Re: Should I do more now, with my 19 month old?

[Guest guest]

,

I am a mom of a little one. 2.5 years now. At 18 months, the ST (private 1x

per week) was getting nothing from my son. Sent him to neurologist who

diagnosed w/ apraxia. My son also started to talk and then stopped, by the

way. I listed to the doctor like a good daughter of a nurse and step

daughter to a VP of a hospital. But I only waited until he was 2 thank

goodness.

At 2 I started fishoil and E. and took it further to examine my childs body

internally through labs. I also increased ST to 3x per week and included

PROMPT! Therapy, Kaufman Cards and OT.

We are now working with a DAN!

In august my son had 6-10 approximations. He now is repeating what we say,

answering questions and speaking in 4-5 word sentences. Both ST say he

really does not need it anymore. But better to be safe than sorry. This is

what is working for my son.

I encourage you to go ahead and move quickly on this. Put it at the top of

your list. I wish someone would have emailed me this when he was 18 months.

These little ones are resiliant for the most part. The sooner, the better,

the easier, the cheaper, too.

You can email me off line for my journal of my first 30 days supplimented.

Thanks,

Colleen

[ ] Should I do more now, with my 19 month old?

Hello,

I'm new to the group, and I look forward to learning more through

this group. I've read The Late Talker, and found it helpful,

although a bit scary. I'm hoping my son, 19 months, is a late talker

and doesn't have a speech disorder, although I want to help him no

matter the root issue (s).

Anyway, he has recently begun Early Intervention, with 1 hour small

group classes twice a week, and some direct 1 on 1 with the SLP as

part of that. When he was tested at 18 months, his expressive

language was at a 9-12 month range, and his pragmatic language at 6-

12 months. I also have some concerns about possible sensory

integration dysfunction, but I haven't had him evaluated yet. He was

so much of an easier baby than my daughter, who was diagnosed with

Asperger's recently, and is receiving SIT with more obvious sensory

problems.

So, I'm wondering, should we have him assessed further now, or wait

until he's 2 years old? I think that its hard to identify a speech

disorder before age 2 or 2.5 years.

Is there anything more we can do at home, beyond what we're doing?

We're teaching him some signs, repeating simple words and he makes

some simple sounds. We're also giving him fish oil daily, beginning

about 2 weeks ago.

Thanks for your ideas,

[Guest guest]

It may help to look at the speech milestone stuff Tina recently

posted. Had I seen that in our case I'd have moved faster. In your

case it may be different and deling with this at 19 months is smart.

>

> Hello,

>

> I'm new to the group, and I look forward to learning more through

> this group. I've read The Late Talker, and found it helpful,

> although a bit scary. I'm hoping my son, 19 months, is a late

talker

> and doesn't have a speech disorder, although I want to help him no

> matter the root issue (s).

>

> Anyway, he has recently begun Early Intervention, with 1 hour small

> group classes twice a week, and some direct 1 on 1 with the SLP as

> part of that. When he was tested at 18 months, his expressive

> language was at a 9-12 month range, and his pragmatic language at 6-

> 12 months. I also have some concerns about possible sensory

> integration dysfunction, but I haven't had him evaluated yet. He

was

> so much of an easier baby than my daughter, who was diagnosed with

> Asperger's recently, and is receiving SIT with more obvious sensory

> problems.

>

> So, I'm wondering, should we have him assessed further now, or wait

> until he's 2 years old? I think that its hard to identify a speech

> disorder before age 2 or 2.5 years.

>

> Is there anything more we can do at home, beyond what we're doing?

> We're teaching him some signs, repeating simple words and he makes

> some simple sounds. We're also giving him fish oil daily,

beginning

> about 2 weeks ago.

>

> Thanks for your ideas,

>

>

>

[Guest guest]

Starting ST and sign language is a really great start for a 19 month

old! I also recommend Signing Time videos to help with signs. My son

is 3 today and we started signing with him at 2. What a HUGE help!!

He now communicates more with words, but he ALWAYS falls back on a

sign when I can't figure out what word he's trying to say. Just today

he was trying to say the word shoe and I just couldn't figure it out.

After a few tries he dropped his toy, did the sign for shoe, and gave

me a look that seemed to say " sheesh mom!! " Signs have helped us

through many frustrating moments! The DVD's can be a little

expensive, but we just bought 3 a month until we completed our

collection. Fish oil and Vit E are also good places to start.

My advice would be to give these things about 5-6 months while you

watch for progress. During those 5-6 months research other options

that you might like to try at age 2. There is enough info on this

message board alone to keep you busy that long! Once you've

researched you will probably have a better idea of what you think your

next step should be. Make some decisions about what you would like to

try and what age you will try it. One of our goals/decisions is that

if we don't see significant improvement by age 4 we'll make an appt

with a DAN Dr.

By the way, my youngest son is close to your son's age. My son is

almost 17 mos. He's not talking, either, and will be having an

evaluation in March when he's 18 months. Even with all that we've

gone through with my 3 yr old I don't plan on doing much other than

therapy, sign language, and supplements until he's 2.5.

Bridget

>

> Hello,

>

> I'm new to the group, and I look forward to learning more through

> this group. I've read The Late Talker, and found it helpful,

> although a bit scary. I'm hoping my son, 19 months, is a late talker

> and doesn't have a speech disorder, although I want to help him no

> matter the root issue (s).

>

> Anyway, he has recently begun Early Intervention, with 1 hour small

> group classes twice a week, and some direct 1 on 1 with the SLP as

> part of that. When he was tested at 18 months, his expressive

> language was at a 9-12 month range, and his pragmatic language at 6-

> 12 months. I also have some concerns about possible sensory

> integration dysfunction, but I haven't had him evaluated yet. He was

> so much of an easier baby than my daughter, who was diagnosed with

> Asperger's recently, and is receiving SIT with more obvious sensory

> problems.

>

> So, I'm wondering, should we have him assessed further now, or wait

> until he's 2 years old? I think that its hard to identify a speech

> disorder before age 2 or 2.5 years.

>

> Is there anything more we can do at home, beyond what we're doing?

> We're teaching him some signs, repeating simple words and he makes

> some simple sounds. We're also giving him fish oil daily, beginning

> about 2 weeks ago.

>

> Thanks for your ideas,

>

>

>

[Guest guest]

I think the SLP should give you some ideas as to what is going on with

your child as she gets to know your child more in the EI program. That

is really great that you already have your child in therapy! I think

you are doing a great job already! Wow. At 19 months we still didn't

know my son had issues.. he didn't start intervention until nearly 3.

So this is great for your son to get such an early start. It seems

like you have everything in line.. the only thing I was curious that

might need to be checked out is hearing loss. Has your child had an

audiological exam recently? I know that even if your child passed a

hearing exam at birth hearing loss can occur at any time for a variety

of reasons. Also, even a mild to moderate hearing loss can cause

speech language delays. Also chronic ear infections or other ear

issues that are treatable can cause temporary hearing loss which

causes speech language delays.. all of which could be checked out by

an audiologist. So that may be something you want to look into (you

may have already done so) If your child had a hearing exam in the past

6 months.. then you're find I would think. (unless the delay just

popped up in that time).. So you may have already done that.. in which

case I would just say looks like you're doing great, and just keep it

up.. (which may not be what you want to hear) Sorry I couldn't offer

more help but I really think you are on top of this and hopefully very

soon your child will be making huge gains

[Guest guest]

Hi and welcome!

Since you have already read The Late Talker I know you have much of

the basics such as speech milestones and types of therapies etc.

Here's an article I wrote for Contemporary Pediatrics on things we

can do at home to stimulate speech:

http://www.contemporarypediatrics.com/contpeds/data/articlestandard/contpeds/492\

004/136315/article.pdf

Why did The Late Talker make you nervous? You say that he doesn't

have a speech impairment and it's just a simple delay. Is it that

you aren't sure of that yet? What are his signs of sensory issues.

We tend to micro analyze our children in this group but many times

there are things that " normal " kids go through too. Here's a link

about this from speechville

http://www.speechville.com/associated-disabilities/sensory-

integration-books.html

Remember the odds are in your favor that your child is 'just' a late

talker in that 75% of late talkers are just that.

but most " late talkers " with simple delays don't have DSI.

Below is an archive on more:

Re: At what age can Apraxia be diagnosed?

Hi !

If apraxia is suspected -a visit to a neurodevelopmental medical

doctor (pediatric neurologist or neuro developmental pediatrician)

is recommended.

It's true that a solid diagnosis of apraxia prior to 2 is not likely -

but oral apraxia can be diagnosed possibly before 18 months -and a

good neuroMD will be able to look for or rule out signs that what you

are seeing is or is not just a simple delay in speech. If apraxia is

suspected -it's possible the diagnosis will be " suspected apraxia "

and then therapy can begin that is appropriate for apraxia just in

case. If it ends up your child is just a late talker -the therapy is

benign/won't hurt your child. May help stimulate speech even!

Your feelings are so normal -but know that there is so much hope.

