Re: Motor apraxia without verbal apraxia/auditory processing & receptive concern

[Guest guest]

In a message dated 6/18/2008 7:33:17 A.M. Central Daylight Time,

writes:

So what are the actual reasons for the concerns? When you have a

chance provide a few examples. And don't worry Sandy -many of us

have gone through this a few times and just like Dakota is an honors

student in spite of his issues which for the most part most wouldn't

know -we know how to help our children grow and overcome. Guess the

man upstairs figured out who's the best to deal with it.

Thanks for the encouragement, ! I'm trying to stay focused and not

freak out, lol!

(31 mos) tends to overstuff her mouth (as did my apraxic son), and

this resulted in a minor choking episode a few weeks back. She got spooked

(she's VERY sensitive and cautious), and right after this she refused to eat ANY

solid foods for 20 days! We finally took her to a feeding therapist (an SLP),

and incidental to this appointment (which was successful, thank goodness),

the SLP told me she had serious concerns about 's " receptive language "

and " auditory processing " skills. I was surprised, but didn't want to be in

denial, so I called EI and set up evaluations for these and also the sensory

and

motor areas (given family history of hypotonia, very late walking, sensory

issues, and motor planning issues, which, when I thought about it, I realized

might be exhibiting as well).

Anyway, the most obvious thing does is she repeats A LOT of what is

said. Especially in response to questions. She has a lot of trouble with " wh "

questions, making choices, playing games, etc. She's great with

self-generated language (uses full sentences, has a fantastic memory and thus a

fantastic

vocabulary), but has a lot of trouble with conversation skills, answering

questions, etc. She'll just repeat the words of your question back to you.

She's sweet, sociable, wants to please - but will look at you blankly and just

repeat what you say or talk about her clothes or something irrelevant if you

ask her a question or give a direction or something that she doesn't

understand. She had trouble with the puzzles and things like that too - she'd

know the

information but couldn't execute the plan (e.g., she knows her colors and

shapes, but couldn't put the colored shapes into the proper place in the

puzzle). They also felt her play skills are limited, not creative enough in her

play, etc.

Now, I don't know how much a 2 year old SHOULD be able to do. Plus, all kids

are different, and in general, my kids (like me) are late bloomers.

Compared to my other kids, she's advanced if anything. But they seem to expect a

lot

from kids this age.

Still, I do find it odd that she knows so many words, knows what they mean,

but doesn't seem to understand questions (she doesn't just repeat words

without understanding them - she DOES understand individual words, but strung

together, she seems to get lost, esp. if it's a question). If you give her

prompts

(visual or tactile) and/or rephrase, then sometimes she will understand,

which again leads me (and the therapists) to believe there is some sort of

language processing problem.

Any thoughts?? Your help (and that of this group) is VERY much appreciated!!

Sandy

Sandy, Illinois (alpy2@...)

Volunteer Webmaster, www.OurChildrenLeftBehind.com (IDEA & NCLB

reauthorization)

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[Guest guest]

Don't freak out Sandy!!

Tanner was a mouth stuffer- for him it was sensory. There are

therapies to help with this and here are just two from Tanner's one

SLP from when he was a wee bit older than your little .

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

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

With a little therapy -this too shall pass.

For sure you don't just want any SLP -but one that specializes in

oral motor therapy. As you may be aware there is apparently not just

a milk debate -but some from ASHA have started an oral motor debate.

For the record I'm pro for almost all therapy and that includes oral

motor. Besides as clueless as the insurance companies may be this is

one area that even they get over ASHA. Eating and feeding therapy is

one of the easier therapies to get coverage by insurance companies

since it's necessary for life.

I know some of your children are very advanced -so is able to

play appropriately with age appropriate toys? (on level?)

http://www.fisher-price.com/us/playstages/play.asp?lMinAge=2.00 & lMaxAge=3.00

Here's an online Dora puzzle you can make into 6 shapes and play with

her

http://www.dltk-kids.com/crafts/cartoons/puzzles/dora.htm

Here's what is considered " normal " by some:

The Two-Year- Old: Play Two-year-olds are wonderful, exciting, busy

and very demanding. They've come a long way in two years and there's

much more growing ahead! This fact sheet is designed to provide

information that might be helpful as you play with and care for the

two-year-old in your life. Toys and play Toys are important to the

growth and development of children. Because of their increase in size

and coordination, toddlers are ready to play with many toys and

materials. Through play,children use their muscles, develop their

imaginations and learn about the world around them. Some toys and

materials which delight toddlers include: For active play and physical

development:• Large hollow blocks (can be made from milk cartons with

the ends taped shut)• A wagon large enough to climb into and out of•

Small tricycles• Blocks that can be joined together• Push and pull

toys such as automobiles, trucks and trains• A " tunnel " made from a

large cardboard box• A sand pile• A large container of water with

items to float, sink and pour• Pots and pans from the kitchen For

imaginative play:• Dolls-unbreakable and washable• House play

materials: brooms, dust pans, dust cloths, mops, a table and chairs•

Unbreakable dishes• Stuffed animals For creative and constructive

play:• Play dough• Paints (nontoxic), brushes, sponge pieces, large

pieces of paper• Blunt scissors• Large wooden beads• Large crayons•

Rings pyramided on wooden pegs

http://extension.unh.edu/Family/documents/ec2_play.pdf

Also I've talked in the past much about the book The New Language of

Toys -great book for using play as therapy.

