Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 Thank you for taking the time to write this. It is so true that seeing the " right " doctor, who truly gets that motor coordination is not equal to intelligence, can make such a life altering difference in what happens to a specific child. It is easy just to slam a door shut and write things off as " cognitively " based. It is much harder to write 10 page reports that take into account a child's history and a child's performance in all areas. This is why finding doctors like Dr. Agin becomes so critical. I wish there were more of them. Hang in there, Tina and . In a message dated 1/28/2006 6:14:20 AM Pacific Standard Time, kiddietalk@... writes: Tina and -I am so sorry!!! I guess I didn't post enough the importance of seeing not just any neuroMD -but one who has a clue. Your examples are what happens when you see one that doesn't. Dr. Myers says " a child who mastered a skill should be able to transfer teh skill to any setting. " Well the word " mastered " could mean they overcame conditions such as apraxia or selective mutism etc. which have separate and very real reasons why a child may not always perform on command in " every setting " But does he know about either of them for just two examples why a child may not transfer skills to every setting? What if a smart child just didn't like him? And diagnosing MR at 18 months... or 2 years old, especially in a child with signs of a motor planning disorder? And saying a child is not MR because she's " too social " ? As much as I'd like to agree that some of the nasty people out there who judge a babies cognitive ability on how much they smile are in some way MR -don't think that's how IQ works. But at least even if Dr. Myers doesn't give advice you can take to the bank -he gives you hope right? Oh wait not right... You say " AT her latest appointment when she was 4, he told me that if he had to classify her now, based on her current abilities he would give her an MR diagnosis. He told me that as she ages it is less likely that she would outgrow her cognitive deficit. " Did he know she has " severe motor planning issues " and that motor planning has nothing to do with IQ? And do you know that if your child is diagnosed as MR the " many services " may be there now at 4 - but don't expect them down the road because after all (example) Mrs , " your child is mentally retarded and no matter how much speech therapy we give her she'll never talk " Check the archives that is why they are there. Get rid of that MR label yesterday -or at the latest ASAP NOW! Boy do you need another exam with a doctor who has a clue! Let me put if this way...you say both of them specialize in autism and ADHD -if I had a child with autism (and I do have a child with ADHD) you wouldn't catch me taking my child to either of them if they were the last doctors on the planet based on what either of you wrote here. And if you are from PA -you are so close to a slew of MDs who are very knowledgeable about apraxia, autism, ADHD...children. And the increased babbling is awesome!! Don't let this unknowledgeable doctor poorly judge your child. Second opinions for both of your babies is my recommendation. You know not that long ago we had a heated conversation about Dr. Agin and her fees. The two of these doctors slams home the reason of why it's so important to take your child to MDs who are knowledgeable. Because it's priceless. My apologies to both of you for what you went through. Please don't let them give up hope on your babies. I bet if either of these MDs saw Tanner when he was a baby they would have found him to be cognitively delayed as well since in addition to severe oral and verbal apraxia he also had hypotonia and sensory integration dysfunction and with his oral apraxia appeared to have no expression most of the time (so didn't look very social) It makes me so angry. Oh -and Tanner's in mainstream 3rd grade today and just tested 5th grade level for math and creative writing and something else I can't remember -visual memory recall? -and on 4th grade level for everything else. Don't make assumptions about a child's learning difficulty. Here's a recent article even saying that about a 5 year old! Wonder what this doctor would say about what these doctors are saying about 18 month olds with suspected apraxia! Fax this to both of their offices and mail them a copy of The Late Talker book! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 (()) I am so sorry that the appointment didn't go as well as you had hoped. I never saw Dr. Challman (boy, did I mess up his name in my prior post!!LOL) but he sounds to diagnose the same as Dr. Myers. Dr. Myers did spend about 2 hours with us at our appointment, but he would do the same-ask Amber once or twice and if she didn't do it he wouldn't give her credit if I told him she could do it at home. He said that a child who mastered a skill should be able to transfer teh skill to any setting. Unlike our SLP's, they do all of their testing at once which leads to a tired, cranky child who is less than cooperative. Originally Dr. Myers told me that Amber was not MR (I think we saw him when she was about 18 or 2) because she was so social, etc etc. AT her latest appointment when she was 4, he told me that if he had to classify her now, based on her current abilities he would give her an MR diagnosis. He told me that as she ages it is less likely that she would outgrow her cognitive deficit. However, she has such severe motor planning issues that I am still holding out hope that when it finally " clicks " for her that her true cognition will come out. Trust me, it was like a knife in my heart when he said it to me. But, we were able to increase all of our services based on the scripts that he gave me. I am sorry that he didn't spend much time with you and that you walked away feeling like you didn't get any answers. Both Myers and Challman specialize in ADHD and Autism so I don't think they are qualified to diagnose with true apraxia (as opposed to their " components of apraxia " that they like to say) and how it can impact a child's cognitive output. However, Myers was able to tell me that while Amber does have behavioral issues he doesn't believe it is PDD-NOS (which is what she was diangosed with to get her a TSS under the autism program). If you ever want to chat, feel free to e-mail me anytime. I don't know what part of PA you are from (I am in NE PA) but if I can be of any help with anything or just lend an ear, let me know > > , Tina, Myra, , anybody! > > Amber's evaluation sound just like Jade's went today. She did see > Dr. Chaullman and he did say he feels Jade is severly delayed in her > cognitive development. He went on to say he doesn't feel she has > Apraxia as a whole, maybe some parts of it, no Autism, a couple of > things he feels can fall within the spectrum disorders, but not > enough to say anything that has to do with Autism. > It felt like I was talked around a diagnosis and he wants to see her > again in 6 months. He did also give her a harsh cognitive score. > We drove almost two hours to get there, Jade was so cranky and tired > from not getting enough sleep and was very uncooperative. I do also > feel its not fair to judge her on one possible 30-40 minute > interaction with her, whereas her therapist work with her weekly and > can get her to do the things that he wanted her to do. It may take > some repeating and prompting and directing, but it will get done > eventually. The doctor asked Jade to do things once or twice and > when she wouldn't, he was writing away on his pad. > > > I did not even bother to make a fuss about the fish oils being Jade > has only been on them for a week and I did tell him that she takes > them and he said well it wouldn't hurt. He just pushed apraxia aside > repeatedly so I felt he wouldn't want to listen to any of my tales > of increased babbling in the last two weeks. I left feeling like I > wasn't sure if I should keep giving her the oils, but I have decided > that I am going to. To hell with him ! (sorry for venting) > > What I do know is that I heard him say developmental delays and that > if she did not improve by the time she is three or four, he would > call that mental retardation. After I my heart started beating > again, I just started to feel like I want to know why my daughter > can't talk and you are not telling me why. He also stated that he > wants