Tell me about your “resolved” apraxia child

[Anonymous]

DS has been in speech for almost a year (he’s 3 now) and it’s been amazing. We’re so proud of his progress but he’s also not talking anywhere near to his peers. His sentences are short and sometimes hard to understand. When longer than five or six syllables he drops syllables or slurs sounds. Our speech therapist seems to think his language could be resolved by kindgergarden but we feel like it’s so hard to see how we get from here to there, even if we don’t send him until he’s six. If your child’s apraxia wasn’t severe and s/he didn’t have anther diagnosis, can you tell me how their process to resolved went? Are there leaps? Do they stay in speech even when most people wouldn’t know about apraxia? Do they sound like their peers? I would love to hear anything and everything. Thank you.

[Anonymous]

Sounds great, op.

I'd just take it as he goes. For example, if he still struggles with letter sounds, then I'd go back and assess for possible language based learning disabilities like dyslexia.

[Anonymous]

We have other language issues, not Apraxia, but I'd be careful with an Apraxia diagnosis that young. It seems to be a catch all and its a very distinct language disorder that needs to be treated differently. I'd also be careful at anyone telling you when or giving you a timeframe as often they aren't very accurate. I would not hold a child back from K. Our experience was the academics helped the language development. Most kids with severe language issues at some point may be able to comfortably mask the symptoms but generally there are some lingering symptoms that kids learn to cope with.

For Apraxia, you want to go to a SLP trained in PROMPT. There is a mix of reviews on it but all the Apraxia parents I know say it is the only thing that helps

That also sounds like an expressive language issue.

You need to plan for the worst of years of therapy and start being prepared to heavily advocate in school. Watch for other issues as PP said but not all kids have it (mine does not) and don't allow the school to underestimate your child as they may be way smarter than people give them credit (they just cannot verbalize it well).

[Anonymous]

My child's was severe.

Started speech at 20 months. Continued through 4th grade. Speech 2-4 times a week, both privately and at school.

We too hoped for 'caught up' by kindergarten. Didn't happen, but he went to a mainstream preschool and elementary school. Other kids knew he had a speech / language issue and it was just the way DC was.

As speech became clearer, therapy continued to increase length and complexity of sentences. DC is still not the most loquacious person, but contributes to class discussions and talks with friends and family comfortably. Some therapists at school later on couldn't tell / didn't really be that he'd ever had apraxia, but agreed there were language issues to work on.

DC has an accent but is 100% intelligible to strangers. Takes high school AP classes, strong reader, struggles a bit with writing, does model UN and debate.

Agree with 18:28. You just have to take it a day at a time. Putting a deadline on it will only leave you frustrated. Yes progress would sometimes be faster, and then slow down, and then speed up again.

[Anonymous]

Anonymous wrote:Sounds great, op.

I'd just take it as he goes. For example, if he still struggles with letter sounds, then I'd go back and assess for possible language based learning disabilities like dyslexia.

Meant to add "around age 6."

[Anonymous]

Anonymous wrote:We have other language issues, not Apraxia, but I'd be careful with an Apraxia diagnosis that young. It seems to be a catch all and its a very distinct language disorder that needs to be treated differently. I'd also be careful at anyone telling you when or giving you a timeframe as often they aren't very accurate. I would not hold a child back from K. Our experience was the academics helped the language development. Most kids with severe language issues at some point may be able to comfortably mask the symptoms but generally there are some lingering symptoms that kids learn to cope with.

For Apraxia, you want to go to a SLP trained in PROMPT. There is a mix of reviews on it but all the Apraxia parents I know say it is the only thing that helps

That also sounds like an expressive language issue.

You need to plan for the worst of years of therapy and start being prepared to heavily advocate in school. Watch for other issues as PP said but not all kids have it (mine does not) and don't allow the school to underestimate your child as they may be way smarter than people give them credit (they just cannot verbalize it well).

Prompt is a good therapy for apraxia. The current published research says that the most effective treatment is based on DTTC (which was developed for something else but has been adapted for CAS by Dr Edythe Strain at the Mayo Clinic). You can find more online about it.

Prompt doesn't work for all children and it won't help with the language issues, just the speech. Ideally you find a therapist who can draw from a range of techniques and who has been through one of the advanced certification from CASANA.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sounds great, op.

