Category: Apraxia

  • She is the definition of perseverence (a poem)

    She is the definition of perseverence (a poem)

    You went to speak, but the words wouldn’t come,
    Stuck in your brain,  so easy for some.

    You went to crawl with the best of intents,
    Yet your body didn’t know what your brain meant.

    You went to walk, big smiles and all,
    yet every time you tried, it ended with a fall.

    You went to drink from a big girl cup
    You would sputter and spit till it came up.

    A new car for Christmas kids want to ride
    Spins in circles, hard to learn how to drive.

    But

    You are a living example to persevere
    and with it you conquer all our fears.

    One day you said mommy, and I love you
    One day you crawled to daddy’s shoe.

    You don’t just walk but now you run
    You drink from any cup till it’s done.

    and I know in time you will do it all,
    with  more patience and practice
    you will conquer it all.

  • “I Will Wait” Struggles have made victory that much sweeter.

    Ashlynn’s progress continues to grow by leaps and bounds.  So many times I catch myself smiling and my eyes well up with tears to see her knock down all of her obstacles.

    Last month she learned to jump for the first time at 3 1/2.  At the beginning of the year, it broke my heart to watch her try on a classroom trampoline.  On their turn, all the other kids exuberantly bounced away.  When it was Ashlynn’s turn, all she could do was march.  Now, she is not only exuberantly bouncing, but she is catching air in my kitchen, on my patio, and even on her bed.  I was scolded for jumping on the bed, but I don’t care if she busts every spring and I have to buy  her a new one.  It’s worth it.  It’s all worth it.  Every penny spent, every happy and sad tear shed, every minute in therapy; it’s all worth it!  
    She also sang to a song that she had never heard before in the car last week.  Mumford and Son’s “I Will Wait” song was on the radio.  I was singing to it, and all of a sudden I heard her.  Her little voice filling the car with the chorus.  There are no words to describe the feeling.  I will buy the CD and put the album cover in her baby book. 
    These little triumphs, so sweet when  you have a child with a developmental delay.  She has taught me so much.  We may have had challenges, but we experience something so much sweeter when there are victories.  We appreciate all the little things so much more.  We never take for granted, not even for a second, her talking, her jumping, her SINGING.  

  • Instant connection with “Ben”

    So, I went back to work this past month.  As I was going through my new caseload and reviewing files, I came across a boy I’ll call Ben.  Ben was a nonverbal Kindergarten student in the Spanish classroom with above average intelligence.  Ben had suspected Childhood Apraxia of Speech.  The SLP who was substituting for me, wrote me an email saying, “he has no motivation or desire to communicate right now. I think he doesn’t really understand how powerful it can be for him. He can also be very sensitive and shut down at the slightest moment.”  Various assisstive technology devices had been trialed, but he showed no interest in using them beyond a therapy session.  The substitute SLP also told me the teacher hadn’t been really helpful.  I consulted with the special education teacher who also reported that Ben seems smart, but doesn’t talk in her class either, but that she keeps trying.

    Of course, I had to see Ben right away.

    I walked into the classroom and interrupted a reading group to pull him out.  The teacher, I guess not wanting to interrupt her group, snapped her finger at him toward me.  He immediately came over and hugged me.  Ben had never met me, or seen me.  Sometimes though, I think there is just an indescribable connection that occurs between two people, and this was one of them.  I instantly loved him.  We made are way down to my room and he avoided eye contact and as promised, didn’t talk.  Once we got to my room, I brought out a beach ball.  I wanted to see if he would try and imitate at least a sound, and I picked ‘b’ since that is what his name started with.  We tossed the ball back and forth for a few minutes, until I stopped and told him I wanted him to try and say ‘b.’  He whispered it, but I took it.  As we played more, we were laughing, and I kept saying “ball” and telling him to turn his voice on.  He finally did!! I high – fived him, and praised him.  He just beamed.

    I got out some simple CV Kaufman cards.  For those of you not familiar with these, these are cards designed by Nancy Kaufman, who is considered an expert in apraxia.  We started with some simple bilabials (p, b, m).  He just imitated the mouth postures at first, but I praised him and told him that was exactly how you make them.  Now he just needed to add sound.  He did shortly after.

    After I took him back to class, I decided to change up his IEP.  This kid was getting 30 minutes in the classroom and 30 minutes pullout.  I called the parents to arrange a meeting so I could see him for a short time everyday I was there.

    Ben is my little buddy.  I love picking him up.  I look forward to seeing him everyday I go to work.  I’m pretty sure he feels the same way, because when I enter his classroom his eyes shine and he waits in anticipation until I call his name and then comes running.  I promised him I’m going to help him, and I will.

    The following week, the special education teacher came running in my office after school.  She asked me what I had done to Ben.  Concerned, I hastily ask her what was wrong?  She smiled and replied, “look at this probe.”  It was a paper with upper and lower case letters arranged in varying order.  More than half of the letters had checks over them.  She informed me that a month ago, Ben didn’t attempt to say any letters or sounds, but today, he said, or at least attempted over half!!

    The next week she came in my office and told me Ben is now doing choral reading with her during group.  This means that he will attempt to read along with her simultaneously.  My heart smiled so big.  “Thatta boy Ben,” I thought, “I knew you could do it.”

    Since then, we are immersed in full on motor based therapy.  He is so motivated and I am so proud of him.  During therapy, he sometimes holds my hand and looks up at me with these shining brown eyes.  I can’t wait until he can say what he is thinking.

  • I Know an Old Lady Who Swallowed a Pie, book of the month

    I Know an Old Lady Who Swallowed a Pie, book of the month

    Product Details

    I Know an Old Lady Who Swallowed a Pie is a knockoff from the classic children’s song, “I know an old lady who swallowed a fly.” 