You don't have to know or do everything at once. Read The Late

Talker and read the following archives and read the rest of the

answers here (not all tonight) It's clear that you are a parent that

is out there seeking help -which tells me that your child's

fortunate! One of the lucky ones. Most of the children in this

group if you check the archives are mainstreamed in school -and many

do well in school and have lots of friends. It's not as bad as it

was -after all there are so many speech impaired children today -you

are not alone!

Below are two archives for new members with young late talkers

Re: 19 month old not talking

Hi all!

Just want to jump in and remind everyone that even with the rise in

children with speech impairments, 75% of late talkers are just that -

children that talk late. And that's with or without therapy. Thing

is that speech therapy is benign even if not needed, and may in fact

provide stimulation to encourage the speech to come in sooner even

with a simple delay.

I'm also posting because there is a large group here of parents and

professionals who were faced with children that they 'thought' was

just a late talker, or 'just' ____. What we all want isn't the

assurance from friends, relatives and even our spouse...we need to

know from a professional who is skilled at knowing the difference

between all the various reasons why your child may not talk yet at

all or as much as you'd like.

Below is an archive which clearly lets everyone know that I too

thought Tanner was " just " a late talker, and then thought he " just "

had apraxia. OK -so he had a few other things going on. Today

Tanner is a cool little 9 year old boy who continues to amaze not

just me -but those that work with him.

Again I had two " late talkers " both my boys, Dakota and Tanner. For

those say " just give him time " that are right most of the time -

since 75% of the children are just late talkers -they would have

been wrong with 50% of my children (Tanner)

We all heard about late talkers with simple delays....just like

We all know about colds with sniffles....

We all know about scrapes that need a band aid.

We don't join a grouplist to learn about colds and scrapes.

This group isn't just for apraxia -but apraxia is a condition we

need to

talk about more since there's no information just about anywhere

else and it appears to be on the rise.

At least know the warning signs and if needed, learn how to help.

Knowledge is power, and in this case, comforting.

(there is so much hope no matter what!)

Below is an archive on more:

From: " kiddietalk " <kiddietalk@...>

Date: Mon Jul 26, 2004 10:08 pm

Subject: Re: question on receptive communication delays/pure

apraxia?

Hi Gail and welcome!

Based on what you wrote it would be hard to say if your daughter has

apraxia. What are the 5 to 10 words she can say? Believe me, as one

who has been there and done that I look back now at what I

considered " words " when Tanner was three. " Ma ma mommy " was a three

word sentence to me of " Where is Mommy? " And when Tanner " learned "

my sister 's name, Aunt , we were all excited to hear him

call her " Doo doo " (we all laugh at that one today -even Tanner)

You guys that read The Late Talker have my Tanner dictionary that I

gave to the school in there, so you know what I mean!

So, how clear and how complex are the words? Does she say them

consistently the same way each time? How quick did she learn the

word? Did she ever say a word and then 'lose' it, where she

couldn't say it again? Can she imitate various sounds? Different

from needing encouragement -apraxic children want to be able to

repeat -they just can't -it's part of the disorder in that at times

the more they want to say it the more it eludes them. This is why

some will say words while you are playing chase, or while you are

pushing them on a swing -while they are not thinking about it.

Apraxia creates of problem of doing the activity 'on demand' Once a

word like " ma " is in an apraxic child's 'motor memory' they tend to

say it the same each time. It's how they learned those words, and

how complex they are.

You did give one sign of apraxia. The child's receptive ability

being ahead of the expressive ability is just one of the signs of

apraxia. Apraxia is simply a motor planning disorder. In itself

apraxia is not a cognitive or psychological behavior, even though it

can co exist with many disorders. Can a gymnast have apraxia?

Sure. Depending on what type of apraxia a child has, it may or may

not affect the child's motor abilities in movement of the body

outside of speech at all. It's wonderful that your daughter is

excelling at gymnastics because it brings her something to take

pride in that doesn't demand verbal abilities. Other children with

apraxia may enjoy karate, swimming, dance, cooking, art, etc.

I too thought Tanner was 'just' a late talker as you will read

below. We, like most, didn't notice his warning signs that were

there long before the neuroMDs and therapists spotted them. After

all, Tanner passed all his developmental milestones on time or

early. Because most apraxic children have normal receptive ability -

they are aware of what is expected of them and will push themselves

to keep up. This is why most that don't receive early intervention

will have " other symptoms " that pop up down the road when more is

expected of the child and they can't keep up.

http://www.cherab.org/information/speechlanguage/parentfriendlysoftsigns.html

Most children with apraxia today present with a delay in speech,

normal to above average receptive ability, and one or more

neurological " soft signs " such as hypotonia (low tone -weakness of

the muscle for speech or body), sensory integration dysfunction,

and/or mild

motor planning deficits in the body. Some can be so mild that they

are not obvious to most until the child reaches school age and more

is expected of them. This is the reason for a thorough

neurodevelopmental exam, so that if any signs are present you can

begin early interventions...early. If there are soft signs present

they should also be viewed as warning signs of a possible speech

impairment like apraxia. This is because most of the children today

with " multifaceted " impairments of speech like apraxia do not

have " pure " apraxia. Pure apraxia is possible, just not probable.

Re: New...not sure if I belong here or not

April welcome! There are all kind of people in this group, parents,

professionals. And the mix of children represented are those that

are 'just' late talkers to those with various diagnosis, even rare

genetic ones. I myself have two former " late talkers " Dakota and

Tanner. Both spoke late for different reasons but both did

wonderful due to early interventions. If you read The Late Talker

book I am one of the co-authors of that book. From this group some

come and go and some stick around even after their child is talking

to continue to learn and help others like you and your child! I

hope all welcome you with support and advice!

Re: What are warning signs of speech delay in 15 month old?

Hi Shilo!

There are a number of warning signs of a disorder vs. a delay of

speech. We have so many covered in The Late Talker book that I

couldn't sum them all up here -so here is just a quick one page

handout from the CHERAB website below. Thing is -they are all just

warnings -and if you notice warning signs then acting early is a

good thing. Contacting EI for an evaluation won't hurt if not

needed -and could help big time if needed. Since you have another

child with apraxia however -you do want to consider taking the late

talking serious as a precaution just in case.

The good news is that since you have an older child with apraxia you

do know many of the warning signs for down the road even though you

may not have been aware of the early signs of apraxia. (please

don't call it childhood apraxia of speech which is what CAS stands

for -it's a cool name for a 3 or 5 year old child -but you are

pushing it using the name even with a 7 year old like my son Tanner

http://www.cherab.org/information/familiesrelate/letter.html -and

forget it by the time they are 9...and insult for anyone in the

tweenie years -10-12, and not at all appropriate for those in their

teens...so just call it what it is -apraxia -or you end up with kids

that grew up like

Khalid http://www.cherab.org/information/familiesrelate/success.html

and http://www.cherab.org/news/.html and they are

stuck saying that they as teens and adults have " developmental "

or " childhood " apraxia of speech. If your child has apraxia you

know right now there is not cure -so it's a lame and mean thing to

call it something that makes it sound like our kids are mentally

retarded to childhood age in some way. OK I'm off on a tangent -

smak to me!)

Is Your Child A Late Talker?

· Are they quiet? · Seem shy? · Not talking like their peers?

· Allow you or siblings to speak for them? · Do you wonder why?

Your baby's babbling and toddlers first words can be music to your

ears. When faced with a child who doesn't speak or seems to have

difficulty with words parents are often told that their child

is " just a late-talker. " Unfortunately, all too often, that is not

the case. The American Speech and Hearing Association (ASHA)

estimates that 16 million Americans under the age of eighteen have a

chronic speech-language disorder and that some 45 million Americans

are affected by communication disorders of one kind or another which

was announded by Congresswoman Carolyn McCarthy during the kick-off

of the Better Hearing and Speech Month Health Fair in Washington, DC

on May 8, 2002 .

Most parents, and even most pediatricians, are not concerned when

faced with a two-year-old who passes all of his developmental

milestones on time - except speech and language. However, they

should be. It is vitally important to identify and treat speech and

language challenges as early as possible in a child's life, with a

strong emphasis on the early intervention years of birth to three.

At this age the brain is undergoing the most rapid development. No

harm will come from therapeutic services. " Early intervention

services are benign in their delivery but can be extremely

beneficial. Don't wait. Six months for a 2 year old is equivalent to

a quarter of their lifetime developmentally " as Dr. Judy Flax says,

who is a Research Coordinator of the Tallal Lab and a Senior

Research Speech Pathologist for the Infancy Studies Laboratory at

the Center for Molecular and Behavioral Neuroscience (CMBN) of

Rutgers University, Newark, NJ

To find out about your nearest Early Intervention program you should

call your local school district, they will be able to refer you to

the program appropriate for your child's age. Waiting to refer is a

loss of precious time that may impact on the child's learning

ability and social-emotional well being in later years.

