Kekoa's Journey With Childhood Apraxia of Speech: What The Future May Hold

Monday, June 27, 2011

What The Future May Hold

I've gotten a lot of questions as to what the prognosis for Kekoa would be. Would he ever learn to talk? Is it likely that he may not ever be able to speak? Or could he eventually just begin talking on his own without help?

The best answer that I've learned is that like Autism, Apraxia is a spectrum disorder; meaning there are all kinds of varying levels and degrees of this treatable diagnosis. There are some children who go through life undiagnosed and eventually do talk. There are children who go through their entire early years in early intervention and aggressive therapy and still have trouble forming singular words, much less stringing word sentences. Additionally, there are children with Apraxia who may have other issues going on connected with the Apraxia that further debilitate their progress with therapy and treatment- Koa being one of them.

Koa was diagnosed with verbal AND oral apraxia. Verbal meaning that the brain connection to make sounds that string words is absent; oral meaning that the movement of the mouth, lips, tongue and teeth are also having movement problems that allow him to make the sound which leads to the words. A good example of this is that Koa can't pucker his lips. Currently we are in occupational therapy for this. But the puckering of the lips allow him to do things like blow out, kiss... this also helps in forming the letter "O" or "OO". Koa also can not move his tongue properly. He can stick out his tongue and touch the top of his lips, but for some reason his motor connection is still off where he can't move his tongue around, the side of his mouth or even point down. Again, more occupational therapy that we are working with.

So depending on the severity of the disorder, its hard to tell. I look at Koa and see the little progress that he's made and have lots of hope for him. But I also know that speaking is just the tip of the iceburg. There have been numerous studies that link Apraxia to all kinds of learning disabilities as well. But in my heart, I have great hope for him and know that some how, in his own way, he's going to push his boundaries and even defy whatever odds may be against him. As a mother and as HIS mother, this I know and hold in my heart.

Kekoa, the little rascal that he is, got himself wedged in between our couch cushions. I walked into our family room and found him stuck here like that, but yet, he's still as happy as ever and made the most of the situation. :)

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Definition of Apraxia per CASANA

Childhood Apraxia of Speech is a neurological 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. Apraxia of speech is a specific speech disorder.

The act of speech begins with an intention to communicate. Next, an idea forms, outlining what the speaker wants to say. The words for the desired message are put in the correct order, using the correct grammar. Each of the words are comprised of a specific sequence of sounds (also called phonemes)and syllables that must be ordered together. All of this information is translated from an idea and information about order of sounds into a series of highly coordinated motor movements of the lips, tongue, jaw, and soft palate.

The brain must tell the muscles of these “articulators” the exact order and timing of movements so that the words in the message are properly articulated. Finally, the muscles must work properly with enough strength and muscle tone to perform the movements needed for speech.

In typically developing speech, children make word attempts and get feedback from others and from their own internal systems regarding how “well” the words they produced matched the ones that they wanted to produce. Children use this information the next time they attempt the words and essentially are able to “learn from experience.” Usually once syllables and words are spoken repeatedly, the speech motor act becomes automatic. Speech motor plans and programs are stored in the brain and can be accessed effortlessly when they are needed. Children with apraxia of speech have difficulty in this aspect of speech. It is believed that children with CAS may not be able to form or access speech motor plans and programs or that these plans and programs are faulty for some reason.