Today is Apraxia Awareness Day. A day to wear blue. A day to … – It is just another day. It is just a beautiful Saturday in the south. The sibling rivalry is high and the punches are swift. Today has been just another day for us with Apraxia. KB has asked “I do my homework?” Her “homework” consists of writing letters and saying them. This Saturday also includes 5 outfit changes and twirly dresses. We won’t be doing anything for Apraxia Awareness. We will just hangout and play. I will count words in her sentences (like I do all day everyday). I will praise her 5 word sentences with high-fives, smiles, and hugs. I will get all giddy when a word has a 3rd syllable. Her words are not pronounced correctly but it’s okay. She isn’t as frustrated with me because I “get her”. She is getting better and you can read all about that here. I mentioned in my last post about her Apraxia and the bees. I found a video from one of the first times she worked with them. She was about 7 therapy sessions in at this point when I videoed her with my phone.
If you have questions about your child, don’t be like me. Don’t wait. Don’t delay. Don’t let denial get in the way. I could have had her in therapy earlier if I would have just seen past what I didn’t want to see. I am her biggest fan. I always will be. She will get past this. “She will outgrow her Apraxia fully one day. And one day this will all be a distant memory embedded in our hearts and etched into our brain.”
According to The American Speech-Language-Hearing Association ::
What are some signs or symptoms of childhood apraxia of speech?
Not all children with CAS are the same. All of the signs and symptoms listed below may not be present in every child. It is important to have your child evaluated by a speech-language pathologist (SLP) who has knowledge of CAS to rule out other causes of speech problems. General things to look for include the following:
A Very Young Child
- Does not coo or babble as an infant
- First words are late, and they may be missing sounds
- Only a few different consonant and vowel sounds
- Problems combining sounds; may show long pauses between sounds
- Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
- May have problems eating
An Older Child
- Makes inconsistent sound errors that are not the result of immaturity
- Can understand language much better than he or she can talk
- Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
- May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
- Has more difficulty saying longer words or phrases clearly than shorter ones
- Appears to have more difficulty when he or she is anxious
- Is hard to understand, especially for an unfamiliar listener
- Sounds choppy, monotonous, or stresses the wrong syllable or word
Potential Other Problems
- Delayed language development
- Other expressive language problems like word order confusions and word recall
- Difficulties with fine motor movement/coordination
- Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like toothbrushing or crunchy foods, may not be able to identify an object in their mouth through touch)
- Children with CAS or other speech problems may have problems when learning to read, spell, and write
An audiologist should perform a hearing evaluation to rule out hearing loss as a possible cause of the child’s speech difficulties.
A certified-SLP with knowledge and experience with CAS conducts an evaluation. This will assess the child’s oral-motor abilities, melody of speech, and speech sound development. The SLP can diagnose CAS and rule out other speech disorders, unless only a limited speech sample can be obtained making a firm diagnosis challenging.
An oral-motor assessment involves:
- checking for signs of weakness or low muscle tone in the lips, jaw, and tongue, called dysarthria. Children with CAS do not usually have weakness, but checking for weakness will help the SLP make a diagnosis.
- seeing how well the child can coordinate the movement of the mouth by having him or her imitate nonspeech actions (e.g., moving the tongue from side to side, smiling, frowning, puckering the lips)
- evaluating the coordination and sequencing of muscle movements for speech while the child performs tasks such as the diadochokinetic rate, which requires the child to repeat strings of sounds (e.g., puh-tuh-kuh) as fast as possible
- examining rote abilities by testing the child’s skills in functional or “real-life” situations (e.g., licking a lollipop) and comparing this to skills in nonfunctional or “pretend” situations (e.g., pretending to lick a lollipop)
A melody of speech (intonation) assessment involves:
- listening to the child to make sure that he or she is able to appropriately stress syllables in words and words in sentences
- determining whether the child can use pitch and pauses to mark different types of sentences (e.g., questions vs. statements) and to mark off different portions of the sentence (e.g., to pause between phrases, not in the middle of them)
A speech sound (pronunciation of sounds in words) assessment involves:
- Evaluating both vowel and consonant sounds
- Checking how well the child says individual sounds and sound combinations (syllables and word shapes)
- Determining how well others can understand the child when they use single words, phrases, and conversational speech.
An SLP may also examine the child’s receptive and expressive language skills and literacy skills to see if there are co-existing problems in these areas.