I'd just take it as he goes. For example, if he still struggles with letter sounds, then I'd go back and assess for possible language based learning disabilities like dyslexia.

Meant to add "around age 6."

I would test sooner than this if you have any concerns. It really depends on the child. Mine was an early reader, partly thanks to the speech therapy, so it was clear we didn't have that concern but if there is a concern for dyslexia, the sooner you get help, the better. My child read before he talked. Had I known, I would have pushed reading earlier as it did help (except when he learned to read things like signs so I couldn't tell him a store was closed when he could clearly read it was open).

[Anonymous]

I agree with doing significant speech therapy. We also did 4 days a week. You may want to look at U of MD as children go 3 days a week and get 3/30 minute private speech sessions and its a literacy based program (or it was when we went but they have been through several directors since). We found therapy most helpful from ages 3-6 and tapered off at 8.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We have other language issues, not Apraxia, but I'd be careful with an Apraxia diagnosis that young. It seems to be a catch all and its a very distinct language disorder that needs to be treated differently. I'd also be careful at anyone telling you when or giving you a timeframe as often they aren't very accurate. I would not hold a child back from K. Our experience was the academics helped the language development. Most kids with severe language issues at some point may be able to comfortably mask the symptoms but generally there are some lingering symptoms that kids learn to cope with.

For Apraxia, you want to go to a SLP trained in PROMPT. There is a mix of reviews on it but all the Apraxia parents I know say it is the only thing that helps

That also sounds like an expressive language issue.

You need to plan for the worst of years of therapy and start being prepared to heavily advocate in school. Watch for other issues as PP said but not all kids have it (mine does not) and don't allow the school to underestimate your child as they may be way smarter than people give them credit (they just cannot verbalize it well).

Prompt is a good therapy for apraxia. The current published research says that the most effective treatment is based on DTTC (which was developed for something else but has been adapted for CAS by Dr Edythe Strain at the Mayo Clinic). You can find more online about it.

Prompt doesn't work for all children and it won't help with the language issues, just the speech. Ideally you find a therapist who can draw from a range of techniques and who has been through one of the advanced certification from CASANA.

OP here - our ST is prompt certified and DS is in intensive therapy - 3-4x/week. It’s definitely CAS. So far no sign of anything else - although we are very aware that this could appear later as dyslexia and will monitor for it. I know there are child out there who thrive after therapy, but I’ve never met them. DS has come so far and it’s been an incredible gift to be able to talk to him (parents without special needs kids have *no* idea what that first “mama” meant to me) and most of the time we just focus on that. But sometimes in a room full of normally developing kids his age, that gap feels so wide. I trust our ST but I would love reassurance from anyone who has been there and done that. We also don’t know if public or private is a better option for him.

[Anonymous]

Children with apraxia are at higher risk for reading issues because they tend to struggle with phonemic awareness.

https://www.apraxia-kids.org/library/literacy-and-children-with-apraxia-of-speech/

Once the child is old enough for a neuropsychological exam, it's a good idea to do one. Just make sure that the evaluator uses a non-verbal intelligence test (the TONI is one) and not just a WISC.

https://www.apraxia-kids.org/library/neuropsychology-in-long-term-educational-planning-for-children-with-apraxia-of-speech/

The closed Apraxia-Kids facebook group has a lot of great information - you can send a request to join https://www.facebook.com/groups/apraxia.kids.group/

[Anonymous]

My DS was diagnosed with possible apraxia at 20 months. Like a PP noted, it wasn't a true diagnosis at that age, but it was clear he had motor planning issues with speech. He did PROMPT therapy with a PROMPT certified instructor until the spring before he went to kindergarten. Progress was super slow at first. We took a couple small breaks in there for a few months at 3 and 4 because his SLP wanted to see if maturity helped some specific difficulties. DS is almost 8 now. No real speech issues that anyone else notices, although I think his Ls are still a little off.

He does have some other issues, like pretty severe ADHD. He also still shows some physical motor planning difficulties. While he's naturally quite athletic, he has trouble watching someone, lik a coach, demonstrate something (like a move in soccer) and then executing it. So the things we saw issues with when he was very young still linger but in different ways.

[Anonymous]

OP I"m 18:36

If you can possibly swing it, you should go to the national Apraxia conference in Charlotte NC next July.