    This is a great repetitive book I use with the kids to get ready for Thanksgiving.  The book chronicles a lady who goes through and eats certain Thanksgiving items. 

    In therapy, I have cutouts of all the various items that the kids hold.  When it’s their turn, the visuals may serve as a reminder to help them remember their word.  At the end, my older kids are required to do a summary and may use the visuals to help them complete it.  However, that’s further down the line for Ashlynn.

    For now, I gave her the word “pie” since this another bilabial she is still mastering.  In addition, it’s also one of the speech words used in the Kaufman apraxia card set.  As before, I read the sentence, “She swallowed the cider to moisten the___, the Thanksgiving___ which was really to dry…” pausing and pointing to her visual to remind her to say the word.
    By the end of the book, she was doing great and said “pie” in the cutest voice when I would pause for her to complete the sentence.  Her daddy even stopped in the hallway the other night to listen as we were reading it before bed.

  • Omega supplements?

    If you have done any research on apraxia, Omega supplements will probably come up.  I have had my daughter on Barlean’s Omega Swirl for a little over a month now.  Though there is no definitive proof that Omega’s help speech, I chose to try it for a few reasons.
    1.) Omega supplements have been getting more attention for helping disorders of the brain.  When I was researching bipolar disorder a few years back, one of the therapies included a good Omega supplement program in place of medication.
    2.) Omega supplements are encouraged with prenatal care.  Web MD says,
    “DHA appears to be important for visual and neurological development in infants.”  Since apraxia is a neurological motor planning disorder, it certainly couldn’t hurt to have her take the supplements.
    3.) Testimonials from other mothers.  I am part of an apraxia support group on facebook, and many mothers believe the supplements have caused great gains in their child’s speech development. 

    For these reasons, I decided to try it with Ashlynn.  I have to say I have seen a jump in her speech development.  She is now attempting to say 3-4 syllable words, one of which is vitamin..lol.  Two days ago she tried to put a sentence together,  “mommy..me…go…shoes” after I told her we were going to go shopping for shoes!  This was very exciting! 

    She just started private speech therapy and has only had one session.  Otherwise, nothing has changed in our routine. 
    I am still making her request items using a carrier phrase such as “I want” and “I see” modeling and expanding her utterances, and scripting our day for her. 

    Of course, I also saw a jump in her speech before supplementation when she finally started imitating sounds, which she wouldn’t even attempt before.  So, in conclusion, have supplements helped her speech development?  I can’t say conclusively that they have, but I also can’t say that they haven’t. 

  • Private speech evaluation

    I have been antsy since the poor and disappointing experience I had in the school district.  Poor Ashlynn has once again been subjected to constant therapy all day long.  In addition, I couldn’t stop thinking that I still have a month until she starts school and therapy, and then it might be another month or more after that to “give the therapist a chance.”  We could potentially be losing two months of valuable time that she could be working on speech!

    A thought came to me in the middle of the night, when my mind was racing once again with how I could help her more; and I realized that my insurance probably covers therapy.  I discovered that it did! 

    I decided Ashlynn can’t wait.  There is so much research showing that early intervention is key, and as her mom AND as an SLP, I know she is at a prime stage in development to effect the most change.  She is open and willing to practice, and even opens the app on my iPad everyday that is just to practice speech.  We have to act NOW.  As much as I pride myself on keeping up on the current research, I am not an expert on apraxia.  You might be thinking, what did you go to school for then?  Well, let me tell you, the scope of practice for speech/language pathology is extremely vast and it grows everyday.  Let me list just a few disorders as a school based SLP I am responsible for treating:

    Articulation/Phonological disorder
    Receptive or Expressive Language Disorder
    Auditory Processing Disorder
    Stuttering
    Autism Spectrum Disorders
    Global Developmental Delay
    Cerebral Palsy
    Down’s Syndrome
    Apraxia
    Cleft lip and palate
    Velopharygeal deficiency

    This list is not exhaustive.  Basically, this list is a group of the most common disorders I see in the schools.  SLP’s are also responsible for:

    Voice disorders and pathology
    Traumatic Brain Injury
    Aphasia
    Dysphagia (swallowing disorders)
    Dysarthria

    This second list is more commonly seen in medical settings and not so much treated in the schools.

    My point in this list is to show that all SLP’s have knowledge and training in all these areas.  However, it’s much like a general practitioner.  Your primary care doctor knows a little about a lot; but if you really want an expert opinion you may choose to go to someone who specializes in just a certain part of the body.  Someone who deals with your certain condition daily and who sees a variety of types.  The field of speech/language pathology is not there yet, but there are SLP’s who choose to focus on just one or a few areas thereby becoming more of an “expert” in that particular disorder.

    In the schools, it’s pretty safe to say the SLP’s are experts in phonological, articulation, and language disorders since these are the most common disorders seen; and the average SLP will work with these disorders daily.  In addition, most school-based SLP’s are extremely knowledeable about the law as it relates to them.  However, the average school based SLP will not see as many less prevalent disorders such as apraxia or stuttering; and though qualified to treat it, may or may not be an “expert” so to speak in the disorder.   After the IEP meeting, I decided I want to get “expert” help for Ashlynn from someone who deals with apraxia daily or almost daily. 

    I took her into a private SLP yesterday who came recommended by other mommies of apraxic children.  I left the session with my mommy sense saying “yes, yes, yes!”  This is exactly who and what we need!  She was extremely knowledgeable in treating apraxia, knew and quoted all the references in the literature, and had Ashlynn working to talk the entire time!  I’m so excited not only for Ashlynn, but also for me to learn from her as I set out to become an expert in this disorder as well.