Early Warning Signs of Childhood Apraxia of Speech

Childhood Apraxia of Speech (often abbreviated as CAS) is a somewhat rare speech disorder. It is estimated that 1 in 1,000 children will be diagnosed with apraxia. In comparison, 1 in 150 will be diagnosed with an Autism Spectrum Disorder. Many parents, and indeed doctors, are not aware of what apraxia is, and thus the early warning signs may go unnoticed. Like many other neurological disorders, early treatment is the key to helping your child overcome the difficulties this speech disorder can present.

In medical terms, Childhood Apraxia of Speech is a motor-planning disorder that is characterized by difficulty sequencing the speech movements necessary for volitional speech. In layman's terms, the messages sent by the brain to the muscles and nerves that control voluntary speech get scrambled and the muscles and nerves can't decode them to understand what to do. This is not a speech delay, but a true neurological disorder. It is unclear what causes apraxia, but it appears to be related to immature neurological development, rather than caused by an injury to the brain, such as is seen in stroke patients with apraxia. Though it has been named "childhood" apraxia of speech, it is not strictly a childhood disease. A child diagnosed with apraxia will struggle their entire lives with their speech, though it will probably get easier to speak as they get older.

Many children with Autism, Down Syndrome, and Cerebral Palsy have been diagnosed with CAS, though apraxia does appear in children who have no other disabilities. Common co-morbid conditions include hypotonia (low muscle tone), sensory integrations problems, and language delay. Many older children with apraxia have trouble with reading, writing, and spelling. Because of this, early intervention with speech therapy and occupational therapy is very important for a child's future at school.

While there are some warning signs that are commonly seen in apraxic children, many parents are told by well meaning friends, family, and even pediatricians to "just wait and see." If your child shows several of the warning signs listed below, don't take the wait it out approach. As your pediatrician to refer you to a speech-language pathologist for an evaluation. Early detection and intervention is key for a bright future for your apraxia child. If your child is older and has speech problems, it's never too late to get them evaluated.

Early warning signs:

• little or no babbling during infancy
• difficulty with nursing or feeding during infancy
• few consonants
• slow, effortful or halting speech
• poor speech intelligibility
• difficulty imitating sounds or words
• late onset of first words (or "losing" words)
• inconsistent or unpredictable speech errors
• groping during speech attempts
• high frequency of vowel and voicing errors
• high receptive language, but low or no expressive language (child understand everything being said, but can't say anything back)
• "soft" neurological signs, such as sensory problems, sensitivity to touch, fine motor problems
• slow or no progress with traditional speech therapy (apraxic kids benefit from specialized, intensive therapy that isn't necessarily know by all speech-language pathologists)

As the mother of a severely apraxic child, I understand the fear that hearing such a diagnosis can bring. My son is not on the spectrum, nor does he have any other disability (well, he does have minor sensory issues and minor hypotonia). Unless you hear him talk, you would never know that he can't talk. My first thought upon hearing the diagnosis was "Will he ever speak?" You are probably wondering the same thing about your recently diagnosed child. The answer is yes, more than likely your child will speak, especially with early intervention. You child may not speak "normally," he may need to use ASL (as mine does) or a communication device, but he will be able to communicate and lead a pretty typical life. The most important thing a parent can do is recognize the early warnings signs, push your pediatrician or other professional for help, and get involved in your child's treatment. With hard work, and possibly years of therapy, most people will never even know that your child has childhood apraxia of speech.

When my son was diagnosed with Apraxia, he was also diagnosed with Sensory Processing Disorder. I found that having a variety of fidget toys on hand helps his attention and focus tremendously. I've reviewed a variety of sensory toys to help others pick the best fidgets for their kids.

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How to Treat Sensory Processing Disorder

The body is designed in a way wherein the different sense organs work with the brain for the interpretation of the different senses so that we can exhibit the appropriate responses, both behavioral and motor. However, there are instances when the responses are not proper because of misinterpretation of the senses. This condition is called sensory processing disorder.

Sensory processing disorder (SPD) was formerly known as sensory integration dysfunction was first described by A. Jean Ayres, a neuroscientist who said that this disorder is similar to a 'traffic jam' that occurs in the neurons, wherein some parts of the brain are prevented from receiving the correct information so that sensory information are interpreted correctly. For someone who has SPD, what happens is that sensory information is perceived differently from that which is normal to other people. This will then result in behavior or responses that are unusual, which makes it hard to accomplish some tasks.

