My Son John's Verbal Apraxia: A Communication Disorder

When Your Voice Won't Say What Your Brain Wants

 

A Parent's Intuition is Usually Right: Listen to Your Inner Voice

John was a year and a half when we started to worry. At first, we used the excuse that he was a boy. The old wive's tale is that boys speak later than girls. My first girl was an early talker. Once she started, her vocabulary and ariticulation grew quickly. But, John was struggling to say the simplest words and phrases. Every attempt at verbal communication seemed to be a great struggle for him.

Some Signs of Developmental Apraxia

  • Child has very few speech sounds that can be used without putting a lot of effort into making them.
  • Child has inconsistent speech errors and speech capability.
  • May say single short words well, but may drop ending or beginning sounds in words strewn together in a phrase.

What is Developmental Apraxia?

"Apraxia is a neurogenic impairment involving planning, executing and sequencing motor movements. Verbal apraxia affects the programming of the articulators and rapid sequences of muscle movements for speech sounds (often asociated with hypotonia and sensory integration disorder)." Marilyn Agin, M.D.

A Simple Definition for Apraxia

"DAS (Developmental Apraxia of Speech) is a speech disorder that interferes with a child's ability to correctly pronounce sounds, syllables and words. It is the loss of ability to consistently position the articulators (face, tongue, lips, jaw) for the production of speech sounds and for sequencing those sounds into syllables or words. Generally, there is nothing wrong with the muscles themselves... However, the area of the brain that tells the muscles how to move and what to do to make a particular sound or series of sounds is damaged or not fully developed. " Ann S. Guild, MACCC/SLP, Tracy Vail, MSCCC/SLP.

Early Intervention

John's experience with Early Intervention was mostly positive. He enjoyed the play therapy. However, the therapist was not a trained speech patholigist. So, although the interaction was helpful, it wasn't the intensive speech therapy that is encouraged now. The difficulty is in getting the diagnosis of developmental apraxia. The waiting list for a diagnosis is sometimes over a year. The referral is often not made until the child is in preschool. Once they enter the school system, the speech therapy in school does not change due to their diagnosis. At least, it hasn't for John. John was given a generic "speech delay" diagnosis. Voice your concerns in advance of any diagnosis. Oftentimes, the speech therapist will agree with your concerns and respond to treatment accordingly.

Lessons from John

John has taught me patience and understanding. While he struggles to tell me a short story, his face expresses his emotions. He uses his hands to interpret the story. Bears have claws. He becomes robots and soldiers. His imaginary play is remarkable. I believe that there are areas in his mind that he has tapped into in order to compensate for his lack of communication skills. He loves stories that I tell him verbally. Jack and the Beanstalk. The Three Little Pigs and the Big Bag Wolf. Goldilocks and the Three Bears. These are his favorites. He loves Mother Goose nursery rhymes. Puppets. Playing with his little sister. Playing T-ball. Building castles. Ants. Sharks. Whales. Snakes. Nature. Cars. He loves to play.

One of the most important lessons John has taught me is to appreciate what we have. He tries to connect with others every day. He rarely lets his frustration turn into anger. He never gives up. He bravely goes to an integrated preschool three times a week. He is one little boy. But, we all know children like John. Their bravery, courage and perseverance encourages us all to be better people.

After all is said and done, the child with apraxia is a regular kid with some special needs. We have the same expectations for behavior and growth for him as we do our other children. Remember that they comprehend what the world throws at them. As time goes by, they will learn to navigate through life. Our hope is that John and all children with this disorder will be able to communicate their intelligence to the world at large.

