My Son John's Verbal Apraxia: A Communication Disorder

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