What is Apraxia?

So what is Apraxia anyway?

WHAT IS APRAXIA? Apraxia is a motor-planning disorder where the brain has a hard time coordinating muscle movements. Apraxia can be verbal, impacting an individual's ability to speak, or global, which impacts all physical movement. It does not impact an individual's ability to THINK or to UNDERSTAND, but does impact their ability to coordinate movement.

WHAT CAUSES APRAXIA? Apraxia can be acquired by a brain injury, such as an accident or a stroke, or can be congenital, meaning present from birth. Childhood apraxia of speech is congenital and the specific cause is unknown.

WHAT ARE SOME SIGNS/SYMPTOMS OF APRAXIA?
Signs in a very young child:
- 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
- May have problems eating

Signs in an older child:
- Makes inconsistent sound errors that are not the result of immaturity
- Can understand language much better than he or she can talk
- Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
- May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
- Has more difficulty saying longer words or phrases clearly than shorter ones
- Appears to have more difficulty when he or she is anxious or tired
- Is hard to understand, especially for an unfamiliar listener
- Sounds choppy, monotonous, or stresses the wrong syllable or word

Potential other problems:
- Delayed language development
- Other expressive language problems like word order confusions and word recall
- Difficulties with fine motor movement/coordination
- Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like toothbrushing or crunchy foods, may not be able to identify an object in their mouth through touch)
- Children with CAS or other speech problems may have problems when learning to read, spell, and write

WILL A CHILD GROW OUT OF APRAXIA? NO. A child with apraxia will not simply start speaking as they get older. A child with apraxia needs specific and intensive therapy in order to learn to coordinate the movement necessary to produce understandable speech.

WHAT IS THE TREATMENT FOR APRAXIA? Frequent and intensive speech therapy by an SLP experienced with this disorder is needed for a child with apraxia. Don't expect rapid improvement - progress for a child with apraxia is a marathon, not a sprint. However, many children with apraxia make SIGNIFICANT improvement with adequate therapy and early intervention.

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Xander has Childhood Apraxia of Speech (CAS) with a sensory processing disorder. He CAN run, walk, eat, draw, and do anything else that involves physical movement but he can't talk well. 

We started speech therapy once a week for an hour as mentioned in the previous post. Angela, our speech therapist, was amazing. She understood Xander and how he worked. See, at the time, I thought my boy was just extremely shy and stubborn. While he is those things regarding new settings, when it came to talking, that wasn't the case. Xander was and is a perfectionist. He knows he can't talk right so when you say, "Xander, can you say cat?" He'd immediately shake his head no and withdraw. We were having temper tantrum after temper tantrum because we couldn't figure out what he wanted. We all were so frustrated and angry.

Then Angela showed me that he wasn't refusing to say a word because he just didn't feel like it. He was refusing because he KNOWS he can't say it right. He was feeling all the pressure, tension, and anger that we were feeling and he didn't want to fail....again. Can you imagine? 

So Angela taught us the "back door approach," as we called it. Instead of asking, "Can you say...?" We changed it to, "Can you remind me how to say this?" while pointing at a picture of a bee. It takes the pressure off, shows him that we aren't perfect either, and gives him the opportunity to help us!

We also got serious about sign language. We noticed Xander loved sign language. He wouldn't try to learn the signs with us, but I would catch him hours later practicing or he'd come up to me and just start using the sign.

A lot of people thought our speech therapy sessions were only for Xander. They weren't. They were for me too. Angela took her time with me, teaching me signs, routines, games, and techniques to use through out the week with Xander. While she did work with him, she worked with me a lot. She showed me signs over and over. She gave me resources to look at online to study up on Apraxia and how it affects Xander. She gave me a way to fight back against Apraxia and help Xander as much as I could. 

She also told me that while Xander would improve it was going to be a long, rewarding, tiring, and trying road but in the end it would be well worth it! So I started looking up signs as we came across them to use in our daily life. I bought books about Apraxia and looked into supplements to help Xander. I didn't have to idly sit by and watch him struggle. No, he couldn't talk, and he would have to struggle with that, but I could find other ways to help him.

Family members would ask me when Xander was expected to talk. He looks like a normal kid. His "special needs" aren't visible to the world. I would explain that there's no way to tell, he could be 7 and still not talking, but in my head I'd be thinking, "Oh, when he turns 2." Then, "Oh, when he turns 3." Every birthday I've thought, "by his next birthday he'll be talking. He's 3 now and while he's improved tremendously he's not close to talking like most kids his age. This has been hard for me. I've been saying that he could be older and not talking without actually accepting that fact myself. I've been blocking that part of his diagnosis out. We recently hung out with a friend who's son is just a bit older than Xander and talks in complete sentences. I watched Xander try SO hard to get his point across, meanwhile the boy he was trying to communicate with just kept getting more and more annoyed with each sound that Xander made. I stepped in to help out and explain what Xander wanted but it made me sad. Another boy said to Xander, "Why don't you talk to me?" As these things happen, I watch the spark in Xander's eyes fade just a little and it absolutely wrecks my heart. What happens when he starts preschool and I'm not there to step in and help the other kids understand? What happens when someone calls my son "weird" or "different" and it breaks his little heart? What then?

They say that God doesn't give you more than you can handle but my heart feels like it can't handle this. Am I enough of a parent to help keep his confidence growing when the world is trying to break him down? I don't feel like I'm strong enough for him and most days I'm certain I'm failing. But then Xander says a word perfectly. Or he grabs my face in both of his precious little hands and shows me the sign, "I love you" and I know we'll make it. 

Xander teaches me daily about strength, persistence, and faith. He's already moved so many mountains to get to where we are today and he keeps pushing. When I grow up, I want to be like Xander.

Strong. Brave. Ambitious. Funny. Perfect.