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Apraxia of speech

1K views 13 replies 8 participants last post by  QueenOfThePride 
#1 ·
I would love some advice from mamas or dads who have experience with apraxia of speech. Ds1 is somewhere on the autism spectrum we believe (have to wait until October for the formal diagnostic eval due to being wait listed) but I feel that he exhibits so many signs of apraxia and although he is in speech therapy I just don't know what I should be doing to help him more (he only goes to speech therapy one hour twice a week).

He is 3 and understands everything I say- his receptive language is great- but expressive language is severely delayed. He never says sentences and only says the first syllable of most words- there are a few words that he says such as "el-fant" for elephant and "i-crum" for icecream but most words he just can't seem to get a handle on. He has been trying so hard to say more words lately but he uses a really nasal mumbled voice and they just don't come out intelligibly.

He does have other motor delays (can't jump with both feet, can't peddle a bike) so I think this is more a motor thing than just a speech delay. Does that affect what sort of speech therapy he needs?

Any resources or advice is very helpful. Thanks.
 
#2 ·
Please see my blog for some good links to resources, and also "day in the life" type stuff. My dd2 is profoundly apraxic, but is making progress. Ask your ST to give you some Kaufman card copies to work on at home. Other than that, we just do a lot of "do you want A or B" and making her say her approximation of which choice she wants. And other spontaneous speech work, as it is relevant in our lives.

Have you discussed apraxia with your ST? Do they have experience with apraxia?
 
#3 ·
Quote:

Originally Posted by Literate View Post
Please see my blog for some good links to resources, and also "day in the life" type stuff. My dd2 is profoundly apraxic, but is making progress. Ask your ST to give you some Kaufman card copies to work on at home. Other than that, we just do a lot of "do you want A or B" and making her say her approximation of which choice she wants. And other spontaneous speech work, as it is relevant in our lives.

Have you discussed apraxia with your ST? Do they have experience with apraxia?

Thank you- I really enjoyed your blog BTW. I haven't talked to the ST about it yet but it seems like they pretty much do the "do you want A or B?" and "What's that?" kind of stuff with him. He does model very well but usually can't finish the whole word. I've been doing the modeling and cueing with him too and lately he's been able to produce the second syllable or even the third if I give him the first. But he can't put them together often. I agree, spontaneous speech is the hardest to get him to do. I think the assistive technology might be a good thing for him too to keep him from getting so frustrated.
 
#4 ·
My son just turned 3 this month and has been diagnosed as apraxic. Until recently, the speech therapists (he had 2) were working on establishing the desire to communicate, functional communication and some work with the Kaufman cards.

We've worked a lot on establishing consistent signs or phrases that would help Kian communicate throughout the day. The one SLP was firm in telling me that I needed to require an attempt at communicating, either through sign or vocally, before I gave my son anything. I can't say I was as consistent as she would've liked, but I think Kian got the point anyway. I think learning some ASL has helped to cut down on a lot of our tantrums and frustrations. One of our SLPs recommended a lot of silly face time in front of a mirror to help Kian become more aware of where his tongue is and how his lips move. We've also practiced putting an initial consonant with short vowels, then long vowels. (ma, me, mi, mo, mu) Some are easier than others. Lots of sound play while doing physical things. For instance, while bouncing on a ball, we might say oh, oh, oh, oh. While swinging, we might do oh, ah, oo, ee. Anything to keep his mouth moving from one position to another.

There's a great website called apraxia-kids.org you may want to check out. There are a lot of articles about apraxia and appropriate therapy. They have a message board and an email list. The site also sells videos to help parents work with their children at home. I haven't bought one yet because they're kind of pricey, but I've heard good things about them.

We were considering an AAC device for my son, but he's recently had a language surge and our therapist wants to wait. If you were interested in seeing a device in action, there's a video on youTube of a little boy who is apraxic and autistic using one.
 
#5 ·
Someone please correct me if I'm wrong, but aren't autism and apraxia "rule-out" diagnoses? As in, if he has autism, then he is not technically "apraxic," although he may be experiencing an autistic language symptom that is exactly the same.

I just point this out because if two conditions look exactly the same (lack of expressive language, in your son's case) but arise from different causes, the therapies for treating them will differ. Finding out if he's autistic or has apraxia of speech would be helpful, probably.