her tested for Fragile X, but I was told that is hereditary > and I know the hospital tests you for that when you are pregnant, so > I am leaning away from that. He also wants a test on chromosones and > blood work done. He said they still might be able to tell me what is > wrong after all of that. > > > Can anyone tell me in an apraxic child, do you feel that the childs > other abilities are more at age level? > For instance, Jade doesn't follow commands, like go and bring me > your shoes, go and get your cup and your shoes. He said that if her > cognitive skills were at a 30 month old level and the speech was > delayed, he would feel comfortable saying that it was apraxia. > I asked him if her making mouth movements with no sound coming out > comes from something other than apraxia, he says well that can be > part of apraxia, but there is a deeper issue. > > The same as Amber, he was very harsh in his cognitive scoring. > > He said her speech was at an 8 month old level and her cognitive was > at ten month old level. He said that 10 month olds should be able to > get things when asked. I think that is a bit early to expect that, > but hey what do I know? > > I am anxious to see what he is going to write in his report since he > says she has nothing basically. > > What I am going to do is try and have the evaluation done again in > New York before Jade's insurance runs out and see if that person > says the same that he does. It doesn't help to hear therapist say > that she is at a 2 year old level and for him to say she is barely > at a one year old level. I am completely and utterly confused. > > So can anyone tell me if there apraxic children always function > normally cognitively and fall way below in their speech? > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 Tina and -I am so sorry!!! I guess I didn't post enough the importance of seeing not just any neuroMD -but one who has a clue. Your examples are what happens when you see one that doesn't. Dr. Myers says " a child who mastered a skill should be able to transfer teh skill to any setting. " Well the word " mastered " could mean they overcame conditions such as apraxia or selective mutism etc. which have separate and very real reasons why a child may not always perform on command in " every setting " But does he know about either of them for just two examples why a child may not transfer skills to every setting? What if a smart child just didn't like him? And diagnosing MR at 18 months... or 2 years old, especially in a child with signs of a motor planning disorder? And saying a child is not MR because she's " too social " ? As much as I'd like to agree that some of the nasty people out there who judge a babies cognitive ability on how much they smile are in some way MR -don't think that's how IQ works. But at least even if Dr. Myers doesn't give advice you can take to the bank -he gives you hope right? Oh wait not right... You say " AT her latest appointment when she was 4, he told me that if he had to classify her now, based on her current abilities he would give her an MR diagnosis. He told me that as she ages it is less likely that she would outgrow her cognitive deficit. " Did he know she has " severe motor planning issues " and that motor planning has nothing to do with IQ? And do you know that if your child is diagnosed as MR the " many services " may be there now at 4 - but don't expect them down the road because after all (example) Mrs , " your child is mentally retarded and no matter how much speech therapy we give her she'll never talk " Check the archives that is why they are there. Get rid of that MR label yesterday -or at the latest ASAP NOW! Boy do you need another exam with a doctor who has a clue! Let me put if this way...you say both of them specialize in autism and ADHD -if I had a child with autism (and I do have a child with ADHD) you wouldn't catch me taking my child to either of them if they were the last doctors on the planet based on what either of you wrote here. And if you are from PA -you are so close to a slew of MDs who are very knowledgeable about apraxia, autism, ADHD...children. And the increased babbling is awesome!! Don't let this unknowledgeable doctor poorly judge your child. Second opinions for both of your babies is my recommendation. You know not that long ago we had a heated conversation about Dr. Agin and her fees. The two of these doctors slams home the reason of why it's so important to take your child to MDs who are knowledgeable. Because it's priceless. My apologies to both of you for what you went through. Please don't let them give up hope on your babies. I bet if either of these MDs saw Tanner when he was a baby they would have found him to be cognitively delayed as well since in addition to severe oral and verbal apraxia he also had hypotonia and sensory integration dysfunction and with his oral apraxia appeared to have no expression most of the time (so didn't look very social) It makes me so angry. Oh -and Tanner's in mainstream 3rd grade today and just tested 5th grade level for math and creative writing and something else I can't remember -visual memory recall? -and on 4th grade level for everything else. Don't make assumptions about a child's learning difficulty. Here's a recent article even saying that about a 5 year old! Wonder what this doctor would say about what these doctors are saying about 18 month olds with suspected apraxia! Fax this to both of their offices and mail them a copy of The Late Talker book! By Dr. YVONNE FOURNIER Scripps News Service 26-JAN-06 DEAR DR. FOURNIER: My 5-year-old has been diagnosed with auditory processing disorder. He is reading first- and second-grade books but has difficulty understanding what is being said to him. His speech is delayed and he has been in speech therapy. I would like to know if there is any type of therapy to treat his problem. THE ASSESSMENT: When I interview parents, I am amazed at how many can recite exactly when their children sat up, crawled, walked and talked. In today's educated society, parents and professionals are often on the lookout for developmental processes, knowing exactly when each milestone should be achieved. The danger in setting a strict schedule of achievement is that it can leave us with the hope that all skills have such a clear-cut beginning and end. This " hope for " and " it's over " schedule can be overextended into abilities that do not run on any timed schedule. When a skill does not develop " by the book, " it is labeled a disorder and the child is deemed developmentally delayed. Although many older students and adults can be accurately diagnosed with learning differences, it is difficult to diagnose a developmental disorder early in a child's life. It could be a delay in your child's overall development or it could be a delay " localized " to a specific developmental area, such as language. It could also be a general delay, such as cognitive function, that is masked by a more obvious one, such as speech. Your child may well need help with auditory processing, but it is important to think of multiple reasons before settling on one solution too early. WHAT TO DO: Think of developmental processes that could be at the root of your child's learning difference. Start by writing a list of possible reasons why your child cannot already do what you expect. Problem: " My child has difficulty understanding what is said. " Possible reason: My child has a speech delay. He might not have enough language to be able to understand what is said. Solution: Patience. Possible reason: My child has had many ear infections and is used to not paying attention because of transitory hearing loss. Solution: Tell my child to look at me when I talk to him to learn to listen. Possible reason: My child's speech delay might be the earliest sign of a developmental language disorder. Solution: He might need language therapy rather than speech therapy. Possible reason: My child might need more time to process what he hears. He might need time to develop auditory processing with expected speed. Solution: Do not expect immediate responses. As parents, we are blessed with the opportunity to see so many of our children's developmental processes blossom before us. We must be careful not to let these blossoms make us believe that the slower- growing ones are of a different species. Only when your calm responses do not resolve your concern, consult with a