John's Favorite Speech Activities

  • Nursery Rhymes
  • Puppets - Soft Toys
  • Retelling Stories with Parent's Help
  • Singing Easy Children's Songs
  • Imaginary Dress-Up Play Together
  • Playing With His Younger Sister

Web sites

http://www.cherab.org/

CHERAB Foundation, Inc.

http://www.speechville.com/Speechville

Speechville Express

http://www.nectac.org/

National Early Childhood Technical Assistance Center

http://www.asha.org/

American Speech-Language Hearing Association

Resource Books

The Late Talker: What to Do If Your Child Isn't Talking Yet, by Marilyn C. Agin, MD, Lisa F. Geng, Malcolm J. Nicholl, St. Martin's Press, 2003

Beyond Baby Talk: From Sounds to Sentences. A Parent's Complete Guide to Language Development, by Kenn Apel, PhD, and Julie J. Jasterson, PhD, Prima Publishing, 2001

Chlldhood Speech, Language, & Listening Problems, by Patricia McAleer Hamaguchi, John Wiley & Sons, 1995

Does My Child Have A Speech Problem? by Katherine Martin, Chicago Review Press, 1997

 

Comments 26 comments

SpecialKids profile image

SpecialKids 4 years ago from Miami Beach and Jerusalem, Israel

I have a daughter with speech delay. A couple of years ago one speech therapist said she had apraxia. I really didn't understand what it was, so I thank you heartily for this informative hub.


Lisa Levine 5 years ago

What a wonderful inspirational blog about your son. I agree with the previous poster, there isn't enough support for parents. As my son Ryan, almost 5, is entering K, he has been in speech since 18 months. We have had o/t for the last 6 months. I find its an uphill battle at every IEP meeting. I feel as though I am trying to best advocate for him, what should my expectations be for the therapy he needs and for him to succeed. I feel that our public school system is inadequate for his disability. I am very anxious that although they attempt to meet his therapy needs, its not going to be enough. I am going to keep researching and see what I can add to his therapy, but, I have a feeling that we will be entering a special educationally based private school with a low student teacher ratio.


minnow profile image

minnow 5 years ago from Seattle

great hub. My son was developmentally delayed--everyone kept saying he was fine and I had to go to Seattle to get him evaluated by Dr. Bennett at the UW. Even though some of his problems persist (speech, fine motor skills) he has done well. I think part of it was that he wasn't allowed on a computer until middle school and that he didn't watch much in the way of television or DVDs and didn't have a game boy. Instead, I took him to the library almost every week and checked books out. Good luck with John and I am glad he has you for a parent.


Cailin Gallagher profile image

Cailin Gallagher 5 years ago from New England Author

John is now six years old. He will be seven in one month. His school team and I decided that he should repeat kindergarten this year. Emotionally, he has matured this year. He is able to follow the routines in the classroom and doesn't have the melt-downs that he dealt with last year.

John receives individual speech therapy five times a week a school. His speech therapist is wonderful! I have been blessed with the support I receive through his school. John also receives OT once a week.

He continues to be challenged with his articulation. Progress is slow. He is a naturally sweet and engaging little boy and loves to communicate using "charades" and by replacing words or phrases that are challenging for him with words or phrases that are easier for him to articulate. I wonder sometimes if I should include sign language in his life?

John is very inquisitive. He loves science, dinosaurs, space...the typical interests for children at this age. But, John is not only interested in these topics. He is always asking questions that make me aware of his high intelligence. Last night, he asked me if "spirits ever die?" He ponders the wonders of the earth, space, evolution, biology and time. As a deep thinker, his communication disability hinders him. However, sometimes I wonder if this disability has opened up other areas in his brain and actually is a benefit to him? I haven't researched this, but I'm sure that it's possible that the brain compensates in one area for a lacking in another. He is very interested in other languages as well. John is still sensitive to loud noises and sensitive to any negativity.

Thank you all for your lovely comments. This is a small community, but we are strong in our love for our children. All my best...Cailin


Renee 6 years ago

Thank you for sharing your story. I have twins both with Apraxia. It has been such a struggle and although CASANA is great, I feel there is a big gap in support for families with this diagnosis. As many have mentioned here and as the families here can attest to, many even in the schools, medical community and even special ed communities are not familiar with this disorder. I find it is getting more attention than in the past but it could also be that I'm learning more. It is a very difficult thing to go thru when your child understands and wants to express themselves but can't. It sounds like all the parents here have been faced with the need to advocate strongly for their child. We are a small community but we are strong. I hope all is going well. Its been a couple years since your original post...if you have a moment to update, it would be great to hear.


