Most of us rarely pause to consider how easily and quickly we can turn our thoughts into words. But for some children, that highway from the brain to the mouth isn’t so smooth. Somewhere along the way, those amazing thoughts hit a pothole and the words won’t come out, says an expert in childhood apraxia of speech.
“That’s the frustrating part for these kids. Oftentimes they know what they want to say and the brain’s telling them what they want to say, but it’s just not coming out correctly so that message is getting lost from their brains to their mouths,” says Jena Lohrens-Becker, Adjunct Clinical Supervisor and Speech-Language Pathologist with the Speech-Language Institute at Midwestern University Multispecialty Clinics, which offers specialized assessment and therapy for kids with apraxia.
While apraxia, a motor speech disorder, has common characteristics, it will look different for every child, she says. But with intensive speech-language therapy and work at home, apraxia is treatable and in a lot of cases can be resolved.
Lohrens-Becker, who has spent her career focused on helping children with apraxia find their voices, shares her advice to help parents get a diagnosis and treatment.
What to watch for
Limited vocalization is cause for concern, says Lohrens-Becker.
When babies don’t babble as much as their peers, this should be considered an early warning sign. By 12 months, parents might notice their baby doesn’t use consonants, particularly the p’s, b’s, m’s, t’s and d’s, she says. “If we don’t have any of those, that’s a red flag for us.”
By 16 months, if your child is using mostly vowels and fewer than three consonants, that’s another signal to check things out with your pediatrician.
Another sign to watch for as kids get older: “If your child’s receptive language is much stronger than what they are able to express or if words are being produced inconsistently,” she says.
She suggests not taking a wait-and-see approach. “The earlier the better to seek treatment,” she says.
A common misconception is that there is a magic age for diagnosis; she says children evaluated for apraxia do need to be verbal enough to participate in a dynamic speech evaluation.
Who to see for a diagnosis?
People often think apraxia is only caused by a neurological disorder, and this leads them to believe that they must find a neurologist or developmental pediatrician to make the correct diagnosis, she says.
“Truth be told, it’s actually the speech-language pathologist who is the expert in speech and language and should be making the differential diagnosis. Other related specialties, the OT, PT, developmental pediatrician and the neurologist, can provide additional insight to the overall child that could help definitively diagnose apraxia. But to really dig down deep, is this apraxia or is it a different speech and language disorder, you would seek out a speech and language pathologist, particularly one who has expertise and training in apraxia,” she says.
When looking for a speech-language pathologist, Lohrens-Becker encourages parents to seek providers with the more specialized approaches in working with apraxia like those available at the Midwestern University Multispecialty Clinics. When seeking a provider, ask about the training they have and the types of therapy approaches they use, she advises.
What therapy looks like
Apraxia is treatable with speech therapy, she says. In fact, she adds, it’s the only evidence-based treatment for apraxia.
She says therapy is intense and frequent, ideally multiple times a week. It focuses on movement versus articulation. With apraxia, there may be only five words to drill and master at a given time, with a lot of repetition. Together, the speech-language pathologist and child might start at the syllable level and work toward functional words, she says.
Family involvement throughout the process is huge, she says, because techniques need a lot of practice at home. That’s one of the main reasons she works so hard to empower parents.
“As a speech pathologist, I love it when parents come to me with questions because that means they are thinking about it and they want to do more and understand more. It’s OK to ask the questions, What are you doing, Why are you doing that, Should I be doing it at home?” she says.
The good news is that with intense therapy, apraxia can be treated and possibly resolved, she says. She shared a special moment she witnessed recently: At the Walk for Apraxia in October, an 11-year-old diagnosed with apraxia at age 2 kicked off the walk with an encouraging speech. No one, she says, would ever know he had apraxia and intensive speech therapy.
At the Speech-Language Institute, part of Midwestern University’s Multispecialty Clinic in Downers Grove, Speech-Language Pathology students and faculty mentors help children and adults with apraxia and other language disorders learn to communicate.
Learn more at mwuclinics.com.