help her get the idea of how to move her lips.

Progress was slow, but she is 15 now and she can talk when she wants to.

We also listened to a lot of child's music and I read a lot of children's poetry.

 I struggle with seeing her struggle and how to find the balance between accessing services

and also continuing to see/celebrate/support all her strengths.

There is absolute NO conflict between celebrating all her strengths and accessing services. None. It's quite possible that this is just a speech problem that she will eventually be past. In our case, it wasn't. My DD is on the autism spectrum. I celebrate her every day, but I also make sure she has every thing possible to reach her potential and have a life that really works for her. Getting her what she needs isn't about seeing her as "wrong," it's about being honest that she needs something different than most kids her age. That's OK. It really is OK to get therapy or go to a special school or whatever. It is about supporting her. What it takes to support her is a little different than what it takes to support some other kids, but it's OK. OK is a much bigger place than I used to think it was.

[RJ11]

I highly recommend this book Play to Talk:

http://www.amazon.com/Play-Talk-Practical-Late-Talking-Conversation/dp/0978832027/ref=sr_1_1?ie=UTF8&qid=1323303505&sr=8-1

[SpottedFoxx]

Hi Les!  My son carries the diagnosis of Apraxia of Speech and also a severe expressive and articulation delay/disorder.  I think they can be interchangeable.   However, keep in mind that if your child only has a few features of a particular disorder or delay, they may feel that is the appropriate diagnosis.  My son didn't babble at all, his tongue hung out all the time and I was amazed he didn't drown himself with the amount of drool he produced.  That being said, with a lot of speech therapy and oral strengthening exercises, he no longer drools and his tongue only falls out when he's tired.  He still has Apraxia though.

As Linda said so beautifully, celebrating your child's strengths and accomplishments and getting them services go hand in hand.  Getting help doesn't equal failure (or her or your part).  Actually, pat yourself on the back for catching this so early!  Speech therapy (at least the therapy my son has had) is fun.  It's games.  It's music.  Even dancing.   

Since she's 2.5 she's close to aging out.  While you are waiting on EI (I hate them for speech issues - long story) - check your local school district.  See if they offer pre-school programming for special needs children.  My son attended a wonderful pre-school where he was given speech therapy 3x a week and OT 2x a week as well as Kindergarten readiness programming.   These programs usually start at 3 so you can approach them now for when your daughter turns 3, give them the speech evaluation from your speech therapist and you'll be ready to go.