My Son John's Verbal Apraxia: A Communication Disorder
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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
CHERAB Foundation, Inc.
http://www.speechville.com/Speechville
Speechville Express
National Early Childhood Technical Assistance Center
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
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Comments
I'll be writing more about this speech disorder soon. Thank you for the comments!
Looking forward to more insights. Thank you for a great hub. I am sure this will be helpful to many people!
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.
My son also has verbal apraxia and motor planning problems. Great Blog Cailin Keep up the good work.
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
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.
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
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.
Very interesting, look forward to hearing more about this.
I learned something new by reading this hub. Thanks for enlightening me about this issue.
Thank you for sharing your experience. As a new parent this information will help.
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.
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!
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!
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.
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.
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, 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 eachother.
I never heard of this until today, so your hub was quite enlightening.
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Karen Ellis says:
2 years ago
This is very interesting. I hadn't heard of Aprxia before. Thank you for educating us.