Parent of Luis in California 6 years ago

Dear Cailin,

My son has also been diagnosed with Verbal Apraxia. I was told the same thing, that boys take longer to talk. Little did they know I had already raised an 18 and a 22 year old with no problems. Luis has been going to therapy since he was 3 1/2 yrs old, he will turn 8 in August. I have been getting Luis help since he was 3. After 1 1/2 years of therapy through Kaiser he was finally diagnosed with verbal apraxia. We also found out that he has a mild loss of hearing in both ears. I held him back in 1st grade because of his reading and comprehension level. I felt very strongly that if he went to 2nd grade I would lose him. It wasn't an easy decision, my husband was against it, but did support my decision towards the end. We made sure that we utilize as much of the school resources as we can. He not only gets speech therapy, ocupational therapy, but is in the RSP program where they work with him one on one. He did much better this year with the classroom instruction, however he still scores low on his overall test. I will continue to get him some help. I found a retired teacher that will help him with his reading for the summer(he hates to read). As his parents, We refuse to give up, we want Luis to see that there is a light at the end of the tunnel. There are days when Luis will hold a conversation and you would never know there was a problem. Then you have those days were he tries so hard to express himself and he has to act it out, because he can't put those words together. Thank you for sharing your story. I will keep your family in our prayers so that God can give you the patience that you need to continue to give your son the support that he needs. I wish you all the best.


SweetiePie profile image

SweetiePie 7 years ago from Southern California, USA

I never heard of this until today, so your hub was quite enlightening.


kbaldwin profile image

kbaldwin 7 years ago

Cailin, I am so gald I found your hub. My son is almost 2 1/2 and has been diagnosed with significant speech delay. He is on target with most all other developmental areas. I also wrote a hub out of frustration. Due to his young age there seems little hope we will get diagnosed anytime soon which is hard as a parent. We have ruled out hearing impairment and I have been very interested in visual spatial learning and sensory processing disorder. Your hub gives me another path to follow as well. Early intervention is wonderful, but I feel like they go down the autism road when I read between the lines. If my son is autistic than so be it, but in my heart I believe it is something else. Anyway, thanks for the information. You are all very lucky to have each other.


Cindy D 7 years ago

I understand your struggles as a parent and appreciate what you are doing for your son. Your story has touched my heart and brought tears to my eyes.

My daughter is 2 1/2 yrs old. She has very few words. She never really babbled as a baby and has always been content to be quiet. I have more fingers on both hands than she has words in her mouth. We work with a speech language pathologist and she suspects, as I have for quite some time, that Katie has apraxia.

I have been teaching her sign language to help her to communicate and she enjoys the freedom it brings to her. She struggles so hard with making words. She is a sweet and kind girl and at times it's very hard to watch her struggle to speak, something we all take for granted.

Keep up the good work with your son! I am not a person of great faith, but someone once told me God never gives you more than you can handle. I try to remember that during the tougher moments and times when I want to break down and cry. Bless you!


Cailin Gallagher profile image

Cailin Gallagher 7 years ago from New England Author

Thank you all for your wonderful comments. My son continues to struggle with this disorder. He will start kindergarten in the Fall and I worry about his ability to communicate in a larger classroom of children. But, he is confident and full of life and I have faith that he will pull through. My thoughts are with all parents who help their children every day to be the best that they can be. We hear so much about parents who fail their children, but the majority of parents do the best they can.


chellabel profile image

chellabel 7 years ago from USA

This is a great hub.  So many people will be able to benefit from your information. I can relate, my son was recently diagnosed with Apraxia. 


