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Conference moira::parenting_v3

Title:Parenting
Notice:READ 1.27 BEFORE WRITING
Moderator:CSC32::DUBOIS
Created:Wed May 30 1990
Last Modified:Tue May 27 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:1364
Total number of notes:23848

846.0. "ORAL APRAXIA/DYSPRAXIA???" by USCTR1::DWOOD () Tue Apr 23 1991 12:08

    I am interested in hearing from parents whose child has been 
    diagnosed with Oral Apraxia/ or Dyspraxia.  Our friend's daughter
    who is 2 1/2 has recently been evaluated by a Speech Therapist and
    that is her diagnosis.  Although our almost 2 year old has not
    yet been seen by a therpist, he seems to exhibit many of the
    symptoms.  We have friends in the Special Needs field who are off
    gathering material to read, but in the meantime, I wanted to hear
    personal experiences from parents themselves whose children have
    been medically diagnosed with this speech disorder.  We have
    appointments set up, but want to learn as much as possible if that
    indeed should be his condition.  Specifically, we wanted to know..
    
    1. How old was the child upon being diagnosed? 
    2. What type of therapy was used?  When did it start?
    3. How successful has it been?
    4. What other impact, if any, doe it have on the child's learning
       or developing ability?
    5. Anything else that might be helpful!
    
    
    Regards,
T.RTitleUserPersonal
Name
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846.1ULTRA::ELLISDavid EllisWed Apr 24 1991 18:4123
My son is also almost 2 years old.  He has developmental delays and has been 
in speech therapy since the age of 13 months.

I am familiar with the terms apraxia (means "absence of speech") and 
dyspraxia (means "improper speech").  None of the people who have worked with 
or evaluated our son has used those terms in diagnosing him.  But he has an
active vocabulary of zero words now and is functioning at roughly the level of
a 15 month old baby.

My wife and I noticed developmental delays within a few months after his 
birth, and it was extremely difficult to get professionals to share our early 
concerns about the delays.  With evaluations at five and six months of age,
we were told there was nothing out of the ordinary, but the evaluation at 12 
months clearly revealed that our son was delayed across the board.

We chose a private speech therapist with an NDT (NeuroDevelopmental Training)
background, and this approach has worked out well for us.  A year ago, the
only sounds our son made were cries, laughs and an occasional grunt.  Now,
he is babbling quite a bit.  Progress has been slow but steady.

Some practical advice:  don't get discouraged when inevitably the people you
go to for help and advice put you off.  You will be told you don't need help,
and this requires perseverance on your part.
846.2Any Dr. or Neuro recommendations??USCTR1::DWOODFri Apr 26 1991 11:4523
    
    Thanks.  Someone else had also suggested we get a neurological team to
    work with Jeremy.  Do you have recommendations?  Our problem is we
    belong to HCHP, and may be limited.  Since Jeremy has developed well
    in other areas, our pedi has been hesitant to refer him, suggesting
    that boys, as well as #2 children talk later.  J. does have 6-7 clear
    words, and about 4-5 (make-up) words he uses.  His receptive language
    and responsiveness is right on target.  We asked Early Intervention
    to evaluate him, and they added that his muscle tone is also on the
    weak side.  Our next pedsi visit is in about 5 weeks, and we will then
    'push' for a hearing/speech/OT evaluation.  Our concern is J's reaction
    to all our word 'games' and 'coaching'.  Already, he seems to be
    frustrated and embarrassed when he can't say a word.  He is acutely
    aware of his limitations and makes disappointing faces and 'go-away'
    hand gestures when he can't repeat the word.  Has your neurological
    team given any indication of prognosis for this speech issues?
    Also, how effective has speech therapy been since you started at start
    at early age?  Do you think the same results would have occurred if
    you had not started so early (15 mos).  Our pedi thinks J. is too
    young, and the benefits are limited at this age.  2 1/2 - 3 yrs old
    is what he is recommending.  We don't want to wait.
    
    Thanks and Regards...  
846.3ULTRA::ELLISDavid EllisMon Apr 29 1991 19:4720
We have taken our son in for neurological evaluation at Children's Hospital,
under Dr. Carl Kuban.  Prognosis?  Don't be ridiculous!  We had to put Ben
through an MRI scan, because Dr. Kuban had suspected some kind of problem
which might include (among other possibilities) dysgenesis of the corpus 
colossum.  This means that an area of the brain responsible for overall 
integration of higher functions would be in some way improperly 
formed/forming.  But the scan was inconclusive.  And there seems to be nothing
we can do except continue Ben in his various therapies.

