2 yr old with speech delay - apraxia? - any hope of help from NHS?

[lilQuidditchKel]

Hi there

I've been reading about apraxia and really think my son may have this problem.

He just turned 2, repeats "oh wow" and "dasch gee" or something sounding like that and says not much else besides "papa" and "dactor" (tractor). There is an awful lot of pointing and grunting, too. He used to say "duckie" but stopped. I tried signing with him when he was younger but he didn't seem to take to it.

Because he's only just 2 and DH speaks German to him, I'm afraid if I go to my NHS GP she won't take me seriously. My gut says that he has a problem making sounds though!

I just heard about the Hanen centre and am going to try the It Takes Two to Talk book. Any other ideas are very much appreciated!

phone up your speech therapy department, you may not need GP or HV permission to refer. Hanen book has lots of sensible advice, but doesn't really address physical problems with sound production.

My DS has apraxia too (as well as autism), but for the apraxia apparently the best thing is just to practise practise practise making all the sounds. So if you could find some way of motivating him to copy all the sounds with you? Or, I have this fanastic jolly phonics video where, in the extras section, called Saying the Letter sounds, a nice lady enunciates each sound very very clearly as the letter appears on screen. For some reason, my DS loves it and it really helps him learn to say the sounds. It was £25 in the Early Learning Centre. Can you afford to pay for speech therapy as (in our area anyway) the waiting list for NHS was 2 years!!!

hi and TotalChaos thanks for the other hints as well, will check out Nancy Kaufman ad Debbie Feit.

I have found (through TalkingPoint) website a way to contact my local Speech & Therapy department ... I didn't even know these existed! ... and someone will speak with me Friday and help determine whether my boy has a problem which a clinic might help, or if we should just try some things at home first.

Ancient - thanks also for that ELC video suggestion. Will def look for it.

Re paying for therapy - as long as it's not hideously expensive we would find a way to pay for it.

we paid £60 per hour for a private SALT, but please don't let her or him put you off ABA (as mine did me) as I reckon I lost a year through prejudice against a therapy which ultimately got more out of my DS in 4 weeks than the SALT did in 1 1/2 years! Sorry to rant, but if another mum had not ranted at me about the benefits, my prejudices would never have been overturned and I would never have given ABA a try! I reckon if I hadn't, my DS would still be non-verbal now, as we tried so many other things that just didn't work! I'll shut up now!

sorry I'm confused - what is ABA? And whatever it is, you strongly recommend that over a therapist?

Sorry lilQ I think I may have been posting over-hastily and mixing up my threads! I was on one before where I was extolling the virtues of ABA but it is for autistic kids mainly so not so relevant here. However, it might be worth just knowing about the theory for apraxia as it uses a lot of echoic practice and also harnesses the kid's motivation in order to encourage words - example: our DS loves the swing, so the ABA tutors would push him for a bit, then stop and stand their with a huge grin expectantly, then prompt him to say something like push. Then gradually they would "fade" the prompt so he knew they'd only push if he made an attempt at the word. It seems to me that it's quite a different approach from the SALT we saw, who was very focused on getting the "pragmatics " of language in place before even trying for words. Eg she'd spend the whole session on eye contact and turn-taking, and seemed almost uninterested in words. I found the ABA approach got better results, but as I say it may not be relevant here. Sorry!

hmm interesting nonetheless, thx! what does ABA stand for?

applied behavioural analysis - it's basically a behavioural therapy and some people are quite anti it because they've heard bad things from the old days, when it was far more rigid and used punishments too (it doesn't do that anymore, though there are some aversive bits to it, like naughty step, for bad behaviours). I was put off it for 2 crucial years, and regret that now as I think it speaks common sense, whereas some of the traditional speech therapy I came across was very idealistic and namby pamby and reallly couldn't do much for my DS (however, his autism is probably more of the presenting problem than his apraxia)

well I use a naughty "spot" for my 2 yo and am convinced that it helps get the point across. sorry if that seems cruel! (however imo it's a step better than my parents' generation's approach which involved smacking...)

anyway, can you recommend a resource on ABA which might explain how to use it in speech therapy? the swing/"push" example was useful. funnily enough I just went to the park with DS and DD and tried it, and he just whined at me, then went silent when I waited for something else. SIGH.

it takes quite a few months lilq but the good news is that he's so young that once he gets it, he'll get it properly. The way they started with my DS was with what they call non-verbal imitations, to get the principle of imitation established, then you move onto imitating speech. Eg you say "do this" and you clap your hands, then you prompt him to clap his hands. We used maltesers as rewards at first so he came to associate good imitation with a choc reward! After a while , you move onto loads of other really obvious/funny movements (poke tongue out, wave hand, open mouth wide). Eventually he learns that "do this " means "do what I do". Then you move onto Do this - ooo, eee, iii, and then words. There is a site called ABA VB community which has some useful stuff on it.

hmm! def sounds interesting and worth a go. thanks so much!! (am certain that smarties will be our treat )

Very good advice Ancient (and I speak as a salt who is training to be an ABA consultant for presicely the reasons you mention)

I wish you worked in Surrey Moondog - as a SALT with ABA training you'd be worth your weight in gold! I bet there are loads of kids with apraxia, or with autism plus apraxia, who would benefit from your combination of skills!

and I wish you worked in Middlesex, followed by Surrey next year (we're planning on moving to Surrey)

on that note, ancient, any advice re moving to Surrey? Am looking to be close enough to Woking so DH can use that station to commute to the city, and in a good primary school catchment area. Have looked at Lightwater for example...

I think mother's instinct should be taken as gospel in these things

but if it helps my DD (2nd child) said nothing at all until past 2 years but it was clear she understood and could communicate her wants and needs easily .. her language came quickly when she did decide ..

a bilingual home can also delay first speech

but that said follow it up if it concerns you

i know, i know, it's not at crisis point yet, but some things about the way he makes sounds does worry me - like the way he repeats "dasth ghee" over and over instead of imitating anything like the right word - even if it's a very simple word with sounds in it similar to ones that he can say. anyway I have a telephone appt to discuss it with an expert from my council on Fri - will let you know how it goes!!