Peggy W profile image

Peggy W 7 years ago from Houston, Texas

This was so educational and I'm sure your article and all those that responded will help many people out there struggling with some of the same issues. You are very correct in that often a parent truly knows something may be wrong prior to an official diagnosis. Your son is adorable. Wishing him and you a great and happy future!


kymbirly 7 years ago

I translated for my son until he was 3. He called trucks "bruches" until he was five. At 3 he woke up one day and everyone could understand him. He didn't rhyme words until he was 10. His reading fluency was almost zero but when he was tested at school he always got enough information out of the words he read to pass the comprehension part so he never got extra resources. I was told over and over again to "read to him more at home"...not an easy task because if he saw me coming with a book he would grab it and throw it and run away.

When he was 15, my friend, an occupational therapist, called and said "I know what's wrong!". She referred me to a "vision therapist" where his symptoms were finally diagnosed as a "visual processing problem".

He suffered a lot of failure in school and by 15 therapy wasn't something he'd do. He's in junior college now. School is still not an easy process for him.

I tell everyone who will listen and especially worried parents of young children....look for the specialists! if you feel something's wrong, You Are right!

Your son's early diagnosis gives you the power to find therapies and support your son through his early education with understanding and a positive experience. He will continue to grow and be the bright light you know and love!

Wish the internet was around when my son was little and I could find no answers from his educators!


Teresa 7 years ago

I can across your site and your son sounds so much like mine. He was diagnosed as apraxic when he was 4 1/2 and he is now 10. Like your son he never gives up and is the most happy, lovable, sweetest child. One idea you might want to explore is whether he has Central Auditory Processing Disorder. Caleb was diagnosed last year with this after I described some problems he was having in class to his SLP. He is only bothered with it on one side. He hears fine but, like apraxia, his brain does not work with his ear on one side and his understanding and comprehension drops to 40-50% on his "bad" side. He has made great strides with some simple therapy with background noise. And also making some changes in his classroom.


Concerned mom 7 years ago

Thank you for sharing your experience. As a new parent this information will help.


SweetiePie profile image

SweetiePie 8 years ago from Southern California, USA

I learned something new by reading this hub. Thanks for enlightening me about this issue.


Jerilee Wei profile image

Jerilee Wei 8 years ago from United States

Very interesting, look forward to hearing more about this.


William F. Torpey profile image

William F. Torpey 8 years ago from South Valley Stream, N.Y.

Your story has touched me deeply, Cailin. Your son obviously has great potential. As I was reading, I couldn't help but think of Helen Keller and the tremendous strides she made in overcoming her deaf/blind handicap. Your son's picture shows a bright, intelligent youngster who, I'm sure, with lots of work, will overcome his handicap as well. If there's one good thing about our modern society, it's that people with handicaps are no long shunned and forgotten. I know your son will find strong support from friends, teachers and everyone of good will.


ChicagolandApraxiaMom 8 years ago

Cailin

I would count your blessings...it sounds like your son has "pure" apraxia with no other issues such as sensory processing disorder. We live in the Chicago area and we had to go to Vanderbilt to find a doctor that would give us a proper diagnosis and a report that we could share with the school.

You need to make sure that your speech therapist knows apraxia and how to treat it...otherwise John's time truly is wasted. Plus I would go to your school district to get help for additional speech therapy. Seriously, this is the stuff you are glad to pay taxes for! Plus, he should be able to attend school 5 days a week.

Also, the Marilyn Agin, MD book is a great place to start (believe me, it was my bible in 2005). I have found better in information at Apraxia-KIDS.org (CASANA-they are based out of Pittsburgh). I have literally brought printed off materials from the site to meetings at school to get what my son needs (e.g. one on one speech therapy vs group therapy).

What I have learned is that you have find everything yourself...help is out there, you just have to look under a bunch of rocks to find it!

Bless you as you continue your journey to to help your son!

