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    Overcoming Apraxia
    Overcoming Apraxia
    Overcoming Apraxia
    Ebook118 pages1 hour

    Overcoming Apraxia

    By Laura Baskall Smith

    ()

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    About this ebook

    When a child isn't speaking, parents are often reassured that all children develop at their own pace.  Many times, experts can't agree on what is normal and offer different advice.  Understandably, parents may not know where to go or with whom to consult.  In many instances, there is no cause for concern; however, in other

    LanguageEnglish
    PublisherLaura Smith
    Release dateOct 20, 2019
    ISBN9781087809502
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      Book preview

      Overcoming Apraxia - Laura Baskall Smith

      img_0.jpg

      Copyright © Laura Baskall Smith 2019

      All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording or otherwise, without prior permission in writing of the author.

      ISBN: 978-0-578-57537-7 (paperback)

      To my husband, who has always been supportive and encouraged me to follow my dreams. To my two children, who are my light and my loves. The greatest privilege of my life has been in being your mom.

      Table of Contents

      Introduction

      Chapter 1 Her Arrival

      Chapter 2 Milestones and Delays

      Chapter 3 Evaluation and IEP

      Chapter 4 Life Before Ashlynn

      Chapter 5 The Journey Begins

      Chapter 6 Starting Preschool

      Chapter 7 Language Explosion

      Chapter 8 Progress and Changes

      Chapter 9 Finding Our People

      Chapter 10 Training

      Chapter 11 Private Practice

      Chapter 12 Her Fight, Our Fight

      Chapter 13 Overcoming Apraxia

      Chapter 14 Additional Characteristics

      Chapter 15 Specialists

      Chapter 16 CEO/CFO of Special Needs Parenting

      Chapter 17 The Big Picture

      Chapter 18 Advocacy

      Chapter 19 Siblings

      Chapter 20 If You’re Happy and You Know It, Shout ‘HOORAY’!

      Resources

      Bibliography

      Introduction

      This book is for anyone who is interested in learning more about childhood apraxia of speech (CAS) from both a clinical standpoint and a personal one. Throughout this book the terms CAS and apraxia are used interchangeably but are both referring to apraxia that started in childhood. I was a speech-language pathologist (SLP) with some modest experience with CAS before the birth of my daughter. When she was nearly three years old, I learned that she had apraxia and my world turned upside down. After learning so much more about apraxia, I am now in private practice, specializing in the disorder.

      Apraxia is a motor planning disorder that affects a child’s ability to plan and program the precise movements needed for speech and results in difficulties producing and blending speech sounds smoothly and correctly. Speech therapy is needed to address this motor planning component. Therapy for apraxia can help other speech disorders; however, approaches that do not target the underlying speech motor difficulty are not likely to be effective for apraxia.

      When a child isn’t speaking, you may receive a lot of unsolicited opinions about why that is. Parents are often assured that all kids develop at their own pace, and it seems even experts can’t agree on what is normal. Some pediatricians refer a child to early intervention at fifteen months and others wait until the child is past two years of age.

      When parents ask me if they should take their child in for an evaluation, my answer is almost always yes. Early-intervention services are federally mandated, cover children ages birth to three years, include an evaluation by a professional, and are usually free to parents. If you are unsure where to start, you can talk to your pediatrician and ask for a referral or call your local school district and ask for the number to early intervention or Child Find services. The evaluation must include cognitive, speech-language, physical, social-emotional, and adaptive-developmental areas. The evaluation will determine if your child qualifies for services. It’s always better to test and know what you’re dealing with than to wait and potentially delay important therapy.

      Once it is determined that a child qualifies for speech services, know that children who have CAS may or may not respond to the traditional methods of teaching, such as language stimulation, which is common in many early-intervention programs. However, their response is not likely to produce the gains in speech production that would be expected unless a motor-based approach to therapy is employed. Parents and professionals should be aware of the early signs and symptoms of CAS, and if CAS is suspected, treatment should be changed and provided under a provisional label, such as suspected CAS. Many times, it may be a parent who is the one to suspect apraxia, and if that is the case, it may be worth it to find a local expert who can provide a differential diagnosis or at least an expert consultation. The Apraxia Kids website is an excellent resource that has a Find a Professional tab to help parents find local experts in their area.