Pediatricians and parents should insist on a speech and hearing

evaluation as soon as there is a real concern about a child's early

language development. Early referral is endorsed by the American

Academy of Pediatrics, and the American Academy of Neurology. In

addition, " any child with a severe speech/language delay should have

a comprehensive health and neurologic assessment to look for medical

conditions that may be causing or contributing to the delay " as

Dr.Marilyn Agin says, a developmental pediatrician who is the

Medical Director for Early Intervention for NYC.

CHERAB is a non-profit foundation that focuses on raising awareness

of Apraxia and other speech and language delays, and the importance

of early intervention. Working with developmental pediatricians,

speech pathologists, neuroscientists and major hospitals the CHERAB

Foundation is working towards research on therapies which may help

late talkers with Apraxia, Dysarthria, delayed language development,

Autism and other speech and language impairments. A list-serv

overseen by pediatricians, speech-language pathologists, and

educational consultants is run by CHERAB and can be found at their

web-site. Through the list you can connect to many other parents who

have children who have speech or language delays, and find out what

they have been able to do to help their child.

Some speech disorders can overlap, or be misdiagnosed. For

example, " Verbal apraxia, a disorder of central nervous system (CNS)

processing, and dysarthria, a disorder of output, are commonly

confused " , says Dr. , chief of child development at the

Chicago College of Medicine. " Experts are able to differentiate

between these two disorders by listening carefully to a child's

speech and by identifying certain physical clues " , says Dr. ,

but adds, " These disorders are poorly understood by physicians and

by a lot of speech therapists as well. " It is possible for

phonological disorders, apraxia and dysarthria to all occur together

in the same child. Speech Language Impairments, which is connected

to language based learning difficulties may also be present. And the

severity of each may vary.

Apraxia is perhaps the most misunderstood of all the speech

disorders. So, what is apraxia? Verbal Apraxia is a neurological

motor speech impairment that involves a breakdown in the

transmission of messages from the brain to the muscles in the jaw,

cheeks, lips, tongue and palate that facilitate speech. There is no

obvious weakness in these muscles and the child may well be able to

move them quite happily when not trying to speak. Apraxic children,

who are usually seen as " just late talkers " when young, are able to

comprehend language at an age appropriate level, however have

difficulty expressing themselves using speech. With apraxia, a child

knows what he wants to say but there is a road block obstructing the

signal from the brain to the mouth. For any child with a speech

disorder, but especially with apraxia, the earlier therapy is begun,

the better the results for your child and their social-emotional

development.

Your Child's Language Development

So how do you know when your child is having problems with speaking?

When is a good time to seek out help? Being aware of average speech

milestones can also help you decide whether or not to speak to your

doctor. Some guidelines are provided here for your information, but

if you have concerns about your child's speech or language

development, or any other developmental issue, make an appointment

with your pediatrician so you can discuss these issues. While the

average milestones are a good way to measure development, every

child develops at their own pace, and this overview should not be

used to diagnose a specific problem.

Normal Language Milestones - Clues of a Possible Problem

Typically seen in first 6 months

· Responds to name by looking for voice · Can regularly find speaker

or source of sound · Cooing, gurgling, chuckling, laughing ·Imitates

sounds and actions · Enjoys social games (peek-a-boo, pat-a-cake) ·

Babbling (bababa, mamama)

Cause for concern in first 6 months

· Cannot focus, easily over-stimulated · Seems unaware of sound,

Cannot find source of sound · Seems unaware of people and objects in

environment · Does not seem to understand or enjoy imitating · Lack

of connection (eye contact, vocal turn-taking)

· No babbling, or babbling with few consonants

Typically seen in first 9-12 months

· Attracts attention by vocalizing · Waves bye · Vocalizations that

sound like first words (mama,dada) · Clearly indicates desire for

objects · Imitates new sounds and actions

Cause for concern in first 9-12 months

· Easily upset by sounds that would not upset others · Lack of

response indicating comprehension of words · Lack of consistent

patterns of babbling · Does not clearly indicate desire for objects

Typically seen in first 12-18 months

· Single word production begins · Requests objects: points,

vocalizes, word approximations · Gets attention vocally or

physically (mommy) · Knows adult can do things for them (wind up a

toy) · Uses " ritual " words (bye, hi, please, thank-you)

Protests: Says no, shakes head, moves away etc) · Comments: Points

and vocalizes or uses word approximations) · Acknowledges: Eye

contact, vocal response, repetition of word

Cause for concern in first 12-18 months

· Lack of communicative gestures · Does not attempt to imitate or

produce single words

· Does not persist in communication (may hold hand up for help, but

gives up if adult does not respond immediately) · Limited

comprehension (understands less than 50 words) · Limited vocabulary

(speaks less than 10 words) · Lack of new words between the age of

12-18 months

Typically seen in first 18-24 months

· Uses mostly words to communicate · Begins to use two word

combinations (more cookie etc) · By 24 months has more than 50

words, or word approximations

Cause for concern in first 18-24 months

· Relies on gestures to communicate · Limited vocabulary (speaks

less than 50 words)

· Does not use any two word combinations · Limited consonant

production · Mostly unintelligible speech · Regresses in language

development: Stops talking, repeats phrases inappropriately

Typically seen in first 24-36 months

· Engages in short dialogues · Expresses emotions · Begins using

language in imaginative ways · Begins providing descriptive details

when speaking · Begins to use articles and word endings (a, the,

ing,) uses plurals (cats)

Cause for concern in first 24-36 months

· Words limited to single syllable and no final consonants · Few or

no multiword utterances · Does not demand a response from a listener

· Asks no questions · Speech difficult to understand · Tantrums when

frustrated · Echoing of speech without communicative intent

Adapted from Clinical Practice Guidelines Communication Disorders

III 22-25

In addition, the policy statement from the neurology journal

Neurology, (August, 2000), states that Absolute Indications for

Immediate Evaluation include,

· No babbling or pointing or other gestures by twelve months · No

single words by sixteen months · No two-word spontaneous phrases by

twenty-four months · Any loss of any language or social skills at

any age.

Oral-Motor Problems

Early feeding problems could be a sign of later speech challenges.

The same muscles that are used for eating are used for speaking. A

baby that has trouble nursing could be a early sign that the baby

has muscle weakness in the oral motor area for example. If oral-

motor difficulties are present your child should have an evaluation

by a pediatric medical and oral motor speech expert to determine the

cause and best therapy to possibly prevent some future speech

problems. A few possible signs of oral-motor problems are outlined

next.

Does your child have difficulties with any of the following?

· Blowing (unable to blow out birthday candles, or blow bubbles by

one year) · Kissing or making a kiss face · Licking his lips ·

Imitating facial expressions such as smiling · Chewing or

transitioning to solid foods · Excessive drooling

When trying to speak does your child?

· Display groping behaviors, searching for proper mouth position,

silent posturing, dysfluencies · Show expressive language

disturbances: limited vocabulary, grammatical

errors, disordered syntax · Make up sign language, or show

frustrations when not understood?

It is important to note that some children have no difficulty with

oral-motor movements, and may also pronounce speech clearly, but

still may have difficulty learning language. There are many

different types of speech and language problems, which together

represent the number one learning disabiltiy in schools today. That

is why again it is important to seek an assessment if a child is not

attaining the language milestones at the expected age. Early

intervention is key to your child's development. If you have any

concerns about your child's speech or language development be sure

to express them to your child's doctor. If you want to find out more

about early speech and language development and CHERAB's efforts to

help children with speech and language delays you can contact the

group or visit the web-site at:

CHERAB Foundation, Inc., Communication Help, Education, Research,

Apraxia Base

Web: http://www.cherab.org

Grouplist:

PO Box 8524

PSL, Florida 34952

772-335-5135

Speechville

Web: http://www.speechville.com

To find a Speech Language Pathologist near you:

American Speech-Language-Hearing Association (ASHA)

10801 Rockville Pike

Rockville, MD 20852

Phone: 1-900-638-8255

301-897-8682 (Voice or TTY)

Web: www.asha.org

Acknowledgements:

Marilyn Agin MD

Medical Director NYC Early Intervention, Advisor CHERAB Foundation

[Guest guest]

Please consider getting him evaluated now and at 2. I did that and am

ever so thankful to the dr. who said not to wait. The rest of what

you are doing sounds terrific. One thing we learned recently is that

even when my son's receptive and expressive were behind, which they

are not now, he clearly was taking in what we did as it is all coming

out now:) His memory astounds us all. Anyway, I think it is hard

sometimes to keep going when you feel like he is not getting it. Do

it anyway. Be a stalker about therapy stuff and enjoy him. That will

never hurt and will likely enhance all the rest that you are doing. I

wish you and your child only good things.

>

>

> Hi and welcome!

>

> Since you have already read The Late Talker I know you have much of

> the basics such as speech milestones and types of therapies etc.

> Here's an article I wrote for Contemporary Pediatrics on things we

> can do at home to stimulate speech:

>

>

http://www.contemporarypediatrics.com/contpeds/data/articlestandard/co

ntpeds/492004/136315/article.pdf

>

> Why did The Late Talker make you nervous? You say that he doesn't

> have a speech impairment and it's just a simple delay. Is it that

> you aren't sure of that yet? What are his signs of sensory issues.

