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Shanbrite2: Speech questions
I hope you don't mind me paging you like this. I saw a response from you in another post a couple weeks ago and was hoping you might have some thoughts on my DSs speech therapy.
DS has been in speech therapy 1x/week through Child Find since July (he'll be 2 1/2 this month). He has an expressive language delay, but is doing well in all other developmental areas - fine/gross motor, receptive language, etc. We recently added every other week private speech therapy as well - this is an out of pocket expense for us. Yesterday we had our 6 month review with Child Find and our SLP said probably apraxia (she has said this once before, but never elaborated with us). Our private therapist drew the same conclusion after only a couple visits. I think they're both hesitant on giving an official diagnosis because he doesn't present some of the typical (trouble eating, drooling, etc) symptoms associated with apraxia. I've done as much reading as I can on the subject and from what I understand, if it is indeed apraxia, it's going to take a lot of work. Right now he has only about a dozen words he uses regularly.
I'm concerned about the type of therapy he's receiving. Our Child Find SLPs approach is different from our private (both play-based), and I find that DS is somewhat responsive to both. I've been more impressed with his private sessions, but still not sure it's the right therapy for him. I've done some reading on the PROMPT method and wanted to get your thoughts on that. Also any local resources/centers/recommendations you know of that I can look at for therapy? Since we're already paying out of pocket for private speech therapy I want to make sure it's the best type we can get for our money.
Our Child Find SLP recommended preschool as well, so he's been going 3, 1/2 days/week since January.
Re: Shanbrite2: Speech questions
No problem!
They are likely hesitant to diagnose him with apraxia more because there has been a huge debate in the SLP community over this diagnosis (some feel it's rampantly over diagnosed, some think it doesn't exist at all, and others see it everywhere). There is alos a lot of debate over the criteria for diagnosis. For example, based on my training, drooling and difficulty eating actually would be signs of something other than apraxia to me.
If it is apraxia, it will take a lot of work, but you might see amazing progress. I had a 3 year old go from 5 words total to 6+ word long sentences in a year.
I personally have not used PROMPT, but it does have strong proponents among clinicians. When I treat a child with apraxia, I definitely use a "multisensory" approach (lots of movement, touching my own face, sometimes touching theirs to cue). PROMPT is like this, but even more so, I believe (lots of touching the child's face). Would your DS be ok with this? If he has strong personal boundaries or doesn't like people touching him, it might not be a good approach for him. The other approach I typically use is based on the Kaufman approach (not to recommend anything specific for your son, as I don't know him or his needs).
I can't make any specific recommendations for people or centers off the top of my head, but I can ask some of my colleagues. You could also try going to asha.org, which is our professional organization, and see if any of the SLPs there list apraxia as a specialization.
Are they focusing on any functional communication? That's where I like to start. What does he WANT? LOVE? NEED? Figure out what he would actually want to talk about, then figure out a way for him to say it using the sounds he already has. If you aren't working from a place where he is motivated, you won't ever see any change. Haha, ok, I'd better stop before I start writing a dissertation on my theories of apraxia treatment!
Please feel free to PM me too, if you want and I can give you my email address. Good luck! You are an amazing mom to be doing all this for your beautiful son!
How cool! We could practically have our own Nestie therapy center! Your DD is way too cute!!!