      Early signs and possible symptoms of apraxia in children under three may include difficulty with nursing and/or feeding, lack of babbling or limited babbling, words heard once or twice and then not again, a go-to word or sound used to represent many different things, other delayed motor skills, and/or difficulty imitating non-speech motor tasks, such as puckering or smiling.

      Behavioral markers that may be seen in a motor speech exam used to diagnose apraxia include inconsistent errors, difficulty in smooth articulatory transitions between sounds and syllables, errors with prosody particularly with syllabic or phrasal stress, use of simple syllable shapes, limited consonant and vowel repertoire, syllable segregation referring to pauses in between sounds, syllables or words, vowel errors, and/or the presence of oral apraxia (sometimes referred to as oral motor apraxia). Oral apraxia is a term to describe difficulties with non-speech, oral-motor tasks, such as going from a pucker to a smile, blowing, rounding the lips, moving the tongue, etc.

      Based on our current level of knowledge, diagnosis of CAS before age three can be challenging. Children that are nonverbal and cannot imitate or attempt to imitate speech sounds and words should not receive a diagnosis of CAS. In addition, if children’s behavior prevents them from partaking in a motor speech exam, they should not receive a diagnosis of CAS either. However, in either scenario, if apraxia is strongly suspected, children can and should be treated under a provisional label and a treatment approach for apraxia should be implemented.

      There are many programs that purport to be geared toward the treatment of apraxia. However, the most appropriate are those that incorporate the principles of motor learning. Many speech-language pathologists will need postgraduate training or resources in order to treat apraxia effectively. For example, in my practice, I am trained in various methods and I am recognized by Apraxia Kids for Advanced Training and Clinical Expertise in childhood apraxia of speech. I have also attended the PROMPT (Prompts for restructuring oral muscular phonetic targets) Level 1 training, the Kaufman Speech to Language Protocol training, and a DTTC (Dynamic Temporal and Tactile Cueing) training. I attend the yearly Apraxia Kids conference regularly to stay abreast of the current research. For the most up-to-date, credible information, visit my website, SLPMommyofApraxia.com; Apraxia-Kids.org; and ASHA.org for expert articles and resources related to treating apraxia.

      Through this journey, I have experienced what it is like to parent a child with this diagnosis, as well as how to treat this complex neurological speech disorder as a speech language pathologist. My hope in writing this book is to give perspective, provide education, and create understanding of apraxia for both parents and professionals.

      Finally, I hope this book gives a message of hope. My daughter has inspired and continues to inspire me. I once cried, wondering why this had to happen to her. Now I hear her speak and sing, and I no longer wonder. Instead, I am grateful for what the journey has taught us and continues to teach us. I am so grateful for my daughter, apraxia and all. She is the embodiment of inspiration, perseverance, and resilience. My daughter has taught me that the only disability in life is a bad attitude, and that regardless of any challenge, we should wake up each day with a smile and be happy to be alive.

      Chapter 1

      Her Arrival

      One day a spirit appeared,

      taking up residence in my vessel.

      For a time,

      two hearts beat together in

      a harmony of song.

      The sweetest, simplest of songs,

      raw,

      pure,

      visceral.

      Your earthly life hinging on mine,

      we spoke in tongues only we could understand.

      Reminiscent now in your eyes,

      windows to our souls.

      Love begun before birth

      never dies.

      It was a Sunday night. I was pacing around the living room and trying to watch the football game to take my mind off the contractions, which were getting more and more uncomfortable and painful. When the game ended, I called my obstetrician and she told me to come to the hospital.

      I arrived around 11:00 p.m. with my husband and mother. At around 1:00 a.m., I was given Pitocin to induce labor since I was having contractions but not dilating or effacing. At one point the obstetrician suggested we do a C-section, but I dismissed it. As the contractions became stronger,

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