Could It Be Apraxia?

The first thing any modern parent does when concerned about his or her child’s communication development is get on the internet. Of course. You can’t call a speech therapist in the middle of the night but Google is always on call. Good idea? Maybe. But usually not. One of the challenges with childhood speech and language disorders is that they tend to have rather broad names such as “receptive and expressive language disorder” or “articulation disorder” and it can be hard to find very specific information.  Unless you land on one (or both) of the A’s: Autism or Apraxia.  If you find yourself on the subject of either Apraxia or Autism, you will find tons and tons of information in the form of parenting forums, red flags websites, personal stories, and a few very good, reliable sites. It’s easy to remember those names and even easier to decide that your child probably has it.  Nearly all of the parents I meet who bring in their late-talking toddlers ask me about apraxia. Could it be apraxia? How do you know if it is? How do you know if it isn’t? are all common, and understandable questions. With a big-A name, Apraxia can sound incredibly scary to parents. Fortunately, we have a lot of great knowledge and tools to help children with childhood apraxia of speech become great communicators with clear speech.

Apraxia is a complex disorder which is equally complicated to explain. Rather than re-invent the wheel here, I am going to direct you to one of my favorite blogs, Mommy Speech Therapy, where speech-language pathologist April Vogt, has clearly and eloquently explained childhood apraxia of speech in her post What is Apraxia?

These are some of the early signs that a child could have apraxia (from ASHA.org):

  • Does not coo or babble as an infant
  • First words are late, and they may be missing sounds
  • Only a few different consonant and vowel sounds
  • Problems combining sounds; may show long pauses between sounds
  • Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
  • May have problems eating
Older children may:
  • Make inconsistent sound errors that are not the result of immaturity
  • Understand language much better than he or she can talk
  • Have difficulty imitating speech, but imitated speech is more clear than spontaneous speech
  • Appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
  • Have more difficulty saying longer words or phrases clearly than shorter ones
  • Appear to have more difficulty when he or she is anxious
  • Be hard to understand, especially for an unfamiliar listener
  • Sound choppy, monotonous, or stresses the wrong syllable or word

 

Therapy Tip: Helping a Child Respond to His Name

Helping a child learn to respond to his name is often one of the long-term objectives of children with autism spectrum disorders. The social motivation to respond when called may be diminished or lacking. Here are some tips for facilitating response to name:

  • Call the child’s name with a purpose. Avoid calling his name just to “test” his responsiveness. Call his name to get his attention for something he will enjoy.
  • Use high-interest toys and activities to “reward” your child with when he responds. For example, call his name and when he looks, blow a bunch of bubbles. Tickle him, shower him with kisses or give him a cookie – anything that will make him happy!

The combination of calling a child’s name with a purpose and making that purpose be for his enjoyment, will help the child develop a positive association with responding to his name.  In time, responding to his name will become increasingly automatic.