Chicagoland Apraxia Mom


Cailin Gallagher profile image

Cailin Gallagher 8 years ago from New England Author

Someone in Denver, CO,

Thank you for your inspiring words of hope. I often get discouraged and feel that there will be no light at the end of the tunnel. John's disability is very frustrating for him. I know that it is holding back his natural learning. But, your words give me hope for him. He, like you, understands everything that is said. He tries to communicate, but can't get the words out properly. When you said that the hearing is also a factor, it was like a lightbulb went off in my head. People think that he is ignoring them, but I've always thought that he just doesn't hear them for a moment. His hearing has been tested, and it is fine. Teachers have put it down to attention, but it's not that. We haven't found a speech therapist yet who is familiar with his condition. And his preschool teacher seems frustrated with him. He won't follow all the routines in the classsroom.

I will let his teachers know about the hearing issue. Also, I will focus on his writing and reading. You are a true inspiration. You have touched my life and the life of my boy. I thank you from the bottom of my heart.


Someonewhosbeenthere 8 years ago

Hello,

I was browsing through websites because I had, well still have, this disorder but I never knew what the name of it was. Your son's problems reminded me of how I was at his age.

As a child growing up, my parents were very concerned about my speaking when I was around 2 years of age. I could read and understand all of those around me, but I could not communicate effectively. My squencing of sentences was not that of a normal 2 year old child.

My mom tried some speech therapists, but the majority of them were saying that I needed to be in special education programs. They also added that I would probably never fully speak properly and that I would probably never develop fully like other children. God bless my mom because she thought that was a load of bunk. She took me home after the diagnosis, taught me how to write my name, and brought me back to the therapist. The therapist thought it was a fluke, and that was the last time that I ever saw her.

Later on when I started 1st grade is when I met a speech therapist that was familiar with my condition. She was very patient with me and eventually had me talking like normal by the time I was age 10. I will always be grateful to her because lord knows where I would be if my mother did listen to those speech therapists.

Today, I am fluent in French and Portuguese, and I am currently studying German. I am studying in college to complete a degree in Mathematics, and I am looking to go for my masters as well. Just because someone has this disorder does not mean that they are completely lost for life. It just takes a lot of patient people around them to help them get to that point.

I do still struggle with this problem, and I will probably always struggle with it. There are sometimes I get to talking with people, and then it is like a short circuit in my head and I just start struggling how to talk. Learning another language has helped me so much in understanding how to better form my mother language better. It is quite a challenge for someone with this disorder to do, but it is very rewarding to know that something like this cannot slow you down in communicating with the world.

There is an additional component that you might want to observe with your son as he gets older. At times, there are moments that I also have trouble hearing just as much as speaking. It is like I go momentarily deaf because the same part of my brain that tries to help me talk also affects my hearing. I sometimes have my friends repeat things over and over again because I just don't hear them because there is that disconnect. Fortunately, I have very patient friends who do understand that I am not deaf and that speaking louder isn't going to make my brain understand any better.

Another thing that can really help with your son is to teach him how to read and write. Reading will help train him how to overcome sequencing in his mind when it somes to telling stories. Writing will help as well because you have to focus in writing in order to tell stories.

I do wish you the best of your luck with your son. He is a very adorable little boy.

--Someone in Denver, CO


AutismInsideOut profile image

AutismInsideOut 8 years ago from Southern California

My son also has verbal apraxia and motor planning problems. Great Blog Cailin Keep up the good work.


VioletSun profile image

VioletSun 8 years ago from Oregon/ Name: Marie

I wasn't aware of this speech disorder; having a communication disorder (I am hearing impaired) is very challenging, but John is fortunately part of a generation that has superb technology and it will get better. For me being able to communicate with others online, no matter where I live, having the Relay for The Hearing Impaired, so I can talk on the phone, opened up my world. Too bad this wasn't available while growing up. Thanks for bringing awareness on this speech disorder.


stephhicks68 profile image

stephhicks68 8 years ago from Bend, Oregon

Looking forward to more insights. Thank you for a great hub. I am sure this will be helpful to many people!


Cailin Gallagher profile image

Cailin Gallagher 8 years ago from New England Author

I'll be writing more about this speech disorder soon. Thank you for the comments!


Karen Ellis profile image

Karen Ellis 8 years ago from Central Oregon

This is very interesting. I hadn't heard of Aprxia before. Thank you for educating us.

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