I wrote a few weeks ago about beginning the Early Intervention process for Callum – at almost 20 months, he still doesn’t use any words. Since then we’ve had two screenings; one of the bad things about the EI process is that there tends to be several weeks of lag time between each step. Even so, things are moving forward.
The first screening was a global development screening. Our EI “case coordinator” and the child development specialist came out to the house and basically played with Callum for an hour or so. He was asked to complete certain tasks like pointing at pictures or picking up objects and we were asked a number of questions about his behavior as well. All of this information went onto a standardized development “test” (not even two and already being standardized tested…sigh…). Everything – motor, social, cognitive, and receptive language was great, even above average. But expressive language was well below average. To qualify for services, children have to have a mild delay in two areas or a significant delay in one – Callum’s expressive language was low enough to qualify him.
The next step was a hearing screening (to rule out hearing as the cause of the speech delay) and a more thorough speech evaluation by a Speech Language Pathologist. We met with the audiologist and SLP this past Friday. Everyone was very friendly and worked to make Callum at ease – these folks clearly spend a lot of time working with young children! Callum’s hearing checked out fine, so that’s not a cause for concern.
After spending an hour or so playing with Callum and asking me questions, the SLP concurred that his expressive language was significantly delayed. His receptive language was scored as above average at 21-24 months. But his expressive language is only at the level of a 6-9 month old overall (with a few areas where he ranks higher). It’s not just Callum’s lack of words that are a concern. He also doesn’t attempt to imitate sounds (despite imitating everything else we do!) and really only has a few sounds that he uses at all. So even though he clearly knows many words, he isn’t attempting to say them at all because he doesn’t seem to have the sounds to do so.
Although Callum is still too young for a definitive diagnosis, the SLP felt that he may have some sort of motor coordination disorder such as Speech Apraxia based on the sizable gap in his receptive and expressive skills and his limited use of sounds. If this is the case, this means his brain knows the words it wants to say but can’t send the signal to the mouth and tongue to form the sounds. Jesse and I have thought for a while that it often seems like Callum thinks he is saying something or gets embarrassed when he knows he can’t. Maybe we are just imagining things!? In any case, we’ll be working with a therapist who has experience working with motor coordination issues. As Callum progresses through therapy, it should become more clear if this is a problem for him so it’s important to have someone who knows what to look for. The techniques used for motor coordination issues are also a bit different from those used for more typical speech delays so we may be trying different things.
So that’s where we are for now. The next step will be choosing a therapist and then starting sessions twice a week. I’ll keep you updated on our progress!
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Hi Meredith – My brother had apraxia. I’m going to pm you on the bump.
Kathy
Ok so I tried to pm you, but I don’t think it worked. If it didn’t, then please email me (if my email comes through to you via this comment box) or pm me or page me on AP or something lol
Your little guy will do great and begin to blossom before your eyes! These sessions should do him a ton of good. Glad you have a plan and a positive outlook!
Sounds like you’re doing all the right things for your son! I work in early intervention and of the over 1 crowd on my caseload id say more than 1/2 are for speech delay and some form of oral-motor planning. I would like to give you one suggestion after seeing many parents hear apraxia and researching it, please know that apraxia is on a scale, some kids have minor motor planning issues and others have more severe or global motor planning (including gross motor/fine motor) but when you look it up all you see is the severe cases, dont get worried!!!! sounds like your little guy is a lot like most of my kiddos who start making gains in less than 6 months!
I wish you and your little guy the best and I hope you have a great experience in EI.
Thank you
I do think that if we are dealing with apraxia it’s on the minor end since Callum doesn’t have any of the other motor planning issues that come along with it often. We are still waiting for a big breakthrough but he does have one word now – “up” – which he’s been using constantly in the last few weeks! That’s a welcome first!
Please update on Callum!
My 26 month old son has been in ECI for 8 months with VERY slow but steady improvements. At this point he has about 15-20 approximations. It’s comforting hearing about others who deal with children who are speech delayed, to know we are not alone. And to hear the improvements in speech with out kiddos!
I do need to do an update…thanks for the reminder! I can quickly tell you that he had only one word at 24 months. Around 27 months he started picking up words out of the blue and for the first time began repeating words and sounds. A month later, he was using full sentences! It was seriously amazing how quickly he went from nothing to pretty complex sentences. It seems that he was just taking his time (which is why they are reluctant to make an apraxia diagnosis before 3 since he totally fit the profile before; we will continue to monitor things to see if there are any lingering issues). Anyway, he is doing so well that his speech therapist is in the process of re-evaluating him to likely exit the program. I hope your son continues to make good progress – sounds like he’s on the right track!
That’s great news!! I just watched your video of Callum in the babyhawk and he was saying “I’m hopping on the bed!” way to go Callum! You would never even know he was speech delayed if you hadn’t said so. I guess it is true, this word explosion I keep hearing about
Yes – it’s crazy how much he talks now!! He really went from nothing to full steam ahead in no time!