Tag Archives: Apraxia

Another Evaluation.

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Ronan had a follow-up evaluation yesterday.  It has been 6 months since his first evaluation, and the county department wanted to find out if we’d been seeing progress with his speech therapy.

Ronan gets therapy twice a week, which is relatively unheard of, and what they really wanted was to find a reason to bring him down to one session a week.

Ronan had his first evaluation in April of this year.  He was 26 months old.  He had delays across the board, although his speech was definitely the most affected.  At 26 months old, Ronan’s evaluation looked like this:

Gross Motor Skills:  20 months

Fine Motor Skills : 20 months

Self Help Ability: 20 months

Social/Emotional Skills: 24 months

Speech/Communication: 12 months

As you can see, Ronan was more than a year behind in verbal communication.  He has been receiving speech therapy for nearly six months now, with a one month break in services because we moved to a different county.

Yesterday, at 33 months old, his evaluation looked like this:

Gross Motor Skills: 30 months

Fine Motor Skills: Age appropriate (33 months)

Self Help Ability: 30 months

Social/Emotional Skills: 30 months

Speech/Communication: 24 months

The evaluator, when she was giving us this information, seemed very guarded.  She seemed to feel like she was telling us awful news.  And yes, it is sort of awful to hear that your child has such a broad array of delays.

However.

However… we were thrilled.  Ronan went from an 18 month speech deficit to a 12 month deficit in 6 months?  He closed the gap in his delay by 6 whole months.  Sure, he hasn’t caught up yet.  But catching up isn’t what we expect; it’s not the way apraxia works.  What we’ve seen is HUGE progress in a short period of time.

We know that this is going to take a long time.  We know that we have a very long road ahead of us in all areas.  But it feels AMAZING to see how far he has come in such a short time, thanks to Miss Emily, our incredible speech therapist, and the ways she’s helped us teach Ronan to grow.

It’s going to be hard work.  But he is so worth it.  And we are so, so lucky.

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Please excuse any and all errors in this post.  It’s late, I’m tired…and I’m not proofreading before bed.  Boom.

 

Therapy.

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Ronan had his first speech therapy session today.

Our therapist is a sweet young woman.  Until she gives me permission to use her name on my blog, I will call her Miss Lisa.

Miss Lisa showed up about 15 minutes early, but Ronan and I walking around outside.  She got out of her car, and I figured that she was our therapist and introduced myself.  Ronan immediately held his hands out to her so she would hold him, and he gave her a big hug.  I can’t help but wonder if it warmed her heart as much as it warmed mine.  I love that we have raised such a sweet boy.

After her very loving introduction, Miss Lisa came in the house, walked into the living room, sat on the floor and immediately started engaging Ronan in play.  She brought a few toys with her that Ronan was very excited about.  At his tender young age of two, there will be very little actual “therapy” happening, and much more “play therapy.”  While playing, Miss Lisa models sounds and words that she wants him to mimic, and then encourages him to try.  She has prompts and techniques that help him try to make the correct sound.   For example, when he wants “more” she asks him to say “Mmmm-mmmm-MORE.”  While making the mmm sound, she holds two fingers over her lips to show him how his lips should move for an M.  She then holds her fingers over his lips and encourages him to try again.

We were really blown away by Ronan’s willingness to try what she asked, both physically and verbally.  There were a lot of sounds that she asked for that he couldn’t say, but he attempted nearly everything.  Today, for the first time, he said “Bye-bye,” instead of his typical “Aa-yo!” (which means bye-bye.)  Immediately afterwards, I noticed that Ronan had started using the “B” sound very much more in his jabber.  It is encouraging to see how quickly little ones take to proper instruction, and it helps to understand why early intervention is so key.

Miss Lisa explained to us that Ronan has many of the red flags of Apraxia – repeating the same syllables over and over, unable to mimic sounds the way he hears them, comprehension above the level of his speech, etc. – however, a diagnosis of Apraxia is not usually handed out until a child is three years old.  She told us today that with his level of willingness, and how quickly he appears to be catching on, it’s entirely possible that he does “have” apraxia, but will progress so well over the next year that he may never be given the official diagnosis.  I can’t help but tell you that hearing that made my day.

We set up our permanent speech therapy schedule, and will be seeing Miss Lisa twice a week.  I plan to update my blog weekly with Ronan’s Apraxia progress, and have some neat ideas coming.  Part of me hopes that other parents facing an apraxia diagnosis can come here and see what it’s all about, as well as finding out that it may not be as scary as it seems.  So stay tuned.

Evaluation.

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I have been a terrible blogger.

So much has been going on in our lives that I haven’t blogged about, I feel like beginning again is like starting to read a book in the middle – you have no idea what happened previously.

But instead of catching you all up, I’m just going to dive in with NOW.

Yesterday, Ronan had a developmental evaluation.  We scheduled it because we had concerns about his speech, but the evaluation covered all areas of his development – gross motor, fine motor, emotional/social, problem solving, self-care and speech.  The evaluation team was here for about 2 hours, and we watched as they interacted with Ronan at a 2 year old level.  They would pull out a puzzle or activity that they wanted him to try, and begin playing with it – instead of telling him “Come here and do this puzzle!”, he would see them playing and want to play too.  They did shapes, blocks, picture books, kicked a ball, ran up and down the halls, played with a doll, a puppy… all sorts of neat activities.  Ronan was excited every time they pulled out something new, constantly exclaiming “Oooh!  Whasssat?!” and “Oh, WOOOOOOOOW!”

When the evaluation was over, they gave us the results immediately.  In all areas of his development, Ronan is on track or ahead – he ranged from 24-30 months in every category except speech.  Obviously we expected there to be a delay, as we were the ones who requested the evaluation, but it was kind of shocking to hear exactly how far behind he is.  His communication skills are in the 12-15 month range.

So what does this mean?  Ronan will be in speech therapy.  There are a lot of unanswered questions right now, but the therapist that did the evaluation said she suspects Ronan has something call Childhood Apraxia of Speech.  That means that he doesn’t have a normal speech delay, one in which he would eventually catch up even if he had no help, but instead has an actual speech ‘problem’.  The bare bones of it is that his brain has the ability to speak, and his mouth has the capability of speaking, but the connection between the two isn’t there.  With no help, and no therapy, he would likely not progress beyond the speech level he has right now.

It’s overwhelming, and emotional.  It is difficult being told that there is something wrong with your child, and imagining the road ahead to normalcy.  I am trying to keep a positive outlook and a little perspective – he has difficulty talking.  There are people who are going through much worse.  Yes, it will take a long time to help him get to where he should be naturally, but we have the ability to help him.  We will work with him.  We will MAKE SURE he gets the help he needs in order to have the best chance possible.

There are a lot of unanswered questions.  We don’t know when we will start the therapy.  We wont know when or if he will ever actually be given a diagnosis of Apraxia of Speech.  We don’t know what it will take in order for him to NOT get that diagnosis.

We have already been given a lot of tips and advice to help him, and have already seen a huge improvement in his attempts at communication.  Today, in the two hours he’s been awake, he’s already said cheese, apple, watermelon, good… I have the feeling things are going to just get better and better.

I’m going to try to update more often.  It’s frustrating for me not to get things out.  Miss Ruby Kate has been seeing a chiropractor for her car-seat screaming, and we’ve seen some big changes.  She now poops every day(!) and sleeps on car rides.  Spine manipulation – who knew, right?