Tuesday, March 13, 2012

An Email

Good Morning [pre-school teacher and speech language person]!

[The Girl]'s ABR came back fine.  So no hearing impairment.  Nor was there any significant water in her ears but they put tubes in anyway, just in case.  So that leaves us with either a simple developmental speech delay or apraxia, right?  Other ideas or options?  Where do we go from here?


[One Puzzled & Concerned Mom who should know better than to email the school at 9:30pm after a really REALLY long day and a glass of wine.]


  1. I don't know the background details, but it sounds, perhaps, like it's too early for diagnosis? How is receptive language? Does she sign? Does she use AAC?

    1. The Girl is 3.5 and no words yet, not even mom. LOTS of babbling in conversational tones and a couple regular sound approximations (e.g. "buh" for bread & ball). Receptive language is pretty good for daily stuff & she signs SOME, though ltd by age & fine motor skills & her xxxxx parents' inability to pick it up faster. No AAC yet.

      So, yes, it might be too early to call it apraxia. I HAVE NO IDEA. Google & Blogger have taken me this far (rule stuff out!) but now what? She's getting 90 min/ST at school + an addtl 30-60min private/week... Should we just be patient & hope it works? My ltd googling suggests they'd tackle her ST differently w/an apraxia dx so should we switch gears?? Also read the primary dx tool is seeing a gulf btwn her receptive/expressive language but I don't know if hers is 'wide enough'. I do know, though, that fumbling around on the i/net late at night does not a SLP make & I'm sure there are other factors.

      Then again, she's only 3.5 and I may just be seriously overthinking this.

      Aren't you glad you asked? :)

  2. eh, I think we might all be better off if we emailed after wine. get it all out on the table!

    I hope they have some answers.

    I'm glad today went well. enjoy that wine, you definitely earned it.

  3. I hope you get some answers soon!

  4. Max will be 3 this month and he only says daddy, and a few sounds like buh for ball. No mama either :( He did just start saying something like num when eating, so I know he can now make the m sound. I wonder about apraxia, too. Good luck!

  5. Leo didn't really start talking until closer to four. Even then it was just single words. No sentences for a looong time. He called me "Dee-Dee" until, I want to say four and a half or five? That's when he said Mommy for the first time.
    I don't know anything about apraxia but I know it takes some kids a loooong time to talk. Leo is still difficult to understand at age 7 1/2 but now? Man, you can't shut that kid up! :-)
    Hang in there.
    And yes, wine helps too.

  6. Since Kayli is now 12 I can say that all of your experiences sound well within the DS norm based on my experience. Kayli talks, a lot! Her intelligibility is fair unless she is lecturing about a topic out of context to someone who doesn't know her that well. She has occasional bouts of stuttering/stammering which seem to resolve as she moves thru to a new level of capability. She has an excellent vocabulary and fund of knowledge but probably at a third grade level not 5th grade which is where she is - she always surprises me how much she understands. She has difficulty with articulation for sentences or long, complex phrases - singable songs really work to help with that - like "Diners, Drive Ins and Dives". But she practiced that phrase over and over again until now it rolls off of the tongue.
    When she was little I worried a lot but took a lot of heart in how "expressive" she was, how interested in language, her environment and interaction, the babbling. There was a lot going on in there. She spoke in simple one word/2 word phrases at Kindergarten age. Every year since she makes significant progress.
    You guys with pre-school kids, pre-potty training, pre-speech age are all in the thick of the not knowing and wondering years - before that they are just babies and need total care like all babies. Anxiety is the norm but you will develop and understand them as they develop.
    Now, I know that there is a wide range of language ability in individuals with DS so this is not any kind of guarantee but I'm sure that SLP will only support the best possible outcome and I'm not sure that increasing the amount of SLP will change it one way or the other.
    Glad to hear the ABR went well since that measures the brain to speech centers connection process - the neuro issues.
    Sorry for the length - hoping to impart my "lofty" perspective :)