developmental pediatrician for your next step. (Write Dr. Fournier, Fournier Learning Strategies Inc., 5900 Poplar, Memphis, Tenn. 38119. E-mail YF7thsense(at)aol.com.) http://www.shns.com/shns/g_index2.cfm?action=detail & pk=HOMEWORK-FAM-01-26-06 ===== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 Wow, does this sound like appointments with my son's first dev ped. Though he was the first one to use the word Apraxia though I don't think he really knew much about it just that it was a diagnosis that the insurance would cover speech for. Dade speech therapist gave me one of the best things to live by. Who cares if an eval comes back worse than I know he can do if it gets him more services. Dade had horrible cognitive delays but the kid didn't talk and has receptive language delays too. He is now 4. Still with delays everywhere. Global apraxia and autism(high functioning) And he know all his colors, shapes and letters. He can spell his name so he is so not MR. I've heard the don't use MR until at least 5 but more like 7 before they can say that it's not just developmental delays. Nichole Mom to Dade 11/29/01 and Leia 2/7/04 [ ] AFTER THE DEV. PED. VISIT , Tina, Myra, , anybody! Amber's evaluation sound just like Jade's went today. She did see Dr. Chaullman and he did say he feels Jade is severly delayed in her cognitive development. He went on to say he doesn't feel she has Apraxia as a whole, maybe some parts of it, no Autism, a couple of things he feels can fall within the spectrum disorders, but not enough to say anything that has to do with Autism. It felt like I was talked around a diagnosis and he wants to see her again in 6 months. He did also give her a harsh cognitive score. We drove almost two hours to get there, Jade was so cranky and tired from not getting enough sleep and was very uncooperative. I do also feel its not fair to judge her on one possible 30-40 minute interaction with her, whereas her therapist work with her weekly and can get her to do the things that he wanted her to do. It may take some repeating and prompting and directing, but it will get done eventually. The doctor asked Jade to do things once or twice and when she wouldn't, he was writing away on his pad. I did not even bother to make a fuss about the fish oils being Jade has only been on them for a week and I did tell him that she takes them and he said well it wouldn't hurt. He just pushed apraxia aside repeatedly so I felt he wouldn't want to listen to any of my tales of increased babbling in the last two weeks. I left feeling like I wasn't sure if I should keep giving her the oils, but I have decided that I am going to. To hell with him ! (sorry for venting) What I do know is that I heard him say developmental delays and that if she did not improve by the time she is three or four, he would call that mental retardation. After I my heart started beating again, I just started to feel like I want to know why my daughter can't talk and you are not telling me why. He also stated that he wants her tested for Fragile X, but I was told that is hereditary and I know the hospital tests you for that when you are pregnant, so I am leaning away from that. He also wants a test on chromosones and blood work done. He said they still might be able to tell me what is wrong after all of that. Can anyone tell me in an apraxic child, do you feel that the childs other abilities are more at age level? For instance, Jade doesn't follow commands, like go and bring me your shoes, go and get your cup and your shoes. He said that if her cognitive skills were at a 30 month old level and the speech was delayed, he would feel comfortable saying that it was apraxia. I asked him if her making mouth movements with no sound coming out comes from something other than apraxia, he says well that can be part of apraxia, but there is a deeper issue. The same as Amber, he was very harsh in his cognitive scoring. He said her speech was at an 8 month old level and her cognitive was at ten month old level. He said that 10 month olds should be able to get things when asked. I think that is a bit early to expect that, but hey what do I know? I am anxious to see what he is going to write in his report since he says she has nothing basically. What I am going to do is try and have the evaluation done again in New York before Jade's insurance runs out and see if that person says the same that he does. It doesn't help to hear therapist say that she is at a 2 year old level and for him to say she is barely at a one year old level. I am completely and utterly confused. So can anyone tell me if there apraxic children always function normally cognitively and fall way below in their speech? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 Thank you so much !! I really did like Dr. Myers but I knew that he was not qualified to make any " real " diagnosis on Amber (not his specialty!!). To be fair to Dr. Myers, he never brought up MR until I pushed him into telling me whether or not she was. He kept telling me that until she has the ability to take a true IQ test (both verbal and behavioral components are missing) that there was no way he could give me a difinitive answer. When I continued to ask him about kids with delays like Amber's at this age and how they faired out later in life, he said that " based on the level of consistent delays she is showing, that she does fall into the MR category " . He never documented in her files anywhere (since it wasn't a firm diagnosis) and never put that on her scripts. Her diagnosis on her scripts for insurance purposes is somethign like " severe motorplanning deficits " . He did say as she ages and continues to show significant delays, her chances of not being MR decrease (I can't remember exactly how he phrased it but that is what I walked away with). Honestly, I am not angry with him at all, because Amber does present with a lot of delays (she is also showing a receptive language delay, but a mild one-but a delay nonetheless) and I dont' think anyone can know for sure what her future holds. I look at my little girl and the way she interacts and I do get a sinking feeling that maybe she is always going to be a little " slower " , and I am ok with that (well,it took me lots of time and tears to be ok). Maybe that is why she never seemed to " surge " when on teh Pro-EFA's-maybe she is one of those kids who would have had apraxia anyway (but, I am really trying to overcome the diarhea to get her back on them-maybe since she is older I will see some improvement). Of course, I knew enough not to just blindly follow what he says (because he is not an apraxia expert) so maybe that is why I am not angry-I know enough to continue my search for answers. I guess if I were the type of parent to put my full trust into any specialist, then I would really have been screwed by seeing him. Fortunately I had already read your book and did hundreds of hours of research on my own so I knew that she had more than he was capable of diagnosing (mainly her apraxia). Not to say taht I wasn't crushed at first when I got his written report. It's just that in our area, his written reports and scripts held alot of weight in obtaining additional services from EI. He wrote EI a letter back when Amber was about two detailing how many hours of each service she needed and it was approved without question (and we got 3 additional hours of service a week). I guess I look at him as a very caring doctor who did get us what we needed at the time. I honestly can't say anything bad about him, other than the fact that he is not an apraxia specialist. I just didn't want you to think that he was throwing out the MR label without a formal test. I am the one who kept pressuring him to answer my question and just tell me his " thoughts " (and let's just say I wouldn't accept not answering me!!LOL). He did tell me that when she turned 5 that he would have a test performed on her, but I am not even going to schedule it because I am sure it won't be a test geared towards non-verbal (or extremely expressively delayed kids like Amber). I am going to wait for any formal testing until we see Dr. Agin and go from there (and I would never share any formal diagnosis of MR because of the exact reason you stated-it could be used against us in the future). But, you are definitely right and that anyone with an apraxic child does need to see someone specially trained in apraxia. