Childhood Apraxia of Speech is a motor speech disorder. For reasons not yet fully understood, children with apraxia of speech have great difficulty planning and producing the precise, highly refined and specific series of movements of the tongue, lips, jaw and palate that are necessary for intelligible speech. Apraxia of speech is sometimes called verbal apraxia, developmental apraxia of speech, or verbal dyspraxia. No matter what name is used, the most important concept is the root word "praxis." Praxis means planned movement. To some degree or another, a child with the diagnosis of apraxia of speech has difficulty programming and planning speech movements.
It's the speech condition Cooper likely has. Most of you who read our blog know that we have been taking Cooper
to speech therapy on a weekly basis for a few months. He's had his speech evaluated, what seems like a hundred, but more like five times since he turned two. He was a late talker, and I was concerned that he was still just babbling at about 26 months. The only two words that were understandable -"tree" and "cookie."
Then a miracle happened. A few months went by and Cooper had a HUGE spike in vocabulary. By about 29 months, he had started asking and answering questions. It was glorious I tell you. It was tough to understand him sometimes, and he still had a lot of baby babble when he was playing alone - but HE WAS TALKING. Relief, wonderful relief, settled over our house.
More months passed. While Cooper kept talking more and more, the structure of his sentences and the 
clarity of his words weren't improving. Chris and I could understand 90% of what he was saying, our families and close friends could understand about 50% of his words, and the rest of the world could pick up on about 20% of his sentences. No matter how much we worked with him, we realized he was falling behind again, and it was time for yet another speech evaluation.
All of our previous evaluations were done through Ohio's Early Intervention Program known as "Help Me Grow." Honestly, I wish I could pat them on the back and say "job well done", but I found them hard to deal with. They were tough to get a hold of. They missed appointments. They seemed disorganized, and all they ever wanted to talk about was autism. It was frustrating when they would give Cooper a speech evaluation and come out and say - "He doesn't have autism." I would then huffily answer "I know that. I think he has a speech delay though." It was like autism was the only disorder they knew how to diagnose. So this time, we decided to go through Columbus Speech and Hearing. We forked over the lump of cash that private evaluations cost and sure enough, they suggested that Cooper come to speech therapy once a week to work on certain letters and sounds.
Great, right? We were on the road to recovery. Another high for Chris and I!
Of course, that high ended abruptly last Monday. Chris took Cooper for his regularly scheduled appointment, but his behavior was so bad that they suggested we reschedule for Wednesday. In my typical control-freak fashion, I decided that I needed to tag along and make sure things went smoothly. I knew in order for Cooper to get any value out of these sessions, he was going to have to be receptive to it, so I made it my personal mission to make sure he was pumped up for it.
As it turns out, Cooper's therapist, had asked her supervisor, Elizabeth, to sit in on the make-up session with her to make sure Cooper got off on the right foot this time. It's pretty neat setup at CS&H. The child goes into a room with the therapist where there are toys, and bubbles and a big mirror. The mirror is actually a two-way mirror where parents can see and hear everything going on in the other room.
The session was like all the other ones I had watched, except Elizabeth kept using her fingers to almost shape Cooper's lips. At first I thought it was bizarre, but then Cooper said the words "more" and "mine" clear as I've ever heard them! He typically pronounces those words as "nore" and "nine." Cooper didn't know it, but he had his own cheering section behind the mirror. Chris and I were high fiving each other like the Buckeyes had just won the National Championship!!!
When the session ended, Elizabeth The Miracle Worker, told us the technique was something called PROMPT therapy and it's extremely successful for kids who suffer from Verbal Apraxia. It took a minute for those words to sink in. Verbal Apraxia? We had never heard of it, and when she said the word NEUROLOGICAL, I think I almost passed out. I recovered in time to hear her say that Cooper could be just fine with the right treatment, and that she would be taking him on full time as her patient.
So let's get down to the nitty gritty..... After torturing myself for the last week on the Internet, researching doctor after doctor and treatment after treatment, I think I have a good handle on what we are dealing with.....
- Verbal Apraxia is a speech disorder where the brain and the mouth have trouble connecting. It basically means that Cooper knows what he wants to say, but he has trouble getting his mouth to follow the directions of his thoughts.
- There seem to be different levels of Verbal Apraxia. I am hopeful since none of Cooper's previous evaluations have caught it, that we are on the lower level of it. We are still waiting for Elizabeth's official diagnoses, but expect it during our next session.
- Cooper is likely going to need speech therapy several times a week instead of just once a week.
- Cooper needs to see a Developmental Specialist who can rule out any other neurological problems. Also, a diagnoses from an M.D. will likely help us in the good ol' battle with the insurance company. They typically don't like to cover speech therapy. We have an appointment next Thursday at Nationwide Children's Hospital and so I have high hopes for their help. Our original appointment was scheduled for January, but I have a feeling someone pulled some strings to get us moved up. Although she won't admit it, I must tell Jane thank you being such a wonderful friend and for ALWAYS loving Cooper the way you have. You are the person who gave him the nickname Super Duper Cooper! And I love it that you are coming to his rescue this time!
- This does pose somewhat of a problem for his social skills. Many three-year-olds have a really tough time understanding him, so I think he is having some problems connecting with his peers, but there is nothing we can really do about that now. Patience is a virtue - and we will just have to be patient while the PROMPT therapy helps him learn to connect the dots between his thoughts and his words. Something that made me feel better though - Cooper's preschool is designed for kids with speech problems. So while he may be having a tough time finding buddies, other than his brother, at the park - he fits right in at school. And I think that makes him feel good.
- This speech problem is not related to his intelligence. While it is neurological, it does not impact his ability to learn, comprehend, or retain information. Cooper has all the answers to questions people ask him. He's just having trouble making his mouth say the words his head is thinking. He tries hard, but it often comes out sounding a bit jumbled. And when he's excited -it's almost inaudible for people who don't know him well. I still think he is remarkably intelligent for a kid who just turned three though. He knows all his letters, numbers, colors and shapes! He recognizes the spelling of his own name! I swear - he knows more than I did in Kindergarten.
- Cooper is a really good listener! His receptive skills are amazing. He follows directions of all kinds. Someday he is going to make a great boyfriend/husband because of all the listening he's learned to do while the rest of the world just blabs away.
- And finally, it's a true blessing that we caught this early. It's perhaps the best thing that could of come from Cooper acting like a total ass that Monday at speech class. Think about it - if he wouldn't have been so bad, then his therapist would never have asked her supervisor (Elizabeth) to come with her, and Elizabeth would have never met Cooper and recognized the signs of apraxia. It could have been another year before Cooper got the REAL help he needed. God works in mysterious ways, huh? As He would have it - Cooper is getting the help he needs EARLY. Coop is still three years away from Kindergarten, so that gives us a good chunk of time to get him where he needs to be.
So stay tuned as we anxiously await Cooper's appointment at Children's next week and also - the diagnoses from his amazing speech therapist.
If you are interested in more information - I've found http://www.apraxia-kids.org/ to be very helpful.
today was a HIDEOUS idea. His Dad thought it was SUPER COOL that Cooper wanted to try it. In the end, I lost. And considered calling Children's Services on the entire operation, until I saw Cooper's excited face. True thrill.
I think my sweet little baby has turned into the Tasmanian Devil. Don't be fooled by those big blue eyes....this bubby has mayhem on his mind.
Recent Comments