http://www.woodbinehouse.com/main.asp_Q_product_id_E_1-890627-48-8_A_.asp

As far as questions what if you keep them simple? If you ask a

question like " where's your nose? " or " where's your ears? " will she

point to her correct body part?

As far as the echoing there could be a number of reasons for it -so

for now being is just a 2 YO -don't let them assume it's

receptive just yet. Here's why from a quote from one of the two

articles below " The use of echolalia beyond the experimenter stage

was thought to be noncommunicative behavior arising from

comprehension problems. However, research within the past two decades

has revealed much about the nature and functions of echolalia, as

well as intervention strategies. " So tell that professional they are

2 decades behind but you won't assume they have a " receptive delay "

either -you'll give them the benefit of the doubt!

(as long as they'll give the benefit of the doubt too!)

Here are two articles:

Echolalia

Echolalia has two forms, immediate and delayed.

Delayed echolalia may occur days or weeks after children hear the

words or phrases.

Researchers now recognize functional uses of echolalia. It may be

used for

turn-taking,

verbal completion,

protesting, calling,

providing information

as

directives,

declaratives,

yes responses,

requests

Developing Echolalia

Into More Advanced Language

Antecedent strategies

Change the environment

Change the communication styles of the child's partners

Provide relevant language as a model

Consequential strategies

Respond to the communicative intent while providing a simple model of

appropriate language

Provide positive reinforcement for appropriate language

Strategies for Children

With VI and Echolalia

Provide additional environmental information to expose children to

rich language and concepts.

Expand on the child's language to model the next step in language

use.

Don't talk constantly—give children time to listen and process.

Include a third person in the conversation to serve as a model of

appropriate language.

Prizant & Rydell, 1993

http://www.fpg.unc.edu/~EDIN/Resources/modules/cel/3/session_files/powerpoint/CE\

L3.ppt

At What Age Should Echolalia Cease?

Kathleen Fahey Ph.D., CCC-SLP

4/10/2006

At what age should echolalia no longer be used or observed in a

child's speech?

Developmental stages are often used to characterize early language

gains made by infants and toddlers. One taxonomy is often used to

describe such stages according to descriptive categories with

associated age ranges. The examiner (1-6 months), the experimenter (7-

12 months), the explorer (12-24 months), and the exhibitor (3-5

years) captures the nature of normal language development (Owens,

2005).

During the examiner stage, infants begin communication through

responses to their environment through crying and pleasure sounds,

babbling, altering vocal pitch and volume, imitation and

experimentation of sounds. They become quite social with caregivers

and use their motor and cognitive attainments to focus, look at

people and objects, and reach and hold objects. Imitation of some

movements and sounds begins to develop at 5 or 6 months.

At about 8 or 9 months of age, within the experimenter stage, infant

social skills increase and they comprehend some words they hear

regularly. The also begin to develop variety in communication

strategies through the use of imitation of gestures, variegated

babbling, jargon and echolalia. Thus, the period between 8 and 12

months is called " the echolalic stage. " During this stage, infants

produce short utterances spoken by others exactly. They use the same

words, but also imitate the prosodic patterns. As you might imagine,

this display of linguistic knowledge is very appealing to parents and

other caregivers, thus the youngster using echolalia often receives

much attention. And, since echolalia occurs within the experimenter

stage, most youngsters try their newly found skills on all who might

listen. As children enter the one word stage and beyond, echolalia

decreases and is replaced by the child's own creative utterances.

The use of echolalia beyond the experimenter stage was thought to be

noncommunicative behavior arising from comprehension problems.

However, research within the past two decades has revealed much about

the nature and functions of echolalia, as well as intervention

strategies. Echolalic characteristics occur along a continuum of

exactness, degree of comprehension, and communicative intent. Thus,

it is necessary to understand the verbal behavior in the context of

the child's cognitive, socioemotional, and communicative environment.

Prizant and Rydell (1984, 1993) and Prizant (1987) discuss the

functional uses of delayed and immediate echolalia and provide

suggestions for intervention.

Dr. Kathleen Fahey has 28 years experience as a speech-language

pathologist. She is a professor in the Audiology and Speech-Language

Sciences program at the University of Northern Colorado. Her areas of

expertise include normal and disordered language and phonology.

http://www.speechpathology.com/askexpert/display_question.asp?question_id=168

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