> We tend to micro analyze our children in this group but many times

> there are things that " normal " kids go through too. Here's a link

> about this from speechville

> http://www.speechville.com/associated-disabilities/sensory-

> integration-books.html

>

> Remember the odds are in your favor that your child is 'just' a late

> talker in that 75% of late talkers are just that.

>

> but most " late talkers " with simple delays don't have DSI.

>

> Below is an archive on more:

>

> Re: At what age can Apraxia be diagnosed?

>

>

> Hi !

>

> If apraxia is suspected -a visit to a neurodevelopmental medical

> doctor (pediatric neurologist or neuro developmental pediatrician)

> is recommended.

>

> It's true that a solid diagnosis of apraxia prior to 2 is not

likely -

> but oral apraxia can be diagnosed possibly before 18 months -and a

> good neuroMD will be able to look for or rule out signs that what

you

> are seeing is or is not just a simple delay in speech. If apraxia is

> suspected -it's possible the diagnosis will be " suspected apraxia "

> and then therapy can begin that is appropriate for apraxia just in

> case. If it ends up your child is just a late talker -the therapy is

> benign/won't hurt your child. May help stimulate speech even!

>

> Your feelings are so normal -but know that there is so much hope.

> You don't have to know or do everything at once. Read The Late

> Talker and read the following archives and read the rest of the

> answers here (not all tonight) It's clear that you are a parent that

> is out there seeking help -which tells me that your child's

> fortunate! One of the lucky ones. Most of the children in this

> group if you check the archives are mainstreamed in school -and many

> do well in school and have lots of friends. It's not as bad as it

> was -after all there are so many speech impaired children today -you

> are not alone!

>

> Below are two archives for new members with young late talkers

>

> Re: 19 month old not talking

>

>

> Hi all!

>

> Just want to jump in and remind everyone that even with the rise in

> children with speech impairments, 75% of late talkers are just

that -

> children that talk late. And that's with or without therapy. Thing

> is that speech therapy is benign even if not needed, and may in fact

> provide stimulation to encourage the speech to come in sooner even

> with a simple delay.

>

> I'm also posting because there is a large group here of parents and

> professionals who were faced with children that they 'thought' was

> just a late talker, or 'just' ____. What we all want isn't the

> assurance from friends, relatives and even our spouse...we need to

> know from a professional who is skilled at knowing the difference

> between all the various reasons why your child may not talk yet at

> all or as much as you'd like.

>

> Below is an archive which clearly lets everyone know that I too

> thought Tanner was " just " a late talker, and then thought he " just "

> had apraxia. OK -so he had a few other things going on. Today

> Tanner is a cool little 9 year old boy who continues to amaze not

> just me -but those that work with him.

>

> Again I had two " late talkers " both my boys, Dakota and Tanner. For

> those say " just give him time " that are right most of the time -

> since 75% of the children are just late talkers -they would have

> been wrong with 50% of my children (Tanner)

>

> We all heard about late talkers with simple delays....just like

> We all know about colds with sniffles....

> We all know about scrapes that need a band aid.

>

> We don't join a grouplist to learn about colds and scrapes.

>

> This group isn't just for apraxia -but apraxia is a condition we

> need to

> talk about more since there's no information just about anywhere

> else and it appears to be on the rise.

>

> At least know the warning signs and if needed, learn how to help.

> Knowledge is power, and in this case, comforting.

> (there is so much hope no matter what!)

>

> Below is an archive on more:

>

> From: " kiddietalk " <kiddietalk@...>

> Date: Mon Jul 26, 2004 10:08 pm

> Subject: Re: question on receptive communication delays/pure

> apraxia?

>

>

> Hi Gail and welcome!

>

> Based on what you wrote it would be hard to say if your daughter has

> apraxia. What are the 5 to 10 words she can say? Believe me, as one

> who has been there and done that I look back now at what I

> considered " words " when Tanner was three. " Ma ma mommy " was a three

> word sentence to me of " Where is Mommy? " And when Tanner " learned "

> my sister 's name, Aunt , we were all excited to hear him

> call her " Doo doo " (we all laugh at that one today -even Tanner)

> You guys that read The Late Talker have my Tanner dictionary that I

> gave to the school in there, so you know what I mean!

>

> So, how clear and how complex are the words? Does she say them

> consistently the same way each time? How quick did she learn the

> word? Did she ever say a word and then 'lose' it, where she

> couldn't say it again? Can she imitate various sounds? Different

> from needing encouragement -apraxic children want to be able to

> repeat -they just can't -it's part of the disorder in that at times

> the more they want to say it the more it eludes them. This is why

> some will say words while you are playing chase, or while you are

> pushing them on a swing -while they are not thinking about it.

> Apraxia creates of problem of doing the activity 'on demand' Once a

> word like " ma " is in an apraxic child's 'motor memory' they tend to

> say it the same each time. It's how they learned those words, and

> how complex they are.

>

> You did give one sign of apraxia. The child's receptive ability

> being ahead of the expressive ability is just one of the signs of

> apraxia. Apraxia is simply a motor planning disorder. In itself

> apraxia is not a cognitive or psychological behavior, even though it

> can co exist with many disorders. Can a gymnast have apraxia?

> Sure. Depending on what type of apraxia a child has, it may or may

> not affect the child's motor abilities in movement of the body

> outside of speech at all. It's wonderful that your daughter is

> excelling at gymnastics because it brings her something to take

> pride in that doesn't demand verbal abilities. Other children with

> apraxia may enjoy karate, swimming, dance, cooking, art, etc.

>

> I too thought Tanner was 'just' a late talker as you will read

> below. We, like most, didn't notice his warning signs that were

> there long before the neuroMDs and therapists spotted them. After

> all, Tanner passed all his developmental milestones on time or

> early. Because most apraxic children have normal receptive ability -

> they are aware of what is expected of them and will push themselves

> to keep up. This is why most that don't receive early intervention

> will have " other symptoms " that pop up down the road when more is

> expected of the child and they can't keep up.

>

http://www.cherab.org/information/speechlanguage/parentfriendlysoftsig

ns.html

>

> Most children with apraxia today present with a delay in speech,

> normal to above average receptive ability, and one or more

> neurological " soft signs " such as hypotonia (low tone -weakness of

> the muscle for speech or body), sensory integration dysfunction,

> and/or mild

> motor planning deficits in the body. Some can be so mild that they

> are not obvious to most until the child reaches school age and more

> is expected of them. This is the reason for a thorough

> neurodevelopmental exam, so that if any signs are present you can

> begin early interventions...early. If there are soft signs present

> they should also be viewed as warning signs of a possible speech

> impairment like apraxia. This is because most of the children today

> with " multifaceted " impairments of speech like apraxia do not

> have " pure " apraxia. Pure apraxia is possible, just not probable.

>

> Re: New...not sure if I belong here or not

>

>

> April welcome! There are all kind of people in this group, parents,

> professionals. And the mix of children represented are those that

> are 'just' late talkers to those with various diagnosis, even rare

> genetic ones. I myself have two former " late talkers " Dakota and

> Tanner. Both spoke late for different reasons but both did

> wonderful due to early interventions. If you read The Late Talker

> book I am one of the co-authors of that book. From this group some

> come and go and some stick around even after their child is talking

> to continue to learn and help others like you and your child! I

> hope all welcome you with support and advice!

>

> Re: What are warning signs of speech delay in 15 month old?

>

>

> Hi Shilo!

>

> There are a number of warning signs of a disorder vs. a delay of

> speech. We have so many covered in The Late Talker book that I

> couldn't sum them all up here -so here is just a quick one page

> handout from the CHERAB website below. Thing is -they are all just

> warnings -and if you notice warning signs then acting early is a

> good thing. Contacting EI for an evaluation won't hurt if not

> needed -and could help big time if needed. Since you have another

> child with apraxia however -you do want to consider taking the late

> talking serious as a precaution just in case.

>

> The good news is that since you have an older child with apraxia you

> do know many of the warning signs for down the road even though you

> may not have been aware of the early signs of apraxia. (please

> don't call it childhood apraxia of speech which is what CAS stands

> for -it's a cool name for a 3 or 5 year old child -but you are

> pushing it using the name even with a 7 year old like my son Tanner

> http://www.cherab.org/information/familiesrelate/letter.html -and

> forget it by the time they are 9...and insult for anyone in the

> tweenie years -10-12, and not at all appropriate for those in their

> teens...so just call it what it is -apraxia -or you end up with kids

> that grew up like

> Khalid http://www.cherab.org/information/familiesrelate/success.html

> and http://www.cherab.org/news/.html and they are

> stuck saying that they as teens and adults have " developmental "

> or " childhood " apraxia of speech. If your child has apraxia you

> know right now there is not cure -so it's a lame and mean thing to

> call it something that makes it sound like our kids are mentally

> retarded to childhood age in some way. OK I'm off on a tangent -

> smak to me!)

>

> Is Your Child A Late Talker?

>

> · Are they quiet? · Seem shy? · Not talking like their peers?

> · Allow you or siblings to speak for them? · Do you wonder why?