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 At the appt., I was saying to myself there are different types of apraxia, but he just wrote it off so quickly. You are right, if it can get Jade more services than I am all for it, but I am going to get a second opinion also. > > Wow, does this sound like appointments with my son's first dev ped. Though he was the first one to use the word Apraxia though I don't think he really knew much about it just that it was a diagnosis that the insurance would cover speech for. Dade speech therapist gave me one of the best things to live by. Who cares if an eval comes back worse than I know he can do if it gets him more services. Dade had horrible cognitive delays but the kid didn't talk and has receptive language delays too. He is now 4. Still with delays everywhere. Global apraxia and autism(high functioning) And he know all his colors, shapes and letters. He can spell his name so he is so not MR. I've heard the don't use MR until at least 5 but more like 7 before they can say that it's not just developmental delays. > Nichole Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 Thanks , I walked away from that appointment losing all hope. I was actually saying to myself, okay if it's not autism, it's not ASD, it's not Pdd-nos, it's not apraxia, is he actually saying she is or will be mentally retarded? I remember asking him if there was a chance that Jade would ever talk if he felt she was so delayed in the areas he discussed, and he said well some children that have such a delay in cognitive delays don't. I just felt like giving up, but after reading this post again, I have hope again. I will admit that I was thrown by his thoughts and my mind was saying speak up stupid!! Ask him about severe motor planning, the different types of apraxia you see on the post, the sensory problems. I thought to myself why does my OT make such a big deal about the brushing technique, why does she say it does matter that Jade doesn't like to brush her teeth or brush her hair. These are sensory matters. WHY IS HE NOT EVEN MENTIONING THESE THINGS TO ME? WHY IS HE NOT COMMENTING ON THEM WHEN I MENTION THEM??? And you know if you are not completely sure of your thoughts, a doctor can talk circles around you. I will have lots to speak to speak about to her ST and OT when I see them next week. I asked him if there a name for what he said Jade has and he said there is not really a secific name for her delays, but he did say that if she was the same at 4 he would call that mental retardation. I was thinking to myself, I have seen posts where parents have said all that their child would say was " mmmmmmmmm " and went on to speak later, but he just wasn't interested in my thoughts in apraxia because Jade has cognitive delays. The doctor said if it were Apraxia, she would be on her age level in cognitive areas and way lower in her receptive and expressive communication. , when I asked about Dr. Agin, I in no way was trying to question her fees. I just thought that maybe the money would have gone better to private therapy than to a one time Dr's. appt., but I see why a visit to Dr. Agin would be worth it. I know that some parents that would be able to afford her fee would also be able to pay for private therapy or have better insurance than I do. How I wish I had the money to go for her three hour evaluation, viewing of video tapes of Jade's babbling and attempts to talk, etc. I wish I was able to afford the fee. I am going to send him a copy of that article you sent me and I am even going to send him my copy of the Late Talker, and tell him he better send it back ! > > Tina and -I am so sorry!!! I guess I didn't post enough the > importance of seeing not just any neuroMD -but one who has a clue. > Your examples are what happens when you see one that doesn't. > > Dr. Myers says " a child who mastered a skill should be able to > transfer teh skill to any setting. " Well the word " mastered " could > mean they overcame conditions such as apraxia or selective mutism > etc. which have separate and very real reasons why a child may not > always perform on command in " every setting " But does he know about > either of them for just two examples why a child may not transfer > skills to every setting? What if a smart child just didn't like him? > And diagnosing MR at 18 months... > or 2 years old, especially in a child with signs of a motor planning > disorder? And saying a child is not MR because she's " too social " ? > As much as I'd like to agree that some of the nasty people out there > who judge a babies cognitive ability on how much they smile are in > some way MR -don't think that's how IQ works. > > But at least even if Dr. Myers doesn't give advice you can take to > the bank -he gives you hope right? Oh wait not right... > > You say " AT her latest appointment when she was 4, he told me that > if he had > to classify her now, based on her current abilities he would give her > an MR diagnosis. He told me that as she ages it is less likely that > she would outgrow her cognitive deficit. " > > Did he know she has " severe motor planning issues " and that motor > planning has nothing to do with IQ? And do you know that if your > child is diagnosed as MR the " many services " may be there now at 4 - > but don't expect them down the road because after all (example) Mrs > , " your child is mentally retarded and no matter how much > speech therapy we give her she'll never talk " Check the archives > that is why they are there. Get rid of that MR label yesterday - or > at the latest ASAP NOW! Boy do you need another exam with a doctor > who has a clue! Let me put if this way...you say both of them > specialize in autism and ADHD -if I had a child with autism (and I > do have a child with ADHD) you wouldn't catch me taking my child to > either of them if they were the last doctors on the planet based on > what either of you wrote here. And if you are from PA -you are so > close to a slew of MDs who are very knowledgeable about apraxia, > autism, ADHD...children. > > And the increased babbling is awesome!! Don't let this > unknowledgeable doctor poorly judge your child. Second opinions for > both of your babies is my recommendation. You know not that long > ago we had a heated conversation about Dr. Agin and her fees. The > two of these doctors slams home the reason of why it's so important > to take your child to MDs who are knowledgeable. Because it's > priceless. My apologies to both of you for what you went through. > Please don't let them give up hope on your babies. I bet if either > of these MDs saw Tanner when he was a baby they would have found him > to be cognitively delayed as well since in addition to severe oral > and verbal apraxia he also had hypotonia and sensory integration > dysfunction and with his oral apraxia appeared to have no expression > most of the time (so didn't look very social) It makes me so > angry. Oh -and Tanner's in mainstream 3rd grade today and just > tested 5th grade level for math and creative writing and something > else I can't remember -visual memory recall? -and on 4th grade level > for everything else. > > Don't make assumptions about a child's learning difficulty. Here's > a recent article even saying that about a 5 year old! Wonder what > this doctor would say about what these doctors are saying about 18 > month olds with suspected apraxia! Fax this to both of their > offices and mail them a copy of The Late Talker book! > > By Dr. YVONNE FOURNIER > Scripps News Service > 26-JAN-06 > > DEAR DR. FOURNIER: My 5-year-old has been diagnosed with auditory > processing disorder. He is reading first- and second-grade books but > has difficulty understanding what is being said to him. His speech > is delayed and he has been in speech therapy. I would like to know > if there is any type of therapy to treat his problem. > > THE ASSESSMENT: When I interview parents, I am amazed at how many > can recite exactly when their children sat up, crawled, walked and > talked. In today's educated society, parents and professionals are > often on the lookout for developmental processes, knowing exactly > when each milestone should be achieved. > > The danger in setting a strict schedule of achievement is that it > can leave us with the hope that all skills have such a clear-cut > beginning and end. This " hope for " and " it's over " schedule can be > overextended into abilities that do not run on any timed