Apraxia or Oral Motor Warning Signs
There are two types of oral
a disorder where the child,
who typically is a "late talker" is unable to coordinate and/or
initiate movement of their jaw, lips and tongue (articulators) on
Oral Motor disorders,
which could be a different oral motor problem than apraxia (could
weakness for example) is the second type, where the child is unable to
coordinate and/or initiate movement of normal eating movements
Here are some possible warning
signs of the two types of oral motor apraxia written by a professional
with help from Lisa Geng, the parent of two children who were diagnosed
with 2 different types of oral apraxia by Dr. DeSouza, a neurologist.
This was updated after speaking with CHERAB's new advisor Sara R. Johnson
Can your child do the following regularly, or on command..
If your child can not do all or some of the
above -this may be a sign of Oral Motor problems which is worth exploring
with medical and speech professionals.
If you are seeing any of the above signs, seek out the services of a Speech-Language Therapist for
an evaluation of these skills. This can be done through your State's Early
Intervention Programs, a free federally funded program for qualified
children from birth to three years of age or through your school
district's preschool disabled program,
a free program for qualified children between the ages of three to 6
years. You can also contact
the American Speech Language-Hearing Association in Rockville, Maryland
list of certified clinicians in your area." It is very
important to have an ACCURATE assessment completed by a skilled clinician.
You may also want an evaluation from a developmental pediatrician, or
pediatric neurologist to look for signs of low tone (hypotonia) For
more information please continue to explore our nonprofit.
Reason to Know The Signs Of Oral Apraxia
Lisa Geng, A Parent Of A Child With Apraxia
I just received an email
from a parent who has a child that is about 18 months old, is nonverbal,
and was recently diagnosed with oral apraxia. She stated that she
was a "blubbering idiot" because she cried, and I sent her this
response, which may help some of you as well.
remember that I went to a huge fair for "special needs children"
that was a really wonderful and fun event for all the children-even the
"normal" brothers and sisters that were there as well. I
remember having a great time, and then all of a sudden it hit me that my
son was invited there, just like all these other children because he was
"special needs." All of a sudden it hit me-not that I
didn't know before, but up till then those words never meant that much I
stood there and was holding a hamburger for Dakota
and a hotdog for Tanner and I looked at
Tanner who was smiling and I started to tear. My baby is
"special needs." I knew I could have lost it, so I focused
on something else and acted like I had something in my eye.
didn't ask for this when we decided to be parents-this is an added
surprise. It doesn't mean that it's bad, it's just not what most
people go through.
Believe me I know what it's like to go from "he's just a late
this kid is SO smart-just look at him!" and believing he is
completely normal: to finding out a day later that...
"he is not talking because has a severe neurologically based
speech disorder which is called all different names which can mean
different things to different people since the medical and speech
professionals and the world can't agree on just one name so it's called
apraxia or dyspraxia or oral or verbal apraxia or oral motor disorder or
motor planning disorder or phonological motor planning disorder but no
matter which name you call it most of the world is still ignorant to it
but if I don't find out what he needs for appropriate therapy through
insurance and school when it comes to speech and occupational and physical
therapy as well as appropriate ways to educate him he may never learn to
talk, and in addition he always had "soft" neurological signs
like hypotonia and sensory integration that up until yesterday I
didn't even know existed and nobody not even his pediatrician ever knew he
had and it took a neurologist and a developmental pediatrician to point
these "soft" neurological signs out to us."
there are warning signs of oral apraxia, which can be spotted long before
verbal apraxia. Problem is that most people don't know what
they are. Below
are a few of the signs of oral apraxia that our son Tanner
displayed. Not every child with verbal apraxia has oral apraxia as
well, but it is not uncommon. Outside of the obvious, the reason we believe that we need
to include this page in this website is because parents have read
about oral apraxia at this website, and then based
upon the "signs" of oral apraxia they learned about, they took their
2 year old child for an evaluation, where the child was diagnosed with
oral apraxia by a professional.
We have been told that
besides this website, there is nothing else on the internet
with "Parent Friendly "Signs Of Oral Apraxia".
give you an idea what is out there now, here are two examples: This first one is a terribly
complex example: a textbook definition of oral apraxia-scroll down to number
3. This second one goes to the opposite extreme of being an easy
to understand definition of oral apraxia, but VERY limited information
to say the least! If you find anything new you believe is parent
friendly, please let me know.
there is not information out there that can be understood by
people outside the field of speech, then there should be for important reasons: Experts state
that oral apraxia can
be diagnosed as early as 18 months, which is over a year younger than a positive
diagnosis of verbal apraxia is usually received. For
intervention reason of "the sooner the better" for apraxia, awareness should be raised about
oral apraxia while we continue to raise awareness about verbal apraxia.
Is oral apraxia a red flag to verbal apraxia? Well according to Lori
Roth, M.S.CCC-SLP, almost every child with oral apraxia has
verbal apraxia. So by catching these easy to spot warning signs
early, we give our apraxic children the best possible chance. Overcoming oral apraxia gives our
children a smile, overcoming verbal apraxia gives our children a voice.
Below is a quote from "A letter to
parents" which contains some of Tanner's early warning signs of oral
"...We decided that this diagnosis of apraxia finally explained why Tanner didn't move his face much, he
typically would just stare at you without any smiles - we called him the
“serious baby”. Tanner couldn't
even lick his own lips! If Tanner had
peanut butter or chocolate on his lip he couldn't
even lift his tongue to try to lick it off. Tanner would
use his fingers to push the food on his lips into his mouth. Also, Tanner
couldn’t blow the candles out on his second birthday cake, in fact, he
couldn't blow bubbles until almost 3 years old even though he tried and
tried. Nobody, including
Tanner's Pediatrician, or his first Speech and Language Pathologist, knew these were all strong warning signs of Oral Apraxia-which
can occur with Verbal Apraxia. There are professionals who are knowledgeable,
you just have to find them."
Dr. Marilyn Agin is the
Medical Director for Early Intervention in New York, as well as having a
private practice for pediatric and developmental medicine in New York
City. Dr. Agin is also the key
medical authority behind the CHERAB Foundation.
A prominent Developmental Pediatrician in private practice in NY, Dr.
Marilyn Agin, who attends many of our meetings, is
also the Medical Director for Early Intervention in New York.
Dr. Agin, prior to medical school, received her master's degree in
Communication Disorders, and was practicing speech pathology treating
adults and children.
Dr. Agin is extremely knowledgeable about apraxia, and autism, and frequently lectures
to the medical community about what apraxia is, and isn't. Dr. Agin gave permission for me to use her phone
number on this website, (212) 274-9180.
When Dr. Agin saw Tanner
for the first time at 3 years old she shook her head and said,
"I could have told you a year ago this child had severe oral apraxia,
he doesn't know where his tongue is in his mouth!" She
diagnosed Tanner with apraxia after a brief examination where it was never
seen by Tanner's pediatrician, and it took months for even a speech
therapist to diagnose Tanner with apraxia! Tanner could have received appropriate
therapy a year earlier if we only knew."
Dr. Marilyn Agin is in private
practice as a Developmental Pediatrician, and the Medical Director for
Early Intervention in New York City. She is very knowledge about
oral apraxia, and lectures to the medical communities about
apraxia. If you have medical questions
regarding "Late Talker vs. Apraxia," why not "Ask