We feel that the speech therapy has been highly effective.  Even though Ben
is not saying any words (just babbling), there has been a lot of progress
the past few months, after a long period of no progress whatsoefer.

Stand up to your pedi!  The earlier the intervention, especially by
developmentally trained therapists, the more effective it is.  Benefits
are _not_ limited at this age.  Jeremy's problems seem less severe and more
localized than Ben's, so Jeremy might not need speech therapy at all.  That's
for the developmental specialists to decide, not a general pediatrician.

Good luck!
846.42 is young to talk well!!BCSE::WEIERPatty, DTN 381-0877Thu May 02 1991 01:0944
    I hesitate to brush away what the pedi is saying.  Boys and ESPECIALLY
    second children DO talk much later.  There's not as much of a NEED for
    them to talk.  Christopher (our first) was babbling up a storm by two. 
    Jason, our second, could only speak a word or two, until he was about 2
    and 9mos.  He still doesn't enunciate well, but at 3 and 3mos, we can't
    get him to stop trying (-:
    
    More than anything, what I always try to watch for when wondering if my
    child is developmentally 'ok', is if there is improvement.  He was
    definitely doing better at 2 1/2 than at 2, and much better at 3 than
    at 2 1/2, so I'm going to just let things be and let him grow at his
    own rate, not just by what a book says.  If your child ISN'T
    developing, then there might be a problem, but a few words, before two,
    is average from what I've seen of kids.
    
    As far as keep pressing him to say it "right", I'd be **REAL** careful
    about that.  You may be causing _more_ of a problem, especially if he's
    getting frustrated by it.  When he says "See twuck", you can say "Yes,
    I see the truck", so that he hears the word properly, but we've always
    been warned to be quite careful with 'new' talkers and trying to force
    them to speak perfectfully initially.  I believe the thinking behind
    this is because it's SUCH an effort for a little guy (or gal) to learn
    how to talk, that if they're constantly corrected, and not just allowed
    to explore their tongues and noises, that they become too frustrated
    and feel like they're failing and then intentionally NOT talk for fear
    of saying it wrong.
    
    At three+, with Jason, now that he has an established vocabulary, we
    will occassionally work on a single word with him, for a minute or two,
    and then leave him be.  ie  Macaroni and cheese is Mac-mo cheese to
    him.  Quite carefully we'll sound out mac-a-ro-ni  and have him repeat
    each syllable so that he says  mac-a-ro-ni  and then we'll say "See!
    Macaroni and cheese!", and he'll say "mac-mo cheese!"  sigh.  I don't
    care if he says it right or wrong - just once in a while we help him
    with formation so that he knows what it FEELS like to say it right.
    Sometimes it helps, most times it doesn't.  But as I said before, in
    the larger picture of things, he's better than he was, so our minds
    (and his Dr's), he's developing just fine.
    
    Good Luck with Jeremy!!  I think the hardest thing with the second one
    is trying to not expect them to be like the first.... no one ever said
    the rules would change!! (-:
    
    patty
846.5Go with your instincts..USCTR1::DWOODFri May 03 1991 16:3024
    
    Thanks for the thoughts.... In our case, though, we do feel that it is
    more than just '2 is young to talk well'.  His muscle tone in his mouth
    is weak, and his tongue is not where it is suppose to be.  In addition,
    he is drooling heavily due to the position of his mouth and tongue. 
    "Talking" and "Talking Well', are indeed different.  J. seems to have
    an inability to form his mouth and tongue into the right shapes.  He
    does get frustrated when he can not communicate his needs, and we would
    like to help him and avoid this frustration.  Although we have not been
    to the Pedi, J. has been evaluated by Early Intervention, who agree
    that there is a delay.  He starts weekly Speech Therapy ( really
    play..) next week.  In any event, it can't hurt, and he thoroughly
    enjoys playing with the S.T.  If we can guide him and make him less
    frustrated, I think we all will be happier.  He has a wonderful
    warm, open, curious, loving.. personality that we do not want
    smothered.  We will probably continue this route until he gets
    hearing/speech evaluation from the Pedi.  From there, we'll see
    what the recommendation is.  For now, E.I will not conclude that
    he is Apraxic.  They would prefer to spend more time with him
    before they 'label' him, however, they agreed that he does
    exhibit some of the symptoms.  To be continued....
    
    Regards,