schedule. > When a skill does not develop " by the book, " it is labeled a > disorder and the child is deemed developmentally delayed. > > Although many older students and adults can be accurately diagnosed > with learning differences, it is difficult to diagnose a > developmental disorder early in a child's life. It could be a delay > in your child's overall development or it could be a > delay " localized " to a specific developmental area, such as > language. It could also be a general delay, such as cognitive > function, that is masked by a more obvious one, such as speech. > > Your child may well need help with auditory processing, but it is > important to think of multiple reasons before settling on one > solution too early. > > WHAT TO DO: Think of developmental processes that could be at the > root of your child's learning difference. Start by writing a list of > possible reasons why your child cannot already do what you expect. > > Problem: " My child has difficulty understanding what is said. " > > Possible reason: My child has a speech delay. He might not have > enough language to be able to understand what is said. Solution: > Patience. > > Possible reason: My child has had many ear infections and is used to > not paying attention because of transitory hearing loss. Solution: > Tell my child to look at me when I talk to him to learn to listen. > > Possible reason: My child's speech delay might be the earliest sign > of a developmental language disorder. Solution: He might need > language therapy rather than speech therapy. > > Possible reason: My child might need more time to process what he > hears. He might need time to develop auditory processing with > expected speed. Solution: Do not expect immediate responses. > > As parents, we are blessed with the opportunity to see so many of > our children's developmental processes blossom before us. We must be > careful not to let these blossoms make us believe that the slower- > growing ones are of a different species. Only when your calm > responses do not resolve your concern, consult with a developmental > pediatrician for your next step. > > > (Write Dr. Fournier, Fournier Learning Strategies Inc., 5900 > Poplar, Memphis, Tenn. 38119. E-mail YF7thsense(at)aol.com.) > http://www.shns.com/shns/g_index2.cfm?action=detail & pk=HOMEWORK- FAM-01-26-06 > > ===== > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 Thanks , And for anyone who thinks " so what if they diagnose my child as... " autistic " " MR " or whatever just to secure services. If it's not the appropriate diagnosis it's never appropriate to secure services this way. Many of us including me had to fight the hard fight to secure services for a " speech impaired " child. It is harder -but yes even a speech impaired child is entitled to services even if some claim (lie) and say that isn't so. Push them and you'll find the truth. Below is (once again) not only an archived update from Robin about -a child also from PA misdiagnosed from early childhood as MR http://www.cherab.org/news/.html ... In addition and perhaps more important -is an article from " Dr. Bob " a school psychologist -who wrote about the appropriate way to test children with motor planning disorders. A must read and keep: You know so important -I'll post it twice " Summary of assessment procedures Children with significant language and motor skills delays E. Friedle, Ph.D. Clinical/Neuropsychologist Formalized assessment of children with low incidence disablitities does not often provide accurate or practical information about their cognitive functioning skills. Such assessmenet does provide evidence that these children often have not learned how to respond in direct one-to-one reciprocal testing situations, or that they are unable to respond in those situations due to the nature of their disabilities. The lack of response should not be considered then, necessarily, as a global and fixed delay in cognitive/intellectual potential. Developmental theorists and practitioners have long known that cognitive growth is not only enhanced, but also dependent upon opportunities to experience a wide variety of sensory stimuli in an interactive relationship. Problem solving skills, analytical reasoning, and decision-making are all formalized, cognitively, when integration of information is ongoing. Language and motor skill limitations often prevent the integration and experiences and thus certain cognitive growth waits until such experiences may be provided. Children may have learned to problem-solve and reason in ways that are not assessed by formalized evaluations and are only recognizable when the child is allowed to experience sensory information in a manner most productive to them. It is often then necessary for the examiner to assess what opportunities and experiences the child may have had already, how an assessment may prompt the child to show what they can do with various stimuli and how problem solving, analytical, and decision making skills can be exhibited by a child in a non-formalized approach. The purpose of an assessment request has to be relevant to the child and to their experiences, i.e. the child needs to see some purpose for providing a response. A very simple example of this premise is: asking them to name an object may result in no response, but asking them to get the object may show a knowledgeable response. Children with language and motor deficits often play within the restrictions that their limitations have presented and this " changed " pattern of play, from what is seen with non-disabled children, can be a direct reflection of their ability to problem solve and reason in play. An example for this may be when a child finds that laying things down and flat makes it easier to manipulate, or that moving things closer or out of the way facilitates motor planning and play. Often the child may see no purpose to expand experiences, or have not figured out independently how to change their play patterns. Restrictions in movement or language limit the experiences a child has had with objects and stimuli. The need to practice simple movements, to hear the words that go along with those movements, and then to ask a child to duplicate the movements and/or the words can greatly facilitate cognitive growth. If a child can readily make such duplicated responses then the potential for cognitive growth at that point presents no limitations. An examiner can lead the play situation in these types of activities and note the ability of the child to engage in the " play " at a different level. The purpose is then presented clearly for the child, both for the language and for the movement, and thus becomes an active part of their developmental growth and understanding. Sometimes showing them or asking them to change their approach results in a larger perspective of possibilities in play. The examiner is an active participant in the assessment approach, engaged with the child in the semi-directed play type of assessment. The examiner notes closely when a child shows a lack of understanding of the language presented or an inability to make the movements requested. At all times the examiner is assessing how well the child appears to follow the purpose of the activity or the change in direction of an activity. " kiddietalk@... From: " Ketchem " <rcketchem@...> Subject: Fwd: [ ] Re: Autism is a World ~ just nominated for an - Date: Wed, 26 Jan 2005 10:39:50 -0500 > > > Hi , > > Well we finally made it to Georgia! We are now living in the Buford > area and so far we really like the area. We are very fortunate to be > able to have begin working with Zimet a wonderful > speech therapist. Currently we are communicating by phone and e- mail > with regards to what type of program that needs > to be developed for . will be meeting next > month and reviewing the therapy program that has been working > very hard on. really is taking into consideration my > thoughts and feelings and that really makes me feel apart of the new > team that we are developing. > > > did have her day in court on August 10th for her federal > lawsuit. She was very fortunate to have a wonderful federal judge who > really understood what life had been like for her with regards to the > school district and the IU. He scheduled a presettlement conference > and held the conference in his federal court for the day. > We were asked to come to court that day with a cooperative spirit to > try and settle the case. We did just that and settled the case. It > took 8 hours in court but finally came to an agreement. We actually > let Mel tell us when she felt it was best. 