The exact causes of sensory processing disorder are not yet known, and are still subject to research studies. There have been results however saying that this is an inherited disorder, but there can also be environmental factors that can contribute to it. When this is not properly managed while a child is still young, it can result to several problems involving the child's emotional, education and social state. Because of the problems with the child's motor skills, he can become isolated from his peers, suffering from low self-esteem. There can also be poor self-concept and failure with academics. Those who are unaware of this disorder will be labeling the child as clumsy, disruptive or even uncooperative. When this gets worse, it will lead to depression, anger problems, anxiety and aggression.

The treatment of sensory processing disorder will warrant the services of an occupational therapist. The occupational therapist will provide sensory integration therapy for the child, wherein sensory stimuli and experiences will be taught to the child. There will also be sensory diet, a therapy where the therapist will plan and schedule activities for the child to address the different needs of the nervous system. There will be different techniques that will be included in the therapy such as calming, alerting and organizing. The treatment for SPD can also include alternative therapies depending on what the doctor says. One of the common therapies is therapeutic body brushing which is ideal for children who are oversensitive to sensory experiences. This will help the SPD patient to learn how to adjust to certain sensory stimulations.

There is no definite cure for sensory processing disorder for the treatments that were mentioned will only help the affected person learn how to adapt and react properly to stimulations. If you are taking care of a child who is suffering from SPD, you have to be patient when dealing with him, since it is not just frustrating for you but it is more difficult to the child. It will take some time before the child can learn the appropriate responses so you will have to assist him and make sure that he learns properly. And of course, you will need to assist him with developing his mental, emotional and social skills.

For more information on Different Types of Diseases, Symptoms and Diagnoses, Please visit: Sensory Processing Disorder and Sensory Integration Disorder.

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Autism: How Do You Communicate With a Non-Verbal Child?

I am a teacher and recently, I assisted to one of these workshops meant to improve the quality of your teaching methods. I also am the mother of two young autistic children. My oldest is a 5 years old boy, which is considered to be non-verbal as he may not have used more than six words in his life. "Mama" was said for the first time about a year ago when he was 41/2 years old. I can't describe to you how precious this magic moment was. I still enjoy it every time he pronounces it.

Sometimes, teachers need to be taught a few things!

During this workshop, we were studying the multiple ways that a person learns new information. Some are visual and learn using diagrams, drawings, pictures, etc. Others are using manipulative to understand new concepts. There are eight types of learning styles. One of them is called: "verbal". This type of processing is done orally and using written material such as books, essays, etc. One of the statements that was made was that: "The more people express themselves orally, the more easily they will be able to express themselves and show their knowledge through their writing skills."

It burned me inside. That is when I shared both my feelings and my experience concerning my son with my colleagues. It opened a new door for me when I realized that the question that popped up in people's mind really was: "Autism: How do you communicate with a non-verbal child?"

That is when I decided to share some information related to my experience as a parent of a non-verbal child who is affected by the Autism Spectrum disorder.

A bit of personal history of my non-verbal son

My son is considered non-verbal since his vocabulary contains approximately six words which are mainly used when frustration sets in, especially when his message is not understood by the person he is communication with, at the time. Physically, he is able to speak as he is able to pronounce words but for an unknown reason, he is not communicating with others this way.

Doctors have explained that he has 50% chances of becoming verbal one day as in several cases; non-verbal children affected by Autism will start speaking between the ages of 5 to 8 years old. Some children even began speaking as late as 13 years old.

When he does speak without being influenced by frustration, his words are said in such a faint tone of voice that they are often difficult to understand or heard, if at all. As a parent, you sometimes think that you have heard him speak but being unsure you tend to believe that you heard things that you want to hear without reflecting reality. Sometimes, it may be the case but you will never know it for sure.

Communication with a non-verbal child

So, how do we communicate with our son? Well, we are using a variety of techniques. For example, in certain cases we use concrete objects that we either show him or the other way around. If he wants a sandwich, he will bring the container of jam to us. If he wants the remote control, he will take us to the shelf, take our hand and point it towards it. If you ask him to choose between several options, we will observe his reaction towards each one of them. If he gets excited, his body language will display his affirmative response by jumping up and down, some hand flapping accompanied by a huge smile. When the answer is negative, he will become upset, push away the item, turn away from it and sometimes he will even cry.

What are other ways that we use for communication purposes? Well, we use a bit of sign language, the PECS, objects and observe a lot of his reactions and the clues that he gives us such as: his body language, his tone of voice, his sounds, the expression on his face as well as the gestures that he makes us do such as putting our hands on his head with pressure to communicate that he has a headache. Another thing that we keep an eye on is his routine and the slightest changes that may be responsible for his sudden distress.

