I guess I am surveying here to see if anyone else has dealt with Apraxia as a speech delay diagnosis. The speech therapist mentioned it today during her visit.

Our triplets will be 3 on the 25th of Jan. All three have been in speech therapy since they were around 15months old. We are the most concerned about our son. He was making progress and modeling words pretty well with our former speech therapist but no he seems to be almost be silent and not wanting to talk at all with the new speech therapist we have. We have had her for a few months now. We have had him to 3 different speech evaluations in addition to First Steps but are having difficulty affording $100/hr for speech therapy. Our private insurance HMO does not cover speech delays. (infertility treatments are expensive and we won't be finished paying for the majority of them until June). Our pediatrician has referred us to a developmental pediatrician. Our son doesn't fit the autism spectrum. He loves to be cuddled and held and tries to be helpful with most task that I am doing.

Any feedback or suggestions would be appreciated. Thanks!

Debbie
33wks
1/25/08

I'm a pediatric SLP. feel free to email with questions. There is another mom on here who just got a dx of apraxia for one (or maybe two) of her triplets. I wish I could remember who it was, search the main page archives for the last two or three weeks. She posted recently. If it is apraxia, therapy and more therapy is what is proven to help the most. It can be a very long process. Some thoughts, have you ruled out hearing loss? Do all the evaluations agree on test scores and results/recommendations or do they all say different things?

If this current SLP isn't making progress, it's okay to ask for another one. You've given it a few months and he's not working well with her then you should talk to her about it. We all have different personalities with the kids and different toys/games/tx approaches. Once the kids turn three they should be able to get services through the school district for free. Start the process now if you haven't already. Good luck with the developemental pediatrician. Keep us posted

Brenda
mom to GGGs born 6/29/09 at 32w4d

Thanks for the feedback Brenda. I had him evaluated this last summer through a local university speech program and another reputable therapy provider. At 2 1/2 years old we were told he was just significantly delayed. Now at almost three years old other thoughts and concerns about his speech problem are being mentioned. ???? ADD, apraxia, autism??? All three of my children have been in speech therapy since they were around 16 months old. There was no delay in getting help for them. As I said he was doing much better with the other speech therapist at least with modeling words after her. No he is pretty much quiet. The problem is pretty frustrating for us since we have been aware of their delay from an early age and have intervened.

We are in the process of getting them enrolled in preschool and speech therapy through the school system. They should start in February. I am really hoping this helps him and the girls as well. We probably won't get an appointment with a developmental pediatrician for 6 months or so so we were told. (crazy!)

Debbie
33wks
1/25/08

Without seeing your son it's hard to say anything for sure, but if I were evaluating him here are some things that would help me decide between the different diagnoses you listed and a few others...

ADD/ADHD- he's too young. this diagnosis isn't one I ever gave in all my years working. Maybe when kids got to 5 or 6 I would start thinking about it, but it doesn't cause speech and language delays. You can see trouble in behavior and when they get to school, but not the things you mentioned. I'd toss this diagnosis out.

Apraxia-this is only a problem with the precision of speech, namely clarity. It can be severe enough that it impacts expressive language, but you should see normal behavior, play, social skills, and receptive language (comprehension). Since you said he is significantly delayed, this isn't the only issue. It could be in combination with something else, but again, I would put this on a back burner until language skills are at a fairly typical level then work on the clarity if there are issues there.

Autism-not talking is one red flag for autism, but his play skills, social interactions, sensory system, and behaviors will also likely be impacted. He will have delays in expressive language and receptive language. If he has imaginative play, typical toddler behavior (tantrums are okay...three year olds do tantrum but he shouldn't be making himself bleed when he's mad or getting upset if you change the routine a little), and good social interactions (turn taking, sharing, eye contact, following directions, responding to requests, responding when you call his name, etc.) then it may not be autism.

Asperger's Syndrome-this is sometimes called 'high functioning autism'. your DS can't have this since he has langauge delays and part of the diagnosis is normal language.

PDD-NOS-this is similar to autism. To get a diagnosis of autism you have to have a certain number of characteristics from 3 different areas (communication, social/emotional, and behavior). If you have characteristics of autism but not enough for a diagnosis of autism then you could have PDD-NOS. It stands for Pervasive Developmental Disorder-Not Otherwise Specified. We treat it just like autism and it is very similar.

Receptive Language Delay-it sounds like your son has this. It's a delay in how he understands language. Things like pointing to pictures you name in a book, following directions, pointing to things you say (body parts, toys, people).

Expressive Language Delay-it sounds like your son has this too. It's a delay in communication. All kids communicate in some way. It may be in pointing, looking at things they want, using signs, using pictures, or using words. Since he's just starting to copy words then there is a delay. Your SLP may be working on having him use signs or pictures along with trying to say words.

I hope this helps. Sounds like you've been doing everything you can to help. Feel free to ask more questions.

Brenda
mom to GGGs born 6/29/09 at 32w4d

Search the main board for "fish oil" and "speech". The results have been truly unbelievable! Nordic Naturals ProEFA and Coromega are the two brands that are known for being the purest, and that people have seen great results with. If it is going to work, it's pretty quick, so there is very little risk to giving it a try. If you don't see a result with one, try the other. We had NO results with the Coromega, but fantastic results with the Nordic Naturals. Other people have had the opposite.