ETA: I asked my speech therapist friend to explain this. She said that the therapies for apraxia presume that the child is able to relate socially as a neurotypical child would, and that the therapies used for speech disorders related to autism are more holistic in the sense that they are not just addressing language qua language, but language as a part of the autism continuum.
 
#6 ·
It's a struggle, isn't it? We have tried PECS, signs, etc. etc. and mostly she just does her own thing. I understand her because she's mine, of course, but she also does really well explaining herself to others with gestures. She's a bright kid.

She is in an early childhood speech class during the school year and we also go to Easter Seals once a week. She gets OT for her motor issues with her hands (limb apraxia).

Just recently (actually, yesterday, oy) she's been acting out more and tantruming more. I think the frustration is finally kicking in. I've been amazed that she's held it together so well this far. We have a new sign for "mad" that will hopefully help with the hitting her sister problem. I hope.

LoveChild421, did he walk late? My dd started at 18 months, but is pretty much ok now, except for jumping, which is still weak. Any other hypotonia concerns? Are you looking at an evaluation through the school?
 
#7 ·
I have a daughter who has a diagnosis of Autism as well as Apraxia. She was diagnosed after 2 with Autism and then after 3 with Apraxia. The SLP played certain sound games with her and when she attempted she groped, other sounds came out or she often dropped letters in words.
She is now almost 5 and trying to communicate as well as sing songs and echo Tv shows and I can understand some of what she is saying but at other times I am lost. I just keep telling her I am still learning and to keep trying.
For the longest time her "No" was "oooooo" but in the last couple weeks she is really belting out the "NO!" perfectly. DH says in a weird way he misses her cute little "ooooo's".
She also called me "Baba" for the longest time but she is starting to call me "Mama".
At one point when DD was about 18 months old I remember telling her ped that the only sound she made was laughing and "Baba". Now I know she was saying Mama.
 
#9 ·
Quote:

Originally Posted by Individuation View Post
I stand corrected. Wow... I checked this out with an SLP. I find this interesting, and am now going to look into this in more depth.
Interesting. I too always assumed my son was both autistic (PDD-NOS) and dyspraxic. The way I see it is that he has a motor planning problem, and while it doesn't show itself in other areas nearly as badly as it does in his speech, it does show itself in a few ways.

I would think the reason they can be co-morbid is that the approach in speech therapy is a little different for apraxia than other language issues (my son has many language issues, btw - not just apraxia). With apraxia a ST needs to be very careful about not pressuring the child in any way. In general, kids with apraxia of speech will make the most gains when on their own, away from anyone who might be saying, or implying, "Say this! Now!"
 
#10 ·
My ds is apraxic and autistic. One of the red flags is that he can "do" language receptively, w/ gesture and learning sign language. He doesn't talk though. Another red flag is that occasionally a word will slip out when he doesn't think about it. For instance, in preschool the teacher was working w/ child A. The teacher kept encouraging child A to say a word. Ds seemed exasperated with the repetition and under his breath said the 3 syllable "elephant" perfectly. He couldn't have said it if he thought about it. He can't *plan* his speech. The words-- at some level-- are clearly up there. The intentions to communicate are up there.

That is different from his autistic-level of not communicating much of the time.
 
#11 ·
OK, here's the response I got to my email:

"Hmmm, I've always been told to rule out the autistic disorders before suggesting apraxia of speech, but I suppose it's possible they could coexist. I wonder how someone would be able to tell the source of the language issues, though. I'm going to ask my old professor about this."

So I stand corrected!
 
#13 ·
I've come across a couple of articles on the internet that say autism and apraxia are separate conditions that can co-occur. I'm not familiar with autism at all, so I can't say one way or another. I do know there are many parents of children labeled apraxic and autistic, who participate on both of the apraxia email lists I subscribe to. It seems to me that the diagnosis criteria for both conditions are subjective, so it might be difficult to get to the truth of the matter.
 
#14 ·
Quote:

Originally Posted by Mama_in_Maine View Post
At one point when DD was about 18 months old I remember telling her ped that the only sound she made was laughing and "Baba". Now I know she was saying Mama.

LOL My 10mo calls me 'milk'.


-yeah, he's walking, and quite the acrobatic nurser at times.
 
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