Lack of information can lead to harsh and judgmental comments

Today, I went to the hair salon. The hairdresser told me that earlier, she cut the hair of an autistic child. She said that she thought he was "normal" until she was told that he was affected by ASD. Then, she said that as all children with ASD, he was "a bit behind mentally". I was so disgusted, hurt and angry that I even considered leaving but being in the process of a haircut, I did not want to leave with half of it completed.

I explained to her that it was a misconception that all people with ASD were affected by mental developmental delay. I also explained that during my workshop, I was told that someone who is non-verbal cannot communicate which meant, according to them that they were automatically affected by intellectual difficulties. I explained that not being verbal does not mean that someone cannot communicate efficiently their thoughts and knowledge.

Knowledge is present in a non-verbal child

As a parent, I often feel hurt and frustrated about the misconceptions that people have about Autism. At school, my son has been evaluated differently but he still surprises the school staff that work with him by his knowledge. Since he is using the computer efficiently, maybe he can use it later in life to communicate with us if he remains non-verbal.

Autism is often misunderstood

Often, people do not understand the frustration level of a non-verbal person. Well, imagine that you visit a country where you are unable to communicate with people in their own language. Wouldn't you feel frustrated after a while? Now, imagine how it would feel to live like this every day!

If people ask you in the future: "How do you communicate with a non-verbal child?" You will be able not only to answer their question but also to enlighten them by sharing some insightful information as Autism is often unknown, even by the Educational system.

If you wish to learn more information about Autism, I invite you to visit the following sites: http://autism-spectrum-disorder.com, http://autism-spectrum.blogspot.com and http://autism.findoutnow.org.

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Helping the Child Who Has Sensory Processing Issues

There's something up with a child you know. He's clumsy, picky, always on the move, or flopped in a chair like a wet noodle. He's impulsive, intense, and quirky. Maybe he has a learning disability, ADHD, or autism, or maybe not, but his behavior and responses to everyday sensations are puzzling. Why does he withdraw or act out? Why are transitions so difficult? Can he really hear the fluorescent lights that he claims are distracting him?

It's very likely that this child you're concerned about has sensory processing disorder, also known as SPD or sensory integration dysfunction. An estimated 1 in 20 children and almost all children with autism have SPD.

This child's nervous system is wired atypically, causing her body to process everyday sensations differently. Unable to rely on her senses to give her an accurate picture of what is going on in her body and her world, she is prone to anxiety, distractibility, impulsivity, and frustration. A child with SPD will tune out or act out when overstimulated. The need for sensory input such as movement and touch can be so overpowering that the child truly can't control her need to seek it out. Many of us have difficulty tuning out background noise, or prefer clothes that fit a certain way. These are sensory preferences. When a child's sensory issues interfere significantly with learning and playing, he needs the help of an occupational therapist and a sensory smart adult who can teach him how to feel more comfortable in his body and environment.

Fortunately, many of the accommodations that can make a huge difference in the life of a child who has sensory issues are simple and inexpensive. Here are just a few:

• Cut out clothing tags, turn socks inside out or buy seamless ones, and avoid clothing with embroidery and elastic that will touch the skin and create distracting, irritating sensations.
• To tolerate the intense sensation of having his teeth brushed, the child with SPD may need to use nonfoaming toothpaste and have his mouth and lips desensitized by using a vibrating toothbrush or even just gently pressing a hand-held vibrator against his cheek, jaws, and lips before attempting to brush.
• To calm and focus a child with sensory issues, you can try applying deep pressure against the skin as you compress her joints. Hugging, or pressing pillows against her body or rolling her up in a blanket to play "burrito" are often enjoyable ways for a child to get input. Always pay close attention to what a child is telling you, in words or body language, about her response to sensory input. Do not upset her with unwanted touch.
• In school or at home, allow him to sit on an exercise ball or an inflatable cushion, with a smooth or bumpy surface. This will meet the movement needs of a child who just has to be able to squirm and help the child with poor body awareness to better sense where his body is when he's seated. When these needs for movement and body awareness are met, the sensory child will focus better on listening, eating, or doing schoolwork.
• Provide a quiet retreat when she's overwhelmed by the sensory onslaught of everyday life. Whether she sits alone with you in a car outside of a party or restaurant, or in a quiet, darkened room, listening to relaxing music on a personal music player with headphones, a sensory break can do wonders for a child's ability to tolerate her environment.