's attorney kept > coming in with a different offer and the last offer he explained it to > and looked right at him and said " ok " " done " . The > attorney looked at us and we said we wanted to have closure so > she could go on with her life and we respected Mel's decision. Mel > now has a nice trust fund that will help her with her new program. It > was nice as when we went up to meet the judge he > truly did not know which one was out of our three daughters. > That really made the judge think as well. When he read the settlement > agreement into record for everyone to hear Mel just sat there very > calm and smiling. Mel knew it was over. The judge also made some > closing remarks that were very powerful for > Mel to hear. Those remarks he made that day sent a very powerful > message to Mel and our family. > > has been apart of a team of doctors doing a study on PTSD and > the individual that has PTSD and the family that supports that > individual. I was shocked to hear that is the only one home > at this time and recovering from her PTSD so nicely. The other kids > are either in group homes or are in residential > school settings with really no hopes of returning home. Mel had a > very very severe case of PTSD but with the love and support of her > family you would never know today she even has it. Every time I speak > with this set of doctors, I am more determined to try and help other > families. > > is now recovering nicely from her past experiences and > starting to move forward. has regained all of her motor > planning tasks that she lost for so many years and she is saying more > and more words. 's old personality has once again emerged and > she is happy and enjoying life each day. > is really enjoying living in Georgia away from the school > district and the IU personnel. 's doctors believe that our > moving will help one day communicate without support. Mel's > PTSD really took a large toll on Mel's motor planning and her > communication. now lives without fear > that one day someone from the school or IU is going to come and get > her like they told her so many times. > > One of the most exciting changes we have seen in is that she > now wants to join in for family game night. Our other two daughters > like to play dominoes. now has joined us in playing and she > plays without any support. She has watched us for several years now > playing but never really wanted to play. > Mel had no trouble understanding the game right when she started to > play. This proved to us that is absorbing everything thing > around her but unable to express herself due to her global apraxia but > somehow she has the power to over come her apraxia and play dominoes. > This proved to our family > that Mel has so much to offer and it is our job to help Mel overcome > her apraxia. > > We now feel is the time that Mel will really begin to move forward > with her sever global apraxia. and will make a great > team and together one day will be able to share her story with > the world and help others. We truly believe the story needs to come > from so others can be helped. > I think about all the kids that are in Mel's situation now and I truly > want help for all of them. and I will keep great notes during > 's therapy program so hopefully one day we can develop a > program that can be used for older children and adults. There are a > handful of professionals that believe > in our older children but not enough. > > I will keep you informed of Mel's progress. I truly hope one day > Mel will be communicating herself with you and you can ask Mel > questions and Mel will be able to answer them herself. I believe one > day Mel will be at that point but she has a lot of hard work ahead of > her but she also has the determination that > it will take work hard each and every day. > > does use facilitated communication and is using it once again > at home. wants to have support her thru facilitated > communication for the sole purpose of learning Mel's movement > when typing. Mel wants to develop a program that will enable > her to type without support due to > Mel's negative experience with facilitated communication and the > school district/IU personnel. I am also contacting families that > have children who are using facilitated communication and trying to > get ideas for typing without support. Mel at one point was so close > to typing without support so we hope to get > her back to that point once again. > > > I also have a new e-mail address rcketchem@... since the > move. Please e-mail with any questions you may have. > > Take care, > > Robin From: " kiddietalk " <kiddietalk@...> Date: Fri Jan 28, 2005 8:50 pm Subject: Re: & Tricia - Help with Assessment Tests Theresa there really are no tests that will 100% be perfect to test the receptive ability of a speech disabled child -at least one needs to be developed (would be nice) Also as we state in The Late Talker -tests used are important -but the professional chosen to do the testing is at times just as important. The hardcover of The Late Talker had so much cut from it because the publisher didn't want to overwhelm parents of two year old " late talkers " I agree much of the stuff for older children who truly are speech impaired is overwhelming for someone who may not even need that information who has an undiagnosed two year old child with a speech delay. We (the authors) pushed to add a bit more to the paperback version of the book -so a bit more on testing in the PB. I'll retype that part of the book from around page 44 (I unfortunately have the book and drafts on another computer right now, and type faster than it would take me to get to that one -so may be typos in my retype) " Usually the SLP uses a " standardized " speech -language test, one with " norms " based on a large sample of typically developing children. This allows the SLP to assess where your child stands compared to other children of his age. Since young children are not always cooperative in sitting through standardized tests, a more informal evaluation through play may be done. You are then given an estimate of your child's standing, based on the SLP's training, knowledge, and experience -her " informed clinical opinion. " Make sure the testing conditions work for your late talker. children with speech and expressive language impairments obviously score less well on a receptive test that requires verbal responses. It is possible to do speech and language testing for receptive ability even with children that are essentially nonverbal. In these cases, the examiner can look at other forms of functional communication, including the use of gestures, formal sign language, pictures, and augmentative communication devices. Here are the more popular language tests or scales that your SLP may use: Rossetti Infant Toddler Language Scale (birth to three years) Preschool Language Scale -3 (PLS-3) (birth to six years) Clinical Evaluation of Language Functions (CELF) -Preschool (three through six year) and CELF 3 (six through twenty one) Receptive One-Word Picture Vocabulary Test (ROWPVT) (two through eighteen years) Expressive One-Word Picture Vocabulary Test -Revised (EOWPVT) (two through twelve years) Test of Early Language Development-3 (TELD-3) (two through seven years) " And then " Two tests designed more specifically to evaluate children with motor planning disorders are the Kaufman Speech Praxis Test for Children (KSPT) and the Verbal Motor Production Assessment for Children (VMPAC) The KSPT is an assessment tool for kids age twenty- four to seventy-one months. It measures the child's imitative responses, identifying where the child breaks down in her ability to speak, and ranges from simple sounds to polysyllabic words to spontaneous connected speech. The VMPAC targets an older age group, three to twelve year olds, measuring motor speech abilities by first looking at basic processes, like breath support and muscle tone, and then moving to complex sequencing of syllables. " And from the " Visiting the Doctor " section of the chapter " Formal cognitive testing is typically performed by a licensed psychologist or neurophysiologist. Make sure that you are referred to one who is familiar with testing nonverbal or unintelligible children and that she uses