Dr. Marilyn Agin is in private
practice as a Developmental Pediatrician, and the Medical Director for
Early Intervention in New York City. If you have medical
questions regarding "Late Talker vs. Apraxia," why not "Ask
for "Ask The Dr."
Why Early Intervention?
Apraxia is not rare; many people just do not know the name or symptoms
yet. The problem with this is that children with apraxia benefit greatly from
early intervention. Apraxia does NOT self-resolve. The prognosis for
a child with severe apraxia to one day speak like everyone else, is
greater for a child who receives a diagnosis and appropriate therapy at 3,
than that of a child who first receives a diagnosis and appropriate
therapy at 6. So why are some children with apraxia diagnosed
after early intervention years?
According to Dr. Diane Paul-Brown, director of clinical issues in
speech-language pathology for the American Speech-Language-Hearing
Association in Rockville, Md., "We now know the earlier the
intervention, the better the brain can reorganize." Today,
parents are generally told to look for signs of delay early, even in a
baby's first year, and seek help. No one should assume that a silent
2-year-old is a budding genius; silence may be a sign of hearing loss or a
The new advice is based in
part on studies showing that children with speech impairments are more
likely to have reading and social problems later. Working with very young
children, with malleable brain connections, may rewire defective
connections. And in the book Developmental Apraxia of Speech, by
Hall, Jordan and Robin, called "Working with Preschoolers Exhibiting
DAS (Developmental Apraxia of Speech)" starting on page
174, here is another quote:
"...Lohr (1978) stated that with her population of nonverbal clients
with apraxia, 'children who were younger when we began working with them
progressed more rapidly' (p. 6). Our experience has been that the
overall outcome has been best for those children with DAS who were
identified as possibly exhibiting DAS and received services as very young
A parent with a non verbal child may search on the internet under the key
words "late talker", 'non verbal", "speech delay or
delayed speech", but unless they know the disorder called apraxia,
they will not search under "apraxia" on the internet.
Even worse, apraxia also goes by a bunch of other names that are used
interchangeably like dyspraxia, DAS, motor planning disorder, etc.
Besides, the words “neurologically based” can be misleading to
parents, most children with apraxia are above average intelligence, and
parents may not believe that their non-verbal child who is “SO”
intelligent can have a condition that may be neurologically based.
In fact, nobody knows for sure where apraxia comes from.
Hopefully as awareness is raised, more research will be done to
find out more about this frustrating and confusing condition called
My husband Glenn and I are advocates for Early Intervention for a strong
reason. Our oldest son, the
one with all the birth trauma, is now mainstreamed, going on to first
grade, and is an excellent student with tons of friends.
You would never know he ever was in any type of therapy at all,
especially if you saw him as one of the “Lollipop Guild” in a recent
school play production of the “Wizard of OZ."
Glenn and I both work from home to provide as much support as
possible to our children, right now especially Tanner.
Of course there are other
factors besides the age of identification when making a prognosis of an
apraxic child's future success at communicating verbally, such as
severity of the apraxia, frequency and appropriateness of therapy,
attention level of the child, parental involvement, etc
Seek private evaluations from an
ASHA certified SLP (Speech Language Pathologist) as well as medical
evaluations from a neurologist and a developmental pediatrician who are knowledgeable
about apraxia as well as other disorders. Bring these evaluations to
your child's school with the guideline at this link which is a guidelines for
how much speech therapy a child should have in school.
Mid Jersey Cares Early Intervention Collaborative
A partnership of parents and professionals and early intervention
providers working together to ensure high quality early intervention.