A pediatric occupational therapist, trained and experienced in helping children with sensory issues, can work with parents and teachers to plan and carry out activities for the child that can help him or her function better at home, at school, and away. She can also help problem solve and discover accommodations that will ease the child's discomfort, and set up a "sensory diet" of activities that will help him. Whether working on a consultation basis, in a sensory gym nearby, at home or at school, the right sensory smart OT can make a huge difference for a child with sensory processing disorder.

Nancy Peske is an author and editor and the parent of a child who at age 2 was diagnosed with sensory processing disorder and multiple developmental delays. Coauthor of the award-winning Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, available from Penguin Books, Nancy offers information and support on her blog and website at http://www.sensorysmartparent.com She has been active in the SPD community since 2002.

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Hyper-Visual in a Verbal World - Autism and Communication Disorders

A child or adult with Autism or a Communication disorder will have difficulties fitting into our extremely verbal world. These difficulties can create isolation from others and threatening walls of silence. However, there is a specific sub group of people diagnosed with these disorders who have a hyper-visual system. In these cases, when the visual system is harnessed, teaching communication becomes much easier.

I Rode the Train, I Want to be an Engineer

Hyper-visual people are experiencing visually when speaking. Their communications may appear to be almost nonsensical rambling but in fact they are following a very logical pattern. The difference is the pattern followed is visual rather than verbal. The exchange below illustrates this point.

I asked Mark, a college student, "How did you get here today?"

He replied, I took the train in from Long Island. My family went to the beach (Mark was seeing himself on the train but did not say this). Maybe I will be a engineer. The reason I like engineering is that there are serious problems. (Mark was thinking about being a transportation engineering and designing train tracks and freeway intersections) I have always been good in math. When teachers are difficult to understand. (Mark is seeing himself at school doing well except when the teacher is confusing and then associating to a video he watched about Einstein)Like Dr. Einstein- There was an exhibit on Einstein at the history museum did you see it?

Mark was attempting to answer my question but his picture mind took him on quite a ride as one picture blended into the next from the train- to a vacation to an engineering career to Einstein, at the museum. The expected answer was "TRAIN". This very verbal illustration demonstrates how the visual pathway can create leap-frog thinking-which to verbal people can seem like impulsivity.

Instead of negotiating the world with verbal reasoning, a visual person often negotiates with patterns. As a result the "sameness of routines" becomes the template to make sense of the chaos of everyday life. We refer to these visual learners as "Mavericks." We often ask Mavericks to adjust to changes in schedule or adjustments in plans based on how we typically explain things - by talking. These words can create more confusion and frustration as they may not be processed at the speed expected. This lag in processing time can create resistance, immature behavior, odd play, tantrums or reluctance to participate. As a result the normal teaching methods that are based on processing incoming language can fail.

Sequencing & Associating

Visual people often use the brain's Associator to form memories. They learn of a new idea and they relate that idea to their own knowledge base. The opposite of the Associator is the Sequencer from the verbal pathway.

The Sequencer is rigid and ordering, one sound following another to make a word, words produced in specific order to form grammatically correct sentences and ideas linked in order to make paragraphs.

The Associator is time-independent and the Sequencer is very time based. Understanding consequences depends on a time based understanding of cause and effect.

My son, Whitney, at age 4, wanted to jump off of the roof to fly like Superman, without understanding, from verbal reasoning, the danger involved. Whitney would sit mesmerized watching Disney's Snow White as if he were deaf. In fact, at times, I could scream in his ear and he could not hear me even though all of the parts of his ear to brain physiology were judged to be normal. At these times his visual brain powered by his associator were shutting down his verbal sensory system.

If the pictures drive the thought, children can appear to be oblivious to cause and effect. They may disregard threatened consequences. Often Mavericks feel that they must complete the pattern to finish the thought they have developed through the associator before they can transition to the next idea. If the thought is disrupted the Maverick may hit a wall and resort to talking with lines from a movie or echoing what was said or get stuck like a broken record and repeat the same thing over and over again.

With the appropriate training, Mavericks can learn effective verbal communication. The teaching methods must first then harness the visual system first before moving forward to teaching communication.

Dr. Cheri Florance is a brain scientist with training and clinical experience in how to teach the brain to replace symptoms of communication and language disorders. In her books, Maverick Mind, (www.penquinputnam.com) and A Boy Beyond Reach (www.simonschuster.com), she describes how she taught her own autistic son, Whitney to replace disability with ability and become symptom-free. To learn more about her own personal journey and successful methods visit her complimentary Learning Library at http://www.ebrainlabs.com

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Why Is Special Education Needed With Autism?

If your child has been diagnosed with autism, you need to get his or her life has normal and structured as possible so they can thrive in their environment. That includes obtaining the appropriate education. You need to find a school that caters to autistic children in order to have the right balance of education necessary in a structured class.