>

> Your baby's babbling and toddlers first words can be music to your

> ears. When faced with a child who doesn't speak or seems to have

> difficulty with words parents are often told that their child

> is " just a late-talker. " Unfortunately, all too often, that is not

> the case. The American Speech and Hearing Association (ASHA)

> estimates that 16 million Americans under the age of eighteen have a

> chronic speech-language disorder and that some 45 million Americans

> are affected by communication disorders of one kind or another which

> was announded by Congresswoman Carolyn McCarthy during the kick-off

> of the Better Hearing and Speech Month Health Fair in Washington, DC

> on May 8, 2002 .

>

> Most parents, and even most pediatricians, are not concerned when

> faced with a two-year-old who passes all of his developmental

> milestones on time - except speech and language. However, they

> should be. It is vitally important to identify and treat speech and

> language challenges as early as possible in a child's life, with a

> strong emphasis on the early intervention years of birth to three.

> At this age the brain is undergoing the most rapid development. No

> harm will come from therapeutic services. " Early intervention

> services are benign in their delivery but can be extremely

> beneficial. Don't wait. Six months for a 2 year old is equivalent to

> a quarter of their lifetime developmentally " as Dr. Judy Flax says,

> who is a Research Coordinator of the Tallal Lab and a Senior

> Research Speech Pathologist for the Infancy Studies Laboratory at

> the Center for Molecular and Behavioral Neuroscience (CMBN) of

> Rutgers University, Newark, NJ

>

> To find out about your nearest Early Intervention program you should

> call your local school district, they will be able to refer you to

> the program appropriate for your child's age. Waiting to refer is a

> loss of precious time that may impact on the child's learning

> ability and social-emotional well being in later years.

> Pediatricians and parents should insist on a speech and hearing

> evaluation as soon as there is a real concern about a child's early

> language development. Early referral is endorsed by the American

> Academy of Pediatrics, and the American Academy of Neurology. In

> addition, " any child with a severe speech/language delay should have

> a comprehensive health and neurologic assessment to look for medical

> conditions that may be causing or contributing to the delay " as

> Dr.Marilyn Agin says, a developmental pediatrician who is the

> Medical Director for Early Intervention for NYC.

>

> CHERAB is a non-profit foundation that focuses on raising awareness

> of Apraxia and other speech and language delays, and the importance

> of early intervention. Working with developmental pediatricians,

> speech pathologists, neuroscientists and major hospitals the CHERAB

> Foundation is working towards research on therapies which may help

> late talkers with Apraxia, Dysarthria, delayed language development,

> Autism and other speech and language impairments. A list-serv

> overseen by pediatricians, speech-language pathologists, and

> educational consultants is run by CHERAB and can be found at their

> web-site. Through the list you can connect to many other parents who

> have children who have speech or language delays, and find out what

> they have been able to do to help their child.

>

> Some speech disorders can overlap, or be misdiagnosed. For

> example, " Verbal apraxia, a disorder of central nervous system (CNS)

> processing, and dysarthria, a disorder of output, are commonly

> confused " , says Dr. , chief of child development at the

> Chicago College of Medicine. " Experts are able to differentiate

> between these two disorders by listening carefully to a child's

> speech and by identifying certain physical clues " , says Dr. ,

> but adds, " These disorders are poorly understood by physicians and

> by a lot of speech therapists as well. " It is possible for

> phonological disorders, apraxia and dysarthria to all occur together

> in the same child. Speech Language Impairments, which is connected

> to language based learning difficulties may also be present. And the

> severity of each may vary.

>

> Apraxia is perhaps the most misunderstood of all the speech

> disorders. So, what is apraxia? Verbal Apraxia is a neurological

> motor speech impairment that involves a breakdown in the

> transmission of messages from the brain to the muscles in the jaw,

> cheeks, lips, tongue and palate that facilitate speech. There is no

> obvious weakness in these muscles and the child may well be able to

> move them quite happily when not trying to speak. Apraxic children,

> who are usually seen as " just late talkers " when young, are able to

> comprehend language at an age appropriate level, however have

> difficulty expressing themselves using speech. With apraxia, a child

> knows what he wants to say but there is a road block obstructing the

> signal from the brain to the mouth. For any child with a speech

> disorder, but especially with apraxia, the earlier therapy is begun,

> the better the results for your child and their social-emotional

> development.

>

>

> Your Child's Language Development

> So how do you know when your child is having problems with speaking?

> When is a good time to seek out help? Being aware of average speech

> milestones can also help you decide whether or not to speak to your

> doctor. Some guidelines are provided here for your information, but

> if you have concerns about your child's speech or language

> development, or any other developmental issue, make an appointment

> with your pediatrician so you can discuss these issues. While the

> average milestones are a good way to measure development, every

> child develops at their own pace, and this overview should not be

> used to diagnose a specific problem.

>

>

> Normal Language Milestones - Clues of a Possible Problem

> Typically seen in first 6 months

> · Responds to name by looking for voice · Can regularly find speaker

> or source of sound · Cooing, gurgling, chuckling, laughing ·Imitates

> sounds and actions · Enjoys social games (peek-a-boo, pat-a-cake) ·

> Babbling (bababa, mamama)

>

> Cause for concern in first 6 months

> · Cannot focus, easily over-stimulated · Seems unaware of sound,

> Cannot find source of sound · Seems unaware of people and objects in

> environment · Does not seem to understand or enjoy imitating · Lack

> of connection (eye contact, vocal turn-taking)

> · No babbling, or babbling with few consonants

>

> Typically seen in first 9-12 months

> · Attracts attention by vocalizing · Waves bye · Vocalizations that

> sound like first words (mama,dada) · Clearly indicates desire for

> objects · Imitates new sounds and actions

>

> Cause for concern in first 9-12 months

> · Easily upset by sounds that would not upset others · Lack of

> response indicating comprehension of words · Lack of consistent

> patterns of babbling · Does not clearly indicate desire for objects

>

>

>

> Typically seen in first 12-18 months

> · Single word production begins · Requests objects: points,

> vocalizes, word approximations · Gets attention vocally or

> physically (mommy) · Knows adult can do things for them (wind up a

> toy) · Uses " ritual " words (bye, hi, please, thank-you)

> Protests: Says no, shakes head, moves away etc) · Comments: Points

> and vocalizes or uses word approximations) · Acknowledges: Eye

> contact, vocal response, repetition of word

>

> Cause for concern in first 12-18 months

> · Lack of communicative gestures · Does not attempt to imitate or

> produce single words

> · Does not persist in communication (may hold hand up for help, but

> gives up if adult does not respond immediately) · Limited

> comprehension (understands less than 50 words) · Limited vocabulary

> (speaks less than 10 words) · Lack of new words between the age of

> 12-18 months

>

> Typically seen in first 18-24 months

> · Uses mostly words to communicate · Begins to use two word

> combinations (more cookie etc) · By 24 months has more than 50

> words, or word approximations

>

> Cause for concern in first 18-24 months

> · Relies on gestures to communicate · Limited vocabulary (speaks

> less than 50 words)

> · Does not use any two word combinations · Limited consonant

> production · Mostly unintelligible speech · Regresses in language

> development: Stops talking, repeats phrases inappropriately

>

> Typically seen in first 24-36 months

> · Engages in short dialogues · Expresses emotions · Begins using

> language in imaginative ways · Begins providing descriptive details

> when speaking · Begins to use articles and word endings (a, the,

> ing,) uses plurals (cats)

>

> Cause for concern in first 24-36 months

> · Words limited to single syllable and no final consonants · Few or

> no multiword utterances · Does not demand a response from a listener

> · Asks no questions · Speech difficult to understand · Tantrums when

> frustrated · Echoing of speech without communicative intent

>

> Adapted from Clinical Practice Guidelines Communication Disorders

> III 22-25

> In addition, the policy statement from the neurology journal

> Neurology, (August, 2000), states that Absolute Indications for

> Immediate Evaluation include,

> · No babbling or pointing or other gestures by twelve months · No

> single words by sixteen months · No two-word spontaneous phrases by

> twenty-four months · Any loss of any language or social skills at

> any age.

>

> Oral-Motor Problems

> Early feeding problems could be a sign of later speech challenges.

> The same muscles that are used for eating are used for speaking. A

> baby that has trouble nursing could be a early sign that the baby

> has muscle weakness in the oral motor area for example. If oral-

> motor difficulties are present your child should have an evaluation

> by a pediatric medical and oral motor speech expert to determine the

> cause and best therapy to possibly prevent some future speech

> problems. A few possible signs of oral-motor problems are outlined

> next.

>

>

>

> Does your child have difficulties with any of the following?

> · Blowing (unable to blow out birthday candles, or blow bubbles by

> one year) · Kissing or making a kiss face · Licking his lips ·

> Imitating facial expressions such as smiling · Chewing or

> transitioning to solid foods · Excessive drooling

>

> When trying to speak does your child?