age-appropriate 'nonverbal' intelligence tests, such as the Leiter-R for children two years old and up, the Kaufman Assessment Battery for Children (KABC) for children four years old and older, the Universal Nonverbal Intelligence Test (UNIT) for children five years old and above, or Comprehensive Test of Nonverbal Intelligence (CTONI) for those six and above) " And...Here is a great message on how to test children who are globally apraxic from one of our member's (Sherry) child's doctor - " Dr. Bob " You can use this in addition to what's in The Late Talker to help advocate. (Hurray for " Dr. Bob " ! The type of neuropsychologist we all would love to take our child to) " Summary of assessment procedures Children with significant language and motor skills delays E. Friedle, Ph.D. Clinical/Neuropsychologist Formalized assessment of children with low incidence disablitities does not often provide accurate or practical information about their cognitive functioning skills. Such assessmenet does provide evidence that these children often have not learned how to respond in direct one-to-one reciprocal testing situations, or that they are unable to respond in those situations due to the nature of their disabilities. The lack of response should not be considered then, necessarily, as a global and fixed delay in cognitive/intellectual potential. Developmental theorists and practitioners have long known that cognitive growth is not only enhanced, but also dependent upon opportunities to experience a wide variety of sensory stimuli in an interactive relationship. Problem solving skills, analytical reasoning, and decision-making are all formalized, cognitively, when integration of information is ongoing. Language and motor skill limitations often prevent the integration and experiences and thus certain cognitive growth waits until such experiences may be provided. Children may have learned to problem-solve and reason in ways that are not assessed by formalized evaluations and are only recognizable when the child is allowed to experience sensory information in a manner most productive to them. It is often then necessary for the examiner to assess what opportunities and experiences the child may have had already, how an assessment may prompt the child to show what they can do with various stimuli and how problem solving, analytical, and decision making skills can be exhibited by a child in a non-formalized approach. The purpose of an assessment request has to be relevant to the child and to their experiences, i.e. the child needs to see some purpose for providing a response. A very simple example of this premise is: asking them to name an object may result in no response, but asking them to get the object may show a knowledgeable response. Children with language and motor deficits often play within the restrictions that their limitations have presented and this " changed " pattern of play, from what is seen with non-disabled children, can be a direct reflection of their ability to problem solve and reason in play. An example for this may be when a child finds that laying things down and flat makes it easier to manipulate, or that moving things closer or out of the way facilitates motor planning and play. Often the child may see no purpose to expand experiences, or have not figured out independently how to change their play patterns. Restrictions in movement or language limit the experiences a child has had with objects and stimuli. The need to practice simple movements, to hear the words that go along with those movements, and then to ask a child to duplicate the movements and/or the words can greatly facilitate cognitive growth. If a child can readily make such duplicated responses then the potential for cognitive growth at that point presents no limitations. An examiner can lead the play situation in these types of activities and note the ability of the child to engage in the " play " at a different level. The purpose is then presented clearly for the child, both for the language and for the movement, and thus becomes an active part of their developmental growth and understanding. Sometimes showing them or asking them to change their approach results in a larger perspective of possibilities in play. The examiner is an active participant in the assessment approach, engaged with the child in the semi-directed play type of assessment. The examiner notes closely when a child shows a lack of understanding of the language presented or an inability to make the movements requested. At all times the examiner is assessing how well the child appears to follow the purpose of the activity or the change in direction of an activity. " And...Don't forget the proven " Rosenthal theory " I've written about! http://www.pineforge.com/newman4study/resources/rosenthal1.htm ===== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 At 09:50 AM 1/28/2006, you wrote: >. The doctor said if it were >Apraxia, she would be on her age level in cognitive areas and way >lower in her receptive and expressive communication. How does he measure cognitive areas? How does the receptive and expressive language not impact a cognitive level test? My son's SLP refuses to even look at cognitive because she feels his levels would be inaccurate due to his speech and lang levels, particularly because of his receptive delays. Miche Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 Thanks for clarifying Tina. I appreciate that you must 'really' like this doctor and perhaps what you wrote didn't present what he said exactly, or how the exam went. Perhaps he didn't want to give you false hope because your child is so severely mentally retarded and he doesn't want to give you " false hope " ? See for me -I have a son, Dakota, who was globally delayed and had a very small chance of ever being " normal " based on top neuroMDs from NJ to NY. But still - my son's doctors always gave me hope for Dakota and encouraged me to do all I could do. After all -you look back years from now and say " I tried everything to give him a chance, but I have to face reality -he's mentally retarded. " Me? I could never face that with my son at 2...or 4. Not until I helped him overcome the challenges I could help with through therapy. Dakota's page http://www.cherab.org/information/familiesrelate/workandfamily.html I do believe that as parents we kind of know things about our children before the tests -in our gut. The parent instinct they call it I guess, it's typically more on than most of us give it credit. Not that the gut instinct and the mind don't debate once a perception of the child is in writing states something we never thought prior. What was your perception of your child at 17 months old -prior to seeing any of the professionals you have taken your child to? Did anyone ever say " look how smart he is he just... " Perhaps not. Of course there are those children who are cognitively delayed in addition to having a speech impairment. It's not the norm -but yes it happens. I liked the article I just posted because it states what I so strongly believe in. In a nutshell give the child the benefit of the doubt, especially if there are delays in areas such as speech (and of course motor planning) There are of course differences between a child not doing something because he or she can't understand the command, or he or she does understand the command - but can't get his or her body to do what is wanted. Question -does your child exhibit frustrations when trying to do things or say things? See while most parents including me don't like to see our children frustrated -to me it's also a sign that they are aware of what they can't do and that's a good thing. Guess it's the silver lining to the tantrum? And speaking about parent instinct and never giving up hope and realizing that frustration (if it's there) can be a great thing -may want to read this archive: contains the really really true story (unlike the Million Little " stories " book) " The Day he knew that would be OK " From: " kiddietalk <kiddietalk@...> " <kiddietalk@...