Background and suspicions of apraxia in my own daughter
Apraxia has been a topic of intense interest to me, ever since I was a speech/language pathology assistant. Apraxia is misunderstood even among the SLP community. Many SLP’s learned about apraxia, but may not have the skills or experience to correctly diagnose and/or treat it. I was fortunate to have a mentor who was familiar with the disorder and who took me to a professional development workshop given by Ruth Stoeckel from the Mayo Clinic. It didn’t take long to put her therapy techniques into practice. Denver Public schools has a high rate of children living in poverty. These kids many times didn’t receive early intervention, and therefore may start speech/language therapy for the first time in Kindergarten.
I remember one boy in particular. His name was Daniel and he won my heart immediately. He had a million dollar smile that made my heart happy every time I saw him. He was sweet, friendly, playful, and funny. Unfortunately, his classmates couldn’t see what I saw because Daniel didn’t talk. His IEP read that he had a basic speech delay, but fortunately with my training I quickly realized he had apraxia. I changed his service delivery to 4 days a week and we began intense therapy sessions. Daniel was the hardest worker. He was so motivated, and despite repetitive and intense drills, he tackled them all and never once complained. By the end of that semester, his dad heard him say “hi dad” for the first time. He was so overcome with joy he cried. Daniel’s smile had never been bigger. We had practiced so long and so hard just to get those two words out and he had done it! I never realized then that 4 years later my own unborn daughter would be struggling with the same disorder.
I knew something was wrong when she didn’t babble. She smiled, cooed, and laughed, but she never babbled. Friends and family members told me I was being too picky because I was a speech/pathologist; but in my heart, I knew something wasn’t right. Despite my daily, almost nauseating dose of blowing raspberries and babbling to her, she still didn’t babble. By her first Birthday she had successfully learned the word ‘hi.’ It was by far her favorite word and the most powerful since everyone she said it to responded back to her. However, this was her only word. My colleagues reminded me you only need one word by your first Birthday, but I still had this gut feeling something was wrong. She couldn’t drink out of a straw, she had trouble even drinking out of cup, and I always feared she would choke because she didn’t chew up her food all the way sometimes either.
By the time she was 18 months, I knew she at least had a delay. Kids this age start to go through a “language explosion” adding new words to their vocabulary almost daily. Each month I waited for this milestone, and each month passed without her meeting it. By now my colleagues were starting to agree she was delayed and encouraged me to take her in. Call it pride or denial, but I just couldn’t bring myself to take her in. What would they think of me? I’m a SPEECH/LANGUAGE PATHOLOGIST for God’s sake. I must really suck at my job if my own child can’t talk. I thought these things despite knowing that a speech delay or disorder many times has no known cause. Children learn to talk even in homes where there is very little language. In fact, I tell heartsick parents daily that it is not their fault. However, I felt like my situation was different since I was an SLP. I felt I had failed her. What’s the point in having a mom who is a speech therapist if she can’t even teach you to talk.
Every day after work I would come home and work again with my own daughter. I was racked with guilt if I didn’t do therapy with her one night because I was too tired or busy. She needed me. The burden was getting so heavy and I was feeling crushed by the responsibility to not only be her mom, but her SLP as well. During this time, she did make gains. On my Spring Break, when she was almost 2 1/2, I had her requesting juice, water, and milk for the first time. I was thrilled with the breakthrough; however, her words were imprecise and not easily understood by others. I enrolled her in a nearby junior preschool so she could get language models and see other kids getting their needs met through language. My heart fell when a little boy her age walked up to us and said as clear as day, “Hi! My name is Brian. Would you like to play with me?” My poor baby could only say ‘hi.’ I started gaining a better appreciation of how my students’ parents feel.
By the time summer came around I was ready to have my second child. We worked on my summer break for an entire month, and she gained so many words; however, talking remained very difficult for her. Talking shouldn’t be so hard. Watching her grope for sounds and words gave me a real world appreciation for just how complicated talking really is. All that training in graduate school came flooding back to me. I remember my professor saying how it is a miracle any of us learn to talk at all when you consider all the muscles, nerves, and cognitive functioning that go into talking.
When my new baby came, I had no time to devote to her. She had a terrible adjustment. She was so used to getting one on one time with me everyday, and now she had none. I had mom guilt now along with the lingering guilt I felt as a speech therapist that couldn’t help my daughter talk. I was sleep deprived and exhausted. I finally decided to take her into Child Find. I knew she would qualify, but I felt like such a failure. By making that appointment, I had to accept that I had failed her.