My triplets were in speech for like 4 years, and my baby for 3. I saw amazing improvement in 2 kids within a week with the NN, but no change for the other 2. So much improvement that I had comments from everyone for like 2 weeks afterward - it wasn't just noticeable to me!

Camille seemed to have maybe 10 words previously, and went to phrases. Not great phrases, but a subject & a verb so at least she could communicate. This greatly reduced her frustration which made everyone's life better!

Elise went from grunts to sentences. Seriously - in like 2 weeks. It was unbelievable! She still talks in complete sentences - it's a little freaky for a 4 year old to never ever use phrases!

Meredith & James were somewhat delayed in their speech, but I did not see any change in them.

BGG born 4/25/05 at 31w1d




New baby girl born 9/19/06

Thanks so much for the information and your responses! We finally meet a speech therapist that felt confident enough to diagnose our Son with Apraxia. She has several other clients with the same difficulties and seems to have a good knowledge base and skill level to work with his speech delay. I am praying to God that intensive speech therapy and preschool will help him. Now if we can pay for his therapy
Thanks again!

Debbie GBG
1/25/08

That's great to have answers. It can get expensive to pay for all the therpay. Ask the SLP if her company has a sponsored care program or a scholarship program to help pay your copays. The company I used to work for had both so if you didn't qualify for one you might still get the other. Good luck!

Brenda
mom to GGGs born 6/29/09 at 32w4d

Since your triplets have turned 3, will the school system where you live offer speech therapy? I am not sure what state you live in, but I believe most have speech therapy through the school system. My triplet boys are being seen twic a week at their daycare through the school system. We were originally seen on base (Air Force) and had to be referred off base to a program called Early intervention until they turned 3. Once they turned 3, the school system took over (we of course had to do the testing and everything all over again). My boys have progressed tremendously. They have not been diagnosed with Apraxia though, it was just called speech delay. After reading the replies, I will probably start them on a fish oil supplement to see if that helps even more. Good luck with your son and I pray he starts making progress soon.

Destiny, Dave, Luke, Trent and Brandon

Born at 36 weeks on Thanksgiving Day 07

Luke 5lbs 4oz
Trent 5lbs 14oz
Brandon 5lbs 7 oz

God Bless!

careful with fish oil supplements...many of them contain high levels of mercury.

Brenda
mom to GGGs born 6/29/09 at 32w4d

>Since your triplets have turned 3, will the school system
>where you live offer speech therapy? I am not sure what state
>you live in, but I believe most have speech therapy through
>the school system.

My children started public preschool this last week since they aged out of first steps in home therapy. The girls will be getting 60 minutes of speech therapy a week and Steven will get 90 minutes a week. To be totally honest I guess I don't have a lot of faith in the system right now. I really feel like the system has failed my son so far. He has been in speech therapy since 16 months old. He was not making much progress and the therapist of course would write that he was making some progress and all the same goals were always written for all 3 kids which wasn't appropriate since they are 3 very different children. He has the vocabulary right now of maybe 10-15 words. (it breaks my heart every time I think about it). Seems like a great loss of time to me that something else couldn't have been done to help him. We have had him to 3 private practices now for additional speech evaluations. The last lady seemed confident that apraxia was his problem. I hope and pray that she knows what she is talking about will be able to help him.

We plan on pursuing private speech therapy for him since he is so behind and seems to have the most complex problem with speech.
I pray that he will begin to make progress as well and that apraxia IS the only problem that we are dealing with.

thanks so much for the feedback and responses!
Debbie

You may want to take a look at a site called wrightslaw.com . He also has a facebook page. It is free and has lots of great advice on acting as an advocate for your kids.

Thanks!

My triplets just aged out of Early Steps (all 3 passed their evaluations so no public pre-school, but we'll be starting private this summer). We started speech at 22 mo. for all 3. Of the 3 only one had a dx of apraxia which we received from her ped. neurologist. My DS received one hour a week, and the girls each qualified for 2 hours a week. Ours was split into 2 sessions, but if your child has an apraxia dx shorter sessions more frequently are generally more beneficial. Also something known as the Kaufmann method is fairly effective. I'm assuming you've done the research on apraxia at this point and understand that it's a motor planning issue and that things beyond speech may be affected. With my DD I notice it most in terms of showing her movements (her therapists agree). She will have to be shown the same movement maybe 6 times before she can repeat it while the other two get it after 2 or 3. You might also take a look at a book called The Late Talker by Marilyn Agin if you haven't already. Good luck!

Hi Debbie,

I haven't read through all the replies, so I apologize if I'm repeating. Yes we did have that with Alexander. He didn't start talking until almost 3. He's still sounds a bit odd, kind of like a deaf person, when he talks. His vocabulary is fantastic through. I think the reason we were so successful was pivotal response therapy which is play based but also demands that the kids have to give something in return for something. We've seen remarkable results.


Vicki
http://threepeasinapod.typepad.com
Oliver, Rosie, Alexander 33 weekers born 2/10/06
Gracie 1/7/09

I haven't read all your responses but wanted to share...

2 of mine have had speech issues and the speech therapist thought both had issues with apraxia. They started speech therapy around 2.5 when I found a state/county program here in Tallahassee, Florida. They were assessed and then granted free services based on their need. They aged out of the first program at 3 and entered the school readiness program where they go to preschool for free. It has made a HUGE difference. They are getting speech therapy at school because they are still difficult to understand but they are MUCH better.

Danielle
GGB 33w1d 10/29/07