> Date: Wed Dec 25, 2002 12:35 pm Subject: Re: Proefa side effects/ " The Day he knew that would be OK " kiddietalk Dear Brock, Just wanted to jump in and say I'm sorry that you are not having a happy day today. I'm not sure why is whiney –could be lots of reasons like a cold coming on ...or ...he just realized he can't easily tell Santa what he wanted for Christmas? –which is a good thing if that is what it is. Why would I say that? I have a story to tell you that maybe will cheer you up –then I too have to get back to my relatives! My ex-boyfriend years ago was in a severe car accident on a snowy night –his friend was driving –they were just out of high school. The car went into a skid and the friend lost control of the car and it went into a snow plow. The snow plow went through the car's front window –and through 's head/eye/and taking off his ear. was rushed to the hospital -his father and mother were told that only had a 2% chance of living –and that even if he did survive – and - regained consciousness, he will be brain dead. 's parents could afford the best doctors money could buy -and that was the prognosis from all. With hope -they were told that the 'best' they could hope for was that within a year they could get a place in Kessler where -they will teach him how to put " square pegs in square holes " -I'll never forget his mother telling me this. didn't die –and went from coma –to semi coma – to months of not being able to anything for himself. He couldn't feed himself or dress himself -etc. He was allowed to -after months - go out with mom and dad once in awhile. one day 's dad –who is a teacher at FIT in NYC, told me the following story of " The Day he knew that would be OK " " I wanted to take to play golf. I knew I wasn't supposed to do that - wasn't able to do things like that yet, he couldn't even dress himself yet. It was a beautiful day though and I just wanted to take him out to smell the fresh air and just try to hit the ball around a bit. As his father -I knew what was best for him. I knew couldn't hit the ball or play golf yet -he had trouble even holding the club -but was so good at golf and really loved playing it so much before the accident -I just though this would be good for him. tried to swing the club -but he couldn't hold the club or swing it right. He kept trying though over and over. It was painful for me to watch my son like this -I was about to say let's go. All of a sudden - threw down the club and threw himself on the ground and started to cry. At this point -a tear started to roll down 's dad's face as he said the next sentence " and that's when I knew was going to be OK. " I looked at 's dad who never turned to me as he drove the car -and asked " Why? " He then looked at me and said " Because he realized he couldn't do it -and he cared -he cared so I knew he would be OK. " I met about a year after the accident at a club with my friends -around the time he was " at best " going to be trying to put square pegs into square holes. to this day is one of the best dancers you would ever meet -and was a walking personality/charm/ intelligence people magnet. He went through plastic surgery and eye surgery -but that was the minor stuff. , just like his dad thought -was OK! Since many of you may think this story is made up? His real name is L. -or L. -and he is from Upper Montclair, NJ and I've given enough details that you could check this story out -it's 100% a real life miracle -and it's hopefully a story that will inspire you Brock. and his parents know me very well -but just in case - use my maiden name - Fernandez. I have the last email you posted below -it appears there are some good things you were seeing in the first three weeks. Again -I don't know all the whys of whiney -but tears -and the present -isn't always as bad as they may appear -in fact they may be bright. I hope they are for you too. Merry Christmas! ===== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2006 Report Share Posted January 28, 2006 That's all Tanner said - " mmmmm " -and with his blank but adorable little cherub face - you've read his story either here or in The Late Talker book right? Tanner today -yes there are days he is told to " Be Quiet Tanner! " (cute face or not!) And nobody today would in their dreams call him MR...in fact some don't even know there is anything " wrong " with him -till they try to have a long conversation with him...then it's there. But it doesn't stop him from being a normal little boy. Again don't let anyone label your child with something that is not appropriate 'just' to secure services. It's one of those " come back to bite you later " things. Please do go for the second opinion -and don't worry about questioning any MD about their fees. They may be able to work something out for you. Keep that hope for your baby . And keep this email and let us all know the great news about where he is next year. ===== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 29, 2006 Report Share Posted January 29, 2006 OH I agree I diagnosing wrong is bad. I was just saying results of evaluations. I would never allow a diagnosis I didn't agree with but a poor eval is different. Especially since it can be shown to be wrong over time. Each eval usually knocks out the one before it but diagnosis's don't work that way they stay around. Nichole Mom to Dade 11/29/01 and Leia 2/7/04 ----- Original Message ----- From: kiddietalk Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2006 Report Share Posted January 30, 2006 Certainly you want to be realistic with what is going on with your child. But it seems that so many of the children with apraxia get an evaluation that incorrectly includes " cognitive delay " . ph was evaluated as moderate cognitive delay as well, with his greatest weakness being in receptive language (9-12 months) during the first evaluation at 17 months. I was devastated but wanted to be realistic. But the more I thought about it - the more I thought they were wrong about his cognitive skills. Yet there was definitely something " wrong " - I just couldn't put all the pieces together until I learned about apraxia. A motor planning problem can affect not only speech and coordination - but also the ability to get the shapes into the right puzzle spot, string beads etc - all the little tasks they look at in an evaluation. Now, no one would ever think he is MR - in fact his 6-month eval put him ahead of his age in cognitive skills - confirming our suspicion that he was in fact a very smart albeit uncoordinated little guy. Once these kids get the appropriate therapy (and omegas - if they are a responder), they take off. I remember thinking - well at least we qualify for services. You may see a completely different picture 6 months from now once appropriate therapy starts. -claudia [ ] Re: AFTER THE DEV. PED. VISIT Try not to be too upset and frustrated with the dx right now. So much can change month to month with proper therapy and biomedical intervention. Our first evaluation when our son was 2-3/4 didn't go very well. Tired, sick, scared of all the strangers. He came out pretty delayed. With therapy to help his oral and verbal apraxia as well as language issues, and OT for hypotonia and motor coordination difficulties, he is looking better and better. As his skills improve, it seems clear that some of his delays are probably due to auditory processing disorder and related receptive language problems. His teachers are so optimistic that they were " shocked " that the dev. ped. thinks he needs summer services. They claim he won't even qualify for speech by kindergarten. (He's 3-1/2 right now.) As his tone improves, his speech production improves, and so does his ability to sit in a chair and do tablework with therapists. I don't want to give false hope, but at such young ages it can be very hard to tell where the problems are coming from. As one thing improves, other problems that were previously hidden become visible. The key is to do everything you can right now to give them the best possible shot for recovery. The SLPs who work with her will be able to give you a better idea of prognosis after they've worked with her for awhile and can she how she progresses. If there are other issues, OTs, PTs, etc. will also be a great resource. The specialists aren't great at giving you the overall picture, but they can be excellent at pinpointing the problems related to their field. And check out a few other , too. 75% of the great advice I have received came from moms on the listservs. They often can point you in the right direction before the docs and therapists. For each aspect of her dx, you'll find at least one really good group out there. Good luck!!! Quote Link to comment Share on other sites More sharing options...
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