> · Display groping behaviors, searching for proper mouth position,

> silent posturing, dysfluencies · Show expressive language

> disturbances: limited vocabulary, grammatical

> errors, disordered syntax · Make up sign language, or show

> frustrations when not understood?

>

> It is important to note that some children have no difficulty with

> oral-motor movements, and may also pronounce speech clearly, but

> still may have difficulty learning language. There are many

> different types of speech and language problems, which together

> represent the number one learning disabiltiy in schools today. That

> is why again it is important to seek an assessment if a child is not

> attaining the language milestones at the expected age. Early

> intervention is key to your child's development. If you have any

> concerns about your child's speech or language development be sure

> to express them to your child's doctor. If you want to find out more

> about early speech and language development and CHERAB's efforts to

> help children with speech and language delays you can contact the

> group or visit the web-site at:

>

> CHERAB Foundation, Inc., Communication Help, Education, Research,

> Apraxia Base

> Web: http://www.cherab.org

> Grouplist:

> PO Box 8524

> PSL, Florida 34952

> 772-335-5135

> Speechville

> Web: http://www.speechville.com

>

> To find a Speech Language Pathologist near you:

> American Speech-Language-Hearing Association (ASHA)

> 10801 Rockville Pike

> Rockville, MD 20852

> Phone: 1-900-638-8255

> 301-897-8682 (Voice or TTY)

> Web: www.asha.org

>

> Acknowledgements:

> Marilyn Agin MD

> Medical Director NYC Early Intervention, Advisor CHERAB Foundation

>

[Guest guest]

Dear ,

Thank you for your reply and archive posts. Thanks also to the

others who responded to my original message. I appreciate your input.

To answer your questions, I felt nervous after reading The Late

Talker primarily because we thought our son was " fine " through his

first year plus of life. We've been going through a challenging time

with our daughter, now four, and we were hoping to have a child who

didn't need special services. My husband still struggles with

accepting my daughter's special needs (she's diagnosed with

Asperger's, and has Sensory Processing Disorder or DSI, whichever

label you prefer). We pay for private OT for her, and we can't

afford to have our son in private therapy too.

As to your other question, our son does have some sensory issues. I

have many books on SPD/DSI, but I haven't gone through them to create

a checklist for our son. I discussed him with our daughter's OT

once, and she said there were some red flags there. We've had him

drinking through a straw to strengthen his oral/motor daily, and he

does some of the things we do with our daughter too.

Some of my concerns for him, without being systematic are: he craves

deep pressure (wants to be hugged and held a lot, sometimes squeezes

himself into tight spaces or requests to be " squished " between couch

cushions etc.); he resists tooth brushing, face washing and water on

his head in the bath, doesn't like swinging and other movement

sometimes. For Oral-motor: he can't blow bubbles, give a kiss or

pucker his lips, can't lick his lips, he doesn't like mixed textures

in food (e.g.spits out fruit fragments in yogurt).

He also seemed to have pretty normal development in his first year,

then lost sounds, (including mama and dada) and was pretty quiet for

about 4-5 months.

Now he makes some word approximations, but missing sounds, like " sth "

or something like that for " bath. " " oo " for a cow's moo.

So my questions are: should we seek an evaluation for Sensory

Processing Disorder from an OT and have a neurodevelopmental exam

NOW? or wait until age 2. What would be the benefit of doing this

now, since he's already in Early Intervention. I'd need to convince

my husband this is necessary in order to do it.

Thanks for your thoughts,

>

[Guest guest]

Please consider an ENT to check for fluid and read prior posts on

milk elimination considerations. Not saying this is your deal but

some of the sensory stuff sounds vesibular so the ears could be at

play. In our case the ENT and GI believe the fluid in ears was an

allergin, likely milk, and the gut stuff was a similar source and the

gut stuff caused word loss.

>

>

> Dear ,

>

> Thank you for your reply and archive posts. Thanks also to the

> others who responded to my original message. I appreciate your

input.

>

> To answer your questions, I felt nervous after reading The Late

> Talker primarily because we thought our son was " fine " through his

> first year plus of life. We've been going through a challenging

time

> with our daughter, now four, and we were hoping to have a child who

> didn't need special services. My husband still struggles with

> accepting my daughter's special needs (she's diagnosed with

> Asperger's, and has Sensory Processing Disorder or DSI, whichever

> label you prefer). We pay for private OT for her, and we can't

> afford to have our son in private therapy too.

>

> As to your other question, our son does have some sensory issues.

I

> have many books on SPD/DSI, but I haven't gone through them to

create

> a checklist for our son. I discussed him with our daughter's OT

> once, and she said there were some red flags there. We've had him

> drinking through a straw to strengthen his oral/motor daily, and he

> does some of the things we do with our daughter too.

>

> Some of my concerns for him, without being systematic are: he

craves

> deep pressure (wants to be hugged and held a lot, sometimes

squeezes

> himself into tight spaces or requests to be " squished " between

couch

> cushions etc.); he resists tooth brushing, face washing and water

on

> his head in the bath, doesn't like swinging and other movement

> sometimes. For Oral-motor: he can't blow bubbles, give a kiss or

> pucker his lips, can't lick his lips, he doesn't like mixed

textures

> in food (e.g.spits out fruit fragments in yogurt).

>

> He also seemed to have pretty normal development in his first year,

> then lost sounds, (including mama and dada) and was pretty quiet

for

> about 4-5 months.

>

> Now he makes some word approximations, but missing sounds,

like " sth "

> or something like that for " bath. " " oo " for a cow's moo.

>

> So my questions are: should we seek an evaluation for Sensory

> Processing Disorder from an OT and have a neurodevelopmental exam

> NOW? or wait until age 2. What would be the benefit of doing this

> now, since he's already in Early Intervention. I'd need to

convince

> my husband this is necessary in order to do it.

>

> Thanks for your thoughts,

>

>

>

>

>

> >

>

[Guest guest]

,

I realize money is tight. We are all facing this along with you. It is

imperative that you do get this little guy in OT and additonal ST. Get a

diagnosis. My son started to talk and then stopped like yours. Said momma,

daddy and duck. Then it went away. It was not until I got a diagnosis that

we knew how to treat him.

INSIST that EI give you at least 2 sessions a week in ST and OT. Stay on

them. My EI coordinator fired me! But I got what I wanted and new

Coordinator.

Fish oil and E helped Charlie with lip rounding. Ask your ST for exercises

to help strengthen the mouth. We had Charlie suck applesauce out of a straw.

Get pinwheels or birthday candles and have him blow them. Whistles are good

too.

Move quickly! We are here to help.

Colleen

Mother of Charlie 32 mos

[ ] Re: Should I do more now, with my 19 month

old?

Dear ,

Thank you for your reply and archive posts. Thanks also to the

others who responded to my original message. I appreciate your input.

To answer your questions, I felt nervous after reading The Late

Talker primarily because we thought our son was " fine " through his

first year plus of life. We've been going through a challenging time

with our daughter, now four, and we were hoping to have a child who

didn't need special services. My husband still struggles with

accepting my daughter's special needs (she's diagnosed with

Asperger's, and has Sensory Processing Disorder or DSI, whichever

label you prefer). We pay for private OT for her, and we can't

afford to have our son in private therapy too.

As to your other question, our son does have some sensory issues. I

have many books on SPD/DSI, but I haven't gone through them to create

a checklist for our son. I discussed him with our daughter's OT

once, and she said there were some red flags there. We've had him

drinking through a straw to strengthen his oral/motor daily, and he

does some of the things we do with our daughter too.

Some of my concerns for him, without being systematic are: he craves

deep pressure (wants to be hugged and held a lot, sometimes squeezes

himself into tight spaces or requests to be " squished " between couch

cushions etc.); he resists tooth brushing, face washing and water on

his head in the bath, doesn't like swinging and other movement

sometimes. For Oral-motor: he can't blow bubbles, give a kiss or

pucker his lips, can't lick his lips, he doesn't like mixed textures

in food (e.g.spits out fruit fragments in yogurt).

He also seemed to have pretty normal development in his first year,

then lost sounds, (including mama and dada) and was pretty quiet for

about 4-5 months.

Now he makes some word approximations, but missing sounds, like " sth "

or something like that for " bath. " " oo " for a cow's moo.

So my questions are: should we seek an evaluation for Sensory

Processing Disorder from an OT and have a neurodevelopmental exam

NOW? or wait until age 2. What would be the benefit of doing this

now, since he's already in Early Intervention. I'd need to convince

my husband this is necessary in order to do it.

Thanks for your thoughts,

>

[Guest guest]

@...: jenniferdarawi@...:

Wed, 13 Feb 2008 02:52:45 +0000Subject: [ ] Re: Should I do

more now, with my 19 month old?

