PDD diagnosis and ABA therapy for an apraxic child

[Guest guest]

I totally understand the frustration in having a child who is

probably apraxic and having him diagnosed as being PDD-NOS which is

part of the autistic spectrum disorders. Often children with severe

speech language impairments, especially those who are essentially

nonverbal, can appear to look uunrelated and lacking in social

interactions.

If a practitioner does not spend enough time evaluating your child

and asking you the right questions, it becomes too easy in this day

and age to smack on the label of PDD and send you out the door with

a " prescription " for ABA.

Children with apraxia need intensive speech therapy that

incorporates multisensory techniques with tactile cues, speech

broken down into readily approximated elements, rhythm and melody,

and often fun oral motor exercises.

If misdiagnosed with PDD, precious time can be lost, however, it is

not usually irrevocable, if you finally find an evaluator who puts

you on the right track. What is also a problem, and why we wrote

The Late Talker, is that apraxia may be a coexisting diagnosis with

autism or other developmental disorders or syndromes. I look at a

broader scope of apraxia than some of the clinicians/researchers in

the field of communication disorders, because recognizing apraxic

features can change the course of treatment and change a child's

life around to meet success!

ABA-discrete trials work beautifully for many children who may be on

the autistic spectrum and others who are so unfocused that they

cannot even sit in a chair and look at you. I see many children who

have benefited greatly from ABA or ABA/VB. Verbal Behavior is an

aspect of ABA that is employed in natural environments, but it is

still ABA. Any child who has had a negative experience or has

received ABA inappropriately has not had an individualized approach

and/or not diagnosed properly as in Mel's case.

I always advise parents, that if you are not seeing some improvement

in your child in 3 months, there should be a reassessment of the

plan, which may entail a team meeting with your therapists or an

independent evaluation. Parents should not be complacent about the

treatment their child is receiving. They need to work with the

therapists and constantly question the methods if they are not

working. As in the case of some of our children, a diagnosis of

apraxia may have been missed.

Sincerely,

Marilyn Agin, MD