A glimpse into Apraxia

Peanut has been in speech therapy for almost a year and a half and he has made some amazing progress.  So much so that people will say things like "I don't think he needs therapy" or "he talks so well, are you sure he has a speech disorder".  I know they are trying to be helpful or supportive but the truth is that apraxia isn't just a speech delay.  He can say words and sounds in isolation but when those same words or sounds are put in a different order or put together he can't say them at all.  Today I was reading some articles and case studies to prepare for his eligibility meeting for Child Find this afternoon and I found this case study that put it so perfectly that I had to clip part to help others understand.

A Case Study of Childhood Apraxia of Speech

by Patti Hamaguchi, M.A., CCC-SLP

In terms of the speech-language assessment, I found that Jamie's difficulties were a pretty classic case of "dyspraxia", also known as "Developmental Dyspraxia of Speech" or apraxia. While he had been previously identified as having a severe articulation disorder, the word dyspraxia never appeared in any of his previous evaluation reports. How did I know? Jamie was able to produce nearly all the vowel and consonant sounds in isolation. If I said, "Jamie, say 'ah' (as in *apple*), he could do it.  He could say "apple" if he concentrated. He could say "pie". But if I asked him to say "apple pie", this is what I heard: "paboo bie". If I asked him to say it three times, I would get three answers. Another attempt might sound like "pappie bah". There was no consistency. He often produced single words clearly, but fell apart in phrases and conversation. Words with more than one syllable were also much more difficult for him to pronounce. Sounds that were produced in one word (the "s" in "bu*s*") were left off in other places ("s" in the phrase "I *s*ee"). Moreover, his global difficulty with sequencing, fine-motor, and sensory integration was typical for children with dyspraxia. He could tell what he said wasn't sounding right, and was visibly frustrated, but couldn't *sequence* the sounds and syllables to match what I said.