Dear ,Thank you for your reply and archive posts. Thanks also to the others

who responded to my original message. I appreciate your input.To answer your

questions, I felt nervous after reading The Late Talker primarily because we

thought our son was " fine " through his first year plus of life. We've been going

through a challenging time with our daughter, now four, and we were hoping to

have a child who didn't need special services. My husband still struggles with

accepting my daughter's special needs (she's diagnosed with Asperger's, and has

Sensory Processing Disorder or DSI, whichever label you prefer). We pay for

private OT for her, and we can't afford to have our son in private therapy

too.As to your other question, our son does have some sensory issues. I have

many books on SPD/DSI, but I haven't gone through them to create a checklist for

our son. I discussed him with our daughter's OT once, and she said there were

some red flags there. We've had him drinking through a straw to strengthen his

oral/motor daily, and he does some of the things we do with our daughter

too.Some of my concerns for him, without being systematic are: he craves deep

pressure (wants to be hugged and held a lot, sometimes squeezes himself into

tight spaces or requests to be " squished " between couch cushions etc.); he

resists tooth brushing, face washing and water on his head in the bath, doesn't

like swinging and other movement sometimes. For Oral-motor: he can't blow

bubbles, give a kiss or pucker his lips, can't lick his lips, he doesn't like

mixed textures in food (e.g.spits out fruit fragments in yogurt).He also seemed

to have pretty normal development in his first year, then lost sounds,

(including mama and dada) and was pretty quiet for about 4-5 months. Now he

makes some word approximations, but missing sounds, like " sth " or something like

that for " bath. " " oo " for a cow's moo.So my questions are: should we seek an

evaluation for Sensory Processing Disorder from an OT and have a

neurodevelopmental exam NOW? or wait until age 2. What would be the benefit of

doing this now, since he's already in Early Intervention. I'd need to convince

my husband this is necessary in order to do it. Thanks for your

thoughts,>

_________________________________________________________________

Connect and share in new ways with Windows Live.

http://www.windowslive.com/share.html?ocid=TXT_TAGHM_Wave2_sharelife_012008

[Guest guest]

Hi ,

This sounds a lot like my son. He lost language (mama, dada....for a few

months.....was very quiet) when he was 14 months old. He had the oral motor

issues that you speak of (couldn't pucker, etc.....) and had similar sensory

stuff (water on the head, etc.....) and could only say parts of words (once he

began babbling again) such as /m/ for milk, /b/ for bird, etc. EI told me to

wait, but I began reading the information on the CHERAB site and finally pushed

for speech assessments. Just because you're getting some services through EI

doesn't necessarily mean that they're going to pick-up on other issues that your

son may have. For example, when we had our first EI meeting (FSP, or whatever

it's called), I mentioned to the team that my son had tons of fears, and was

literally climbing the walls. Moreover, we met in my home, and it was

completely devoid of furniture, pictures on the walls, etc....Not once did

anyone suggest an OT assessment to weed out sensory issues. It was only after

reading the Late Talker that I pushed for an OT assessment, and found out that

many of my son's " behavioral issues " were sensory issues. For us, addressing

this early has enabled my son to still " fit in " (for the most part) with his

peers. While maybe a couple of the moms may suspect something, most everyone

else just sees my son as " all boy " .....so, I guess we're still hanging in

there!!

[Guest guest]

even if it ends up that your child does have an impairment

of speech -the good news is that there is so much hope. If you check

the archives here almost all the children blend and can be

mainstreamed by kindergarten.

And you have The Late Talker so you know there are ways to get

therapy covered by insurance as well as long as you use the right

codes. I can also send out another message of other ways to secure

free or inexpensive therapy if you are interested. You could wait

for an evaluation but I would highly encourage you to go for a

neurodevelopmental exam based upon this email where you mention some

signs of oral motor problems. Can't you get that covered -the exam?

Time goes on whether we like it to or not -and to this day I

so wish I could- SO wish I could go back and get Tanner the therapy

he needed back when we first started to wonder what was wrong. As

you may know from the book or from old archives Tanner didn't have

signs of verbal apraxia as far as most knew back when because he was

completely nonverbal outside of the sound mmmm or the word ma. When

I found out that Tanner probably wanted to smile but just couldn't

(we used to call him the " serious babe " ) I cried. please

don't wait. As a mom of a child like yours- I too thought my son was

just a late talker. Tanner wasn't -but he's doing amazing today as I

just recently posted an update. And please know that the first time

he is recorded on this Talking Page is 'after' 8 months of fish oils

and therapy when he had amazing surges that were incredible to

everyone. Below in the archives is information about one

professional that witnessed Tanner when he was clearly apraxic- today

most wouldn't know outside of the professionals that work with him.

He's clearly overcome and continues to.

http://www.debtsmart.net/talk/tanner.html

And unless there is a reason that one would know of (outside of just being

a " late talker " ) most of us in this group over the years didn't pull

our child off milk. (We do drink organic or raw milk in our house)