There are usually about 3-4 days of workshops that are open to both SLPs and parents. I went when my son was about 6 and learned so much and being with families who 'got it' was priceless.

https://www.apraxia-kids.org/events/event/11770/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We have other language issues, not Apraxia, but I'd be careful with an Apraxia diagnosis that young. It seems to be a catch all and its a very distinct language disorder that needs to be treated differently. I'd also be careful at anyone telling you when or giving you a timeframe as often they aren't very accurate. I would not hold a child back from K. Our experience was the academics helped the language development. Most kids with severe language issues at some point may be able to comfortably mask the symptoms but generally there are some lingering symptoms that kids learn to cope with.

For Apraxia, you want to go to a SLP trained in PROMPT. There is a mix of reviews on it but all the Apraxia parents I know say it is the only thing that helps

That also sounds like an expressive language issue.

You need to plan for the worst of years of therapy and start being prepared to heavily advocate in school. Watch for other issues as PP said but not all kids have it (mine does not) and don't allow the school to underestimate your child as they may be way smarter than people give them credit (they just cannot verbalize it well).

Prompt is a good therapy for apraxia. The current published research says that the most effective treatment is based on DTTC (which was developed for something else but has been adapted for CAS by Dr Edythe Strain at the Mayo Clinic). You can find more online about it.

Prompt doesn't work for all children and it won't help with the language issues, just the speech. Ideally you find a therapist who can draw from a range of techniques and who has been through one of the advanced certification from CASANA.

OP here - our ST is prompt certified and DS is in intensive therapy - 3-4x/week. It’s definitely CAS. So far no sign of anything else - although we are very aware that this could appear later as dyslexia and will monitor for it. I know there are child out there who thrive after therapy, but I’ve never met them. DS has come so far and it’s been an incredible gift to be able to talk to him (parents without special needs kids have *no* idea what that first “mama” meant to me) and most of the time we just focus on that. But sometimes in a room full of normally developing kids his age, that gap feels so wide. I trust our ST but I would love reassurance from anyone who has been there and done that. We also don’t know if public or private is a better option for him.

Stop comparing kids. 3-6 is the hardest ages, or at least for us with a language disorder. It does and will get better. We did a small private for a few years so our child would get the support they needed and I'm really glad we did it. No issue transitioning to public. Its impossible to say what will happen but the important thing is he is talking and trying. It generally does get a lot better. The "I LOVE YOU" was far sweeter than Mama for me. If it makes you feel better, at that age I thought my child would never talk and worried, like you if he'd be ok and he's doing great, on or above grade level and talks non-stop (still struggles some but that's ok, it all comes in its own time).

[Anonymous]

NP here. My DD was diagnosed with apraxia, along with general dyspraxia (motor coordination issues broadly). At 3, her speech was pretty far behind her peers. We did 4 times a week speech therapy until she was 5 or so. She was also diagnosed, along the way, with ADHD and, later, non-verbal learning disability.

Her ability to express herself in language was basically resolved by the time she was 6 or 7. By 8 or 9, her vocabulary was extremely advanced, and she used these words properly in conversation. Now she is 12. No one would ever suspect that she was a delayed speaker. She has some pragmatics issues -- the ability to carry on a higher level conversation, especially involving non-verbal cues or certain kinds of abstract ideas -- but nothing related to apraxia.

I remember being in your shoes. Her developmental pediatrician (Conlon) told us that the day would come when she would no longer be in therapies. I didn't believe him. It happened, though. I don't remember whether it was leaps or a steady progression, but if you keep working, your child will improve and you will put this behind you.

[Anonymous]

My experiences and advice is similar to the PPs. My DS, now 11, srarted in EI for gross motor delay at 15 months, started ST at 24 mos. and diagnosed at 3 with apraxia and MERLD. His speech was mostly unintelligible to non-familiars. He made better progress with a PROMPT SLP. But progress was very slow and hard won. He till goes every other week to a group speech session to continue to work on spontaneous/pragmatic language. His articulation is good but his speech still breaks down with longer, more complex, spontaneous communication.

If your DS does have apraxia, I wouldn't expect it to be 'resolved' by K. Articulation may no longer be an issue but apraxia is so much more than that. As a PP said, it's very common to have reading/comprehension challenges. If you're not already, look into getting into your district's special ed preschool. You're DC will get an IEP that will follow him into K. There is no reason apraxia should delay his entry into K. You want him in a supported language based preschool.