Apraxia anyone? — The Bump
Special Needs

Apraxia anyone?

Let me preface this by saying I'm not 100% in the believer category that Ethan has this. He has been in speech for a year after being delayed due to fluid/not hearing until 18 months of age. He had his first 3 words at 18 months, and 100 words at 2. His receptive speech is normal but his expressive is delayed. He is talking in two word phrases and is starting to put 3 word sentences together. He does have a slower time processing how to say new words and does leave the ending sounds of a lot of words still. The words and phrases he does have he says consistently.  His private speech therapist is leaning towards a mild-moderate form of apraxia.

I think it's too early. His speech is constantly improving, he has tons of words. His articulation his off due to ending sounds not being said....but maybe all of these signs point to apraxia. 

One more thing to add...he is extremely shy and often doesn't show to others all that he shows to DH and myself.

Anyone have any experience with apraxia? What can you tell me about it? Sound like this may be a likely diagnosis down the line?
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Re: Apraxia anyone?

  • Have you had his hearing re-tested lately? Just to be sure there isn't a new issue? Leaving off the endings of words is concerning.

    Maybe you need to remind the SLP that his "hearing age" is his current age minus the age you know he had complete access to all sounds (including the endings of words). So he is actually at around a 1 year old (plus some change) level for receptive language. If the receptive end is lagging, it makes sense that the expressive would too. For a whole 18 months he was not hearing the ends of words, so in his mind the word has been "stored" without an ending. Relearning and refiling the word correctly in the brain will take some time. If you think he is catching up he probably just needs more time for the listening and speech sounds to work themselves out.

    We have a "working dx" of apraxia but it is pretty obvious. Nate cannot get the words out, at all. I am not sure what a mild form would be. Wouldn't all shy kids get an apraxia diagnosis then?

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    Have you had his hearing re-tested lately? Just to be sure there isn't a new issue? Leaving off the endings of words is concerning.

    Maybe you need to remind the SLP that his "hearing age" is his current age minus the age you know he had complete access to all sounds (including the endings of words). So he is actually at around a 1 year old (plus some change) level for receptive language. If the receptive end is lagging, it makes sense that the expressive would too. For a whole 18 months he was not hearing the ends of words, so in his mind the word has been "stored" without an ending. Relearning and refiling the word correctly in the brain will take some time. If you think he is catching up he probably just needs more time for the listening and speech sounds to work themselves out.

    We have a "working dx" of apraxia but it is pretty obvious. Nate cannot get the words out, at all. I am not sure what a mild form would be. Wouldn't all shy kids get an apraxia diagnosis then?

     

    Thank you for the response.  He had his hearing tested in the last five months so I don't think that is an issue right now.

     

    He doesn't leave the ending sounds off all of his words and phrases.  Some of the sounds aren't accurate.  For example, if i ask him how old he is, he'll say two and halp instead of two and a halF.   A lot of words he does put the ending sounds on.  Example. Mommy, daddy, Ethan, Doggy, Pop Pop, Delmy, Annie, Aimee.  I guess I'm seeing a trend of mostly words that end on a vowel sound.

    Some of the words he doesn't: want, school, duck, milk

    Here was a conversation this evening:

     E: Mil, Mil plea

    Me: How do you ask?

    E: I wa mil plea ( I want milk please)

     

    Couldn't this just be an articulation problem and not necessarily apraxia? 

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  • It certainly could be apraxia, but my daughter sounded exactly like that at your son's age and it was just a very serious articulation disorder that with lots of therapy has resolved (she turns 4 next month).

    Her speech is right on track now, and has some residual issues with longer complicated words, but she is improving daily.

     And the halp/half - f is one of the later developing sounds and subbing in an easier sound is actually normal.

    I would check out teachmetotalk.com. Hang in there.

  • image JessandJeremy:
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    Have you had his hearing re-tested lately? Just to be sure there isn't a new issue? Leaving off the endings of words is concerning.

    Maybe you need to remind the SLP that his "hearing age" is his current age minus the age you know he had complete access to all sounds (including the endings of words). So he is actually at around a 1 year old (plus some change) level for receptive language. If the receptive end is lagging, it makes sense that the expressive would too. For a whole 18 months he was not hearing the ends of words, so in his mind the word has been "stored" without an ending. Relearning and refiling the word correctly in the brain will take some time. If you think he is catching up he probably just needs more time for the listening and speech sounds to work themselves out.

    We have a "working dx" of apraxia but it is pretty obvious. Nate cannot get the words out, at all. I am not sure what a mild form would be. Wouldn't all shy kids get an apraxia diagnosis then?

     

    Thank you for the response.  He had his hearing tested in the last five months so I don't think that is an issue right now.

     

    He doesn't leave the ending sounds off all of his words and phrases.  Some of the sounds aren't accurate.  For example, if i ask him how old he is, he'll say two and halp instead of two and a halF.   A lot of words he does put the ending sounds on.  Example. Mommy, daddy, Ethan, Doggy, Pop Pop, Delmy, Annie, Aimee.  I guess I'm seeing a trend of mostly words that end on a vowel sound.

    Some of the words he doesn't: want, school, duck, milk

    Here was a conversation this evening:

     E: Mil, Mil plea

    Me: How do you ask?

    E: I wa mil plea ( I want milk please)

     

    Couldn't this just be an articulation problem and not necessarily apraxia? 

    This sounds exactly like my child who is suspected to have a mild case of apraxia.

    It could be either a mild case of apraxia or an articulation problem. It's really tough to say. Only a SLP can tell the difference.

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