http://www.organicconsumers.org/organic/seven052505.cfm

http://www.raw-milk-facts.com/raw_milk_health_benefits.html

There is much hope!

~~~~~~~~~~~~~~~~~~~~~~~~~start of archives

Some apraxic children " just " have verbal apraxia...but that's just

not as typical. In most cases it's not that our children don't have

other issues when they have apraxia, it's just that we don't

recognize them. I have below an archived message where you can

read 'my' first message to a grouplist (and see how I say that

Tanner is completely normal other than he's a late talker) You

just don't know what you don't know!

Besides up till a certain age, even with a diagnosis, most of us

hold the thought of " just a late talker " in our hopes -but proceed

with early intervention therapy just in case.

Hope these archives help more and welcome!

Hurray Zimet!!!!

Thu Feb 3, 2005 2:38 pm

" kiddietalk " <kiddietalk@...>

Many of you may have read 's post and not given it a thought.

Just wanted to once again brag about Zimet, Tanner's Early

Intervention therapist. used to work for Early Intervention

out of Children's Specialized Hospital in Mountainside, NJ. She is

now working for EI in Georgia -and I'm hoping she moves a bit

further south (and ask her to all the time!) Tanner is so fortunate

that he got to work with early on but he almost didn't.

Because nobody but Glenn and I took Tanner's " not talking yet "

seriously -like pulling teeth to get him in speech therapy as it

says in The Late Talker book, Tanner who was nonverbal only had

about 6

weeks of Early Intervention therapy because nobody told us he

qualified for it. In fact we were told to " wait until he's three

and then if he's still not talking we'll send him for a speech and

hearing evaluation " by his pediatrician. Tanner passed all

developmental milestones on time or early, so as far as his doctor

and the world was concerned 'there was nothing to worry about'. Not

that Tanner wasn't in therapy privately which we got to pay out of

pocket for -Tanner had been in speech therapy from around the age of

2 for around 5 months, 2-3 x a week for 30-45 minute one on one

sessions with little change. he had more facial movements -but his

only word was " ma " or " mmm " . (see first post ever I sent to another

Internet grouplist below from 1999)

I was concerned -but deep down I kept believing that Tanner would

fool everyone and " just start talking " like everyone kept telling us

he would. So as lame as Tanner's EI goal is going to sound -the

magic age for me would be 3. That was the age everyone kept

bringing up. I figured at 3 he would just start. We only had about

6 weeks of Early Intervention. Our EI goal -in writing -which was

considered a good goal by all -was that " by the time Tanner was

three -he would point to a ball and say " ba " instead of " mmm " A

week or so prior to starting the EI therapy was when we started

using an EFA formula called Efalex (ProEFA wasn't even around then)

In the LCP Solution is said the first word was after 3 weeks -but

going over old emails -it was actually 2 weeks till " lellow " When

Tanner graduated from EI, -he was doing much more than saying " ba "

when pointing to a ball -he was saying " lellow " on command to any

yellow object he could find in the house or yard -and 20 other words

too including " purple " .!!! (I remember thinking he was like Bambi

when he first learned to talk and called everything " flower " )

is " the " professional that first had witnessed Tanner's

amazing surges when put on EFAs, and dramatic regression when taken

off (because he was going to be tested for the school program and I

thought he was doing too good to get the 1/1 therapy)

This was written about in The LCP Solution as the first

story under apraxia -read it online here (third story)

http://www.drstordy.com/stories.html

is also the one that encouraged me to start the support group

that became a nonprofit Children's Apraxia Network. She helped me

find a room to have meetings at the Children's Specialized Hospital

in Mountainside, NJ Our first meeting and just about all of them

were off the charts huge!

http://www.cherab.org/news/childrenshospitalarticle.html

http://www.cherab.org/information/dietaryeffects/StarLedgerarticle.htm

l

And now there is CHERAB -and The Late Talker book -and

Speechville...thanks to Zimet who is just awesome, as we

credit her in The Late Talker (paperback edition)

is now helping as Robin just posted -how cool is

that?!

http://www.cherab.org/news/.html

Since there is much talk about newly diagnosed -misdiagnosis.

Please know there are many knowledgeable professionals out there -

like . Make sure your child is evaluated with an appropriate

diagnosis so that your child can receive appropriate therapies. And

for anyone who hasn't read it yet -below the following archive is my

first post ever. Tanner was a child diagnosed by many as " severe to

profound " apraxia. He is doing so amazing today -that he brings

hope that all can do this great. And you know the good news -most

are!

From: " kiddietalk " <kiddietalk@...>

Date: Tue Jan 6, 2004 9:56 pm

Subject: Re: Are these new developments typical of verbal apraxia?

Hi Kim!

In the early days many of us think our child is " just " a late talker-

as you can see in my first email to a grouplist below -I too thought

this of Tanner. Archives and emails are great because they give us

a timeline. When you archive Kim you will not only see how you

learned about new conditions faces -but how far he has come!

The thing about most apraxic (or communication impaired or delayed

for those who have children not diagnosed at all or as something

else) is that most have average to above average intelligence. In

other words kids like know what is expected of them and they

push themselves to do it. As they get older however, more and more

is expected of them independently, and when they can't keep up -they

begin to break down. This is why it is so important to see

knowledgeable neuroMDs when your child is young -and a good one can

diagnose young. And as I covered the other day -there are more

advanced neuroimaging techniques -so between that and genetic

testing -perhaps definitive diagnosis won't remain the crapshoot it

is today for too much longer.

I can tell you as a parent of an older apraxic child (Tanner turned

7 June 11th) that he was late to do a few things other than speech -

like potty train. Lots of parents here also stress out about late

potty training -and it was more than one neuroMD that told me that

Tanner's working hard on other issues -and may not have the muscle

control due to the hypotonia -so " give him a bit more time " Wise

advice -he potty trained late at four...but 20 years from now will

anyone care?

Please don't stress about a 5 year old who has sloppy handwriting.

Who knows where Tanner's self esteem and thus academic work and

social skills would be if he felt there was something wrong with him

because he took a bit longer to learn to write. A child in

kindergarten isn't expected to be sitting at a desk writing

sentences anyway...that isn't until first grade.

Tanner's handwriting started off early in the year horrible, but he

was just learning then. In kindergarten did I care that Tanner was

still learning how to draw lines and circles and hold a pencil

correctly? No -we and the professionals just kept working with

him.

Tanner transitioned out of OT at the end of kindergarten last year

at 6. Up till 6 years old he was still working on holding a pencil

correctly and writing with his OT due to his motor planning

problems. This was one of the main reasons that I also say there is

no way Tanner would have been ready to start kindergarten at 5 -he

would not have been ready for first grade at 6! Starting Tanner at

6 in kindergarten he was one of the top in the class...and no matter

how hard the spelling words and school assignments are each week -

Tanner is still getting straight A's in every subject -and now with

neat handwriting too.

Glenn and I never worried about Tanner catching up -he always does.

And many times Tanner doesn't just catch up -he passes others!

Tanner is a child that pushes himself and works hard to do what

others do not only when others ask him to -but because he so badly

wants to. The teacher told me early in the year that there was a

contest for children that knew how to read chapter books...this is

when Tanner was just learning to read books like Dr. Seuss Hop on

Pop. Tanner came home to me to tell me about this contest and how

much he wanted to do this. In speaking with his teacher -she too

knew how much he wanted to be part of this contest -but he wasn't

advanced enough of a reader. Tanner's going to be able to be part

of it next year -he's not yet quite up to chapter books -but coming

closer every week. And you know what -he may be behind a few others

in his advanced class -but he is doing far better than many in

public schools in first grade at this point.

Tanner takes pride in how neat his handwriting is now. I sometimes

can't even believe he wrote what he wrote it's so perfect!

As I always say in the long run is what matters. Nobody will care

twenty years from now if had neat handwriting in

preschool or it took till first or even second grade -you can always

teach those with sloppy handwriting like me to become doctors

(someone needs to write prescriptions) -or how to type. But if you

shatter a child's self esteem that's something that's hard to teach.

My suggestions other than to not worry about it? Buy things that

are fun that at the same time help with strength and motor

planning. Chunky pencils, markers and crayons are great. Don't

forget the pencil grips to help too. Clay is always

good not just for motor planning -but for working out feelings,

developing creativity. You can even get a PlayDoh Game Pen!

Last time I was in Toys R Us I think I even saw a game for younger

kids that had clay or playdoh. Or just make up your own games. Here

is a cute home game for " Playdough Pictionary " you can age down or

up.

http://lds.about.com/library/bl/games/blplaydough.htm

(the one I have may be too old for -but my boys (7 and 9)

love Cranium Cadoo where they get to make things with clay -act

things out -draw etc. Tanner is finally old enough to read some of

what he needs to with the magic glasses by himself!)

Buy arts and crafts things like SpectraColor Image Pad or even plain

old finger paints where he needs to use his fingers. And if you are

around to supervise -Shrinky Dinks is great for helping with fine

motor skills too -all the coloring and cutting and pasting etc.

Dr. Agin through her keen eye diagnosed Tanner when he was three

years old with sensory integration dysfunction, mild hypotonia, mild

motor planning issues in his body -and of course oral apraxia. His

verbal apraxia was not diagnosed until he was a bit older and

actually started to talk. Now that you know this -read the post

below which was prior to Tanner being diagnosed by Dr. Agin. In

hindsight the signs of other issues were there even when he was

younger -even the reasons why we called him " cherub boy " and " the

serious baby " -we just excused the signs away.

Here is proof you are not at all the only one that thought your child

was " just " a late talker!

Subject: Help for Tanner!

Date: Wed, 10 Mar 1999 01:52:42 -0500

From: & Glenn <shop-in-service@...>

apraxia-kids@...

References: 1

Other Parents:

Help! Our two year old son Tanner, who was born July 11, 1996, was

diagnosed today with apraxia after 4 months of speech therapy at a

hospital.

Unfortunately, before Tanner was 2, when my husband and I were

concerned about how quiet he was, our pediatrician wasn't. She

didn't see any reason for concern at that time since he was always

very bright and his comprehension was excellent. Undaunted, we

pushed to get a hearing and speech evaluation done anyway. It was

like pulling teeth! On a suggestion from Tanner's speech therapist

to get him evaluated, Tanner was also just recently accepted into the

early intervention program in our state of NJ. Tanner (whose knick

name is " Cherub Boy " since that is what he looks like) in every

other way, looks and acts normal (and has tested above average.)

Since Tanner has been going to speech therapy twice a week, he has

made great improvements on imitating basic simple sounds.

Unfortunately, other than some basic sounds he will now mimic if

prompted, he is not attempting to say words yet. For the most part

he is quiet and observant. If you say " 1, 2, 3, a, b, c " to Tanner,

he may try to imitate you, but it will be the inflection of the word

with the sound " mmmm " . Basically that and pointing is how Tanner

communicates all the time.

From the time he was a baby, and up until recently, he rarely showed

any facial expressions. Now, with the small amount of therapy he

has had, he noticeably smiles frequently and can for the first time

blow bubbles!

Around the age of one, Tanner had two episodes of Roseola with a

very high fever each time. Is there any evidence that a high fever

may cause apraxia?

Even though his hearing is normal, would a school for the deaf which

is able to teach speech to deaf children be useful to him in

addition to his other therapies?

We are new to the network and we were wondering if any other parents

or professionals in this network have any words of wisdom. We e-

mailed a local support group. It's comforting to know that this

condition has been resolved successfully by others. From what we've

read on the subject, most of the children at Tanner's age at least

try to talk, does Tanner's condition sound severe? Or, maybe a

better question, was your child, or those you work with, similar at

some point?

Just one other thing, how many e-mails can one expect to get a day

with being on the regular list?

Thanks in advance for being out there and sharing! Out of

curiosity, does

anyone know how many children have aprixia? Tanner's therapist said

it's not that common.

Best!

and Glenn "

See -so don't feel bad!

~~~~~~~~~~~~~~~~~~~~~~~end of archive

=====

[Guest guest]

We are in a similar place- Syd is now 22 months and we started this

all at her 15 month check up when her pediatrician agreed she was low

weight, probably low tone and not making the " right " sounds. I

would urge you to continue pushing for any help you can get. We just

saw a neurodevelopmental doctor and her team (4 hour appointment!)

yesterday. Everything takes so long- all the appointments etc. and

we get 1 hour of 1-1 therapy/week 1 hour group but with snow days/

holidays and illness, we often miss these so really she's not getting

regular therapy. I keep asking for more and its a runaround- EI says

they will do feeding/OT 1-1, but they can't offer more. Can't? I

don't get it. I believe part of it is her lack of an " offical "

diagnosis. So I spoke with her Neurologist who said more speech

therapy was warranted, but still nothing. Her ped said the neuro-dev

team would decide and they said medical won't cover speech because

it's not medical- it's seen as a learning problem so they leave it to

the schools! ARGH! We can not afford private speech therapy, but

after months of pushing I'm wondering if that's our only hope. Today

we're going back to the pediatrician, but for what I don't know.

We tried the dairy-free (my eldest is allergic to milk so it wasn't

hard) but saw no change.We've also done the celiac testing and all

kinds of metal/mineral testing and everything was okay. I was really

hoping for low zinc as friends of ours with very similar symptoms

found their daughter was low zinc and within a short time of

supplementing she made remarkable strides. Oh well We did, however

start fish oil and within a short time saw more mouth movement, and

she's trying to copy sounds now- which is why I feel SLP would be so

helpful right now. We'll start vit E next.