A special education teacher is specially trained to work with children with autism. They know how to help them understand and they work to build up a trust between themselves and the teacher. There are special training classes that a special education teacher must go through before they qualify to teach special education.

When first introducing your autistic child to their special education teacher, it is important to only speak kindly about him or her, even if you have a problem with the teacher. Don't ever pass those harsh feelings onto your child. If you do, your child may not feel as comfortable with the teacher as you want them to and this could ruin your child's day at school everyday.

On the first day, it is important that you take your child to school to meet his special education teacher. Don't cause over excitement in your child waiting on this day. Simply mention the new teacher's name and how they will learn new things with them. Your child needs to create a sense of acceptance and be prepared to adjust to their new structured schedule.

It's always important to keep things as steady as possible when it comes to your child's schedule. They need to start their schedule off on the right foot by going to bed at the same time each night. In the morning, you should have a routine that is easy to accomplish and can be done realistically. Don't set the standards so high that if you are sick or someone else is doing the schedule for you in your absence, they will have a hard time doing so. You want to offer your child a breakfast, an opportunity to get dressed, time for personal hygiene, and to have time to mentally adjust to the change from home to school.

While in school, the special education teacher should be able to combine a balanced curriculum based on your child's age and skill level, not based on their autism. However, this teacher is specially trained to deliver the curriculum to their students with autism.

No two children have the same symptoms when it comes to autism so a special education teacher with autism is usually careful about how many students they can have in their classroom due to the one-on-one attention that each student will need. In some schools, the teacher will have a helper that will be in charge of assisting one child throughout their day.

Your child will be able to be comfortable with this individual and depend on the individual to help them every day they are in school. The added help will depend on many factors such as how severe is the autism? Can your child function better with assistance or by themselves? Does your child need assistance with daily routines? Once it is determined what may be best for your child then the school will accommodate accordingly.

For the latest videos and training information on child development as well as books and curricula on Autism please visit childdevelopmentmedia.com.

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At What Age Does Autism Spectrum Disorder Begin?

Autism spectrum disorder can be complicated to diagnose because there are no set symptoms that everyone can look for. It varies from child to child and so does the severity. Each disorder has a range of symptoms that sometimes can imitate more than one condition. However, with a parent's awareness and a doctor's diagnosis, a child's autism spectrum disorder can be diagnosed and progress made.

Signs that Autism spectrum disorder should be suspected

If by the age of twelve months your child is not making cooing sounds or babbling like babies do by this age, you may want to mention it to your Pediatrician. Your child should be gesturing at the age of twelve months; pointing, waving hello or good-bye, grasping at toys or a bottle. When your child doesn't do any of these then you may want to talk to your Pediatrician by the time the child is twelve months old. By the age of sixteen months, a child should be able to say their first word.

This is a single word that is plain, simple, and easy to interpret however if your child does not say the word by this age then you may also want to mention it to your child's doctor to make him aware of it. He or she may want to send your child to a speech therapist to determine if there is something else causing the interruption in speech or if your child could possibly have the autism spectrum disorder. By the age of two, your child should be saying two-word phrases without assistance or without mimicking you. If your child has started talking but suddenly stops saying anything or suddenly has a change in their social skills no matter what age, then you need to mention that to your doctor.

So a child can begin developing symptoms of autism spectrum disorder as early as twelve months of age but the most common is around sixteen to eighteen months when you are sure that the developmental milestones are not being reached. Your child may not make eye contact with you by this age, may have trouble pretending to play, cannot imitate you, has delayed communication skills, cannot point to people, objects, or animals to have you look at what they see, or cannot show attention to anything.

By the age of three, autism spectrum disorder symptoms are easy to recognize and should be treated as quickly as possible to help the child understand and learn to live with the symptoms too. They will need support from their parents, siblings, family members, caregivers, teachers, friends, neighbors, and more. Autism spectrum disorders can control how the day goes for everyone in the house so its important to seek help as soon as you find out whether your child has it or not. If your child is suffering from autism, you need to team up with other parents who may have children who are dealing with autism as well.

When you notice that your child is not reaching developmental milestones then you need to make your doctor aware even if he or she does not think that anything is wrong. Keep a watchful eye on your child and when it is time for the next developmental milestone to be crossed he or she may catch up and make it however if they do not then your doctor needs to listen to your concerns because you are the one taking care of your child and you are his or her advocate.

For the latest videos and training information on child development as well as books and curricula on Autism please visit childdevelopmentmedia.com.

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