Overcoming Apraxia

Today my son lost something.  It wasn’t a favorite toy or a tooth.  It was much more important than that. He lost the diagnosis of Childhood Apraxia of Speech (CAS).

He is 3 1/2, and until today, has held a trio of diagnoses: Childhood Apraxia of Speech, Attention Deficit Hyperactivity Disorder (ADHD), and Autism Spectrum Disorder (ASD).  His speech therapist gave him a re-evaluation today, and she proudly told me we’d done it.  He can officially speak! His articulation and intelligibility are on par with typically developing children his same age.

Tears filled my eyes, and an overwhelming array of emotions filled my heart.  We don’t hear typically developing often!

My Son’s Apraxia Backstory

He was diagnosed with CAS when he was only 2 1/2 years old. CAS is a neurological speech disorder. Children with CAS have a disconnect between what the brain wants to say AND the ability to create intelligible speech.

The research says it is complicated to diagnose children with CAS as young as my son was, but it can be done.  He had so many of the symptoms: regression in speech, difficulty producing certain sounds, inconsistent speech errors, groping or struggling to “find” words, and problems imitating speech.

He also had other symptoms that often co-exist with CAS, such as fine motor skill deficits, feeding difficulties, and oral sensory issues.  The signs were all there.  The Speech-Language Pathologist gave him the diagnosis so proper therapy could begin. (Click here to read my blog Our Childhood Apraxia of Speech Journey for more information on the signs we saw and how he eventually became diagnosed.)

The Strategies and Tools We Used

Intensive Speech & Occupational Therapy

Initially, my son started intensive speech and occupational therapy, and his therapists taught us how to also help at home.  We practiced things like blowing bubbles to help him learn to push air out of his mouth and sucking through a straw to pull air back in.  We would stand in front of a mirror and make silly faces to show him different mouth and tongue positions.  During meals, we would work on sounds such as “mmm”  and lip-smacking.

Easy Does It Hand Signals for Apraxia

Kaufman Speech to Language Protocol

Teach Me to Talk with SLP Laura Mize

Word FLiPS

Rachel Coleman’s Baby Signing Time

Apraxia Kids

Another beneficial resource for us during this time was the non-profit organization apraxia-kids.org. I called and talked to them numerous times. They sent me literature, offered input on what to look for in a therapist, and their website is packed full of resources. We also attended the Walk for Apraxia and felt even more support from this wonderful organization. They gave us support, but more than anything, they gave us hope.

Overcoming Obstacles

During this time, my son also received the additional diagnoses of ADHD and ASD.  This added even more challenging layers to his communication struggles.  Because of the ADHD, he was so hyperactive and impulsive, which meant it was difficult to get the most out of therapy.  Because of the ASD, he had a receptive language delay, meaning he didn’t understand language the way a neurotypical child did.

Hurdle, after hurdle, was being tossed our way.   Nonetheless, we all kept up the hard work.  We kept pushing forward.

Mand Training through ABA

After he received the diagnosis of ASD, my son started a full-time Applied Behavior Analysis program.  Part of his ABA therapy is what is called “Mand Training.”  Most children with ASD have communication issues.  Mand Training doesn’t specifically target the ability to speak, but rather the attempt at using language to request. For example, before Mand Training, my son would grab my hand and bring me to show what he wanted.  If he wanted milk, he’d bring me to the fridge.

Using Mand Training meant he’d have to use language to request.  Once we’d get to the refrigerator, I’d wait for him to say milk.  If he didn’t, I’d prompt him.  Eventually, we moved to 3-word mands.  If he’d say and/or sign simply “milk,” I’d tell him to say, “I want milk.”  Even if it were unintelligible, he’d get the reward for the attempt.

The speech therapy was helping him gain the ability to speak, while the Mand Training was giving him a reason to learn.

The Outcome

There was no one miracle tool, therapy technique, iPad app, or program that got us to where we are today.  It was the dedication of a team of therapists, his parents, the support of the non-profit organization, and, most importantly, my son’s hard work.

My son overcame CAS at an age when most children are just receiving the diagnosis.

The main points here:

• Push for a diagnosis
• Get your child early intervention
• Don’t put all your faith in a one program approach

I truly believe that early intervention and our multifaceted approach is what helped him overcome CAS.

Moving Forward

Now our good news doesn’t mean the hard work is over, far from it.  My son CAN speak, but he still has lagging communication and conversational skills.  We are working on those in ABA therapy and at home.

However, seeing what he has already overcome gives me the hope that he can and will conquer any obstacle that comes his way.  He will, as I often say, burst through the ceiling of his disabilities, into the universe of his abilities.

I’m not telling you it’s going to be easy – I’m telling you it’s going to be worth it. – Art Williams