Home Speech Therapy Exercises

Using my Repeat, Simplify and Wait process helps give children the time, tools and confidence to practice speaking.

If your child has Childhood Apraxia of Speech, these tips are really helpful. Combine oral language with sign, prompts and Pictos to reinforce and encourage. Always do it in a spirit of learning and fun.

Don't forget to give lots of praise for any speech attempt!

Let me know how it works out for you and feel free to ask me any questions!

We Used to Fear He Would Be Non-Verbal

It wasn't until last year that the Little Man started speaking sentences, and even then, only we could understand him (and only sometimes). That's not so much an autism thing, but an apraxia thing. I mention it also because not a lot of people, including professionals, know about Childhood Apraxia of Speech (CAS). It's a motor-planning speech disorder. Therapy helps, but it will never go away completely. It means, for the most part, he understands very well, but his body is not reliable when trying to express what is in his brain. The whole body type of this condition is called dyspraxia, which he also shows symptoms of. In fact, I often believe his apraxia/dyspraxia is more challenging to him than autism is. It is quite a double-whammy of communication challenges.

Anyhow, we were at some point very concerned and thought maybe he would never be able to make himself understood verbally. With lots of speech therapy, he went through a huge leap in development and now speaks TONS. I have yet to capture one of his amazing monologues on video (he tends to get shy around cameras) but I can try to capture his more verbal moments by writing them out from memory.

Here are two recent events where he got really excited and the words just came flowing out.


I took him with me to the garage to get the tires changed:
"I love this place! We need these tires! We need these...things! (Those are rims) We need those rims! (Those are too big for our car). Oh we need these ones. What are those? (Those are windshield wipers) Look at them! They cost $150. (No, those are 15" blades) Oh my GOD! There are magazines here with monster trucks! I love monster trucks!"

I took him to his great-great aunt's house for her birthday:
"I love your place. I love your door, there's a flower on it. Oh look, you have a table. She is in this house again (This is Aunties' house. She lives here). It's your birthday. I made a blueberry cake for you. You need to eat it now! Eat it, eat it! You want to share with me!"

LOL. This kid cracks me up and I enjoy every moment. Believe me, after being silent for so long, we never tell him to stop talking. 

Being A Burden

He woke up often at night, scared. He would call out to me. I would sit with him and tell him jokes to ease his anxiety.

It was hard to get him to eat anything. He was picky and had problems chewing. He would choke easily and drool a lot. Eating was always a big mess. He did better with liquids, but I had to give him a straw and watch him carefully to make sure he didn't choke.

He had problems going to the bathroom by himself. I helped him pull his pants down and he'd sit on the toilet for what seemed like hours sometimes. He would later tell me it was difficult to coordinate and relax his muscles to do what they needed to do.

His balance was not good, so we had the help of a physiotherapist and OT. He didn't really like it, but eventually he did the exercises and got some confidence. I remember him walking with the aid of a support harness and the OT hanging on tightly to help keep him up. He still tired easily and fell often, sometimes hitting his head quite badly.

His speech was slurred and hard to understand, so we got him speech therapy. Again, he didn't always want to cooperate, but we all pushed him and supported him in his efforts.

Otherwise he spent most of his day quiet in front of the TV. Or sometimes he listened to music and closed his eyes. It was hard to get him to interact with me. And sometimes when he did, he was verbally abusive. He was very controlling about the way things should be in his room.

He was a challenge and a lot of work, but I love him and I never gave up on him.








I'm talking about my father before he died from Parkison's. I was his caregiver.



He never wanted to be considered a burden. That was his fear. I never considered him a burden, even if at times he did not make the process easy and he certainly wasn't always nice. He abused me verbally my whole life, up until just before he died.

I never once thought of killing him.

Do not tell me caring for someone with special needs is a burden. Do not tell me my father was a burden to society.

Do not tell me caring for my Autistic son is a burden. Do not tell me my son is a burden to society.

Do not tell me either of these situations makes it understandable to murder either of these people, no matter how abusive or difficult things get.


This was written for Flash Blog for Isabelle Stapleton

Intensive Speech Therapy

The Little Man started specialized speech therapy for his apraxia. We're happy to be working with the best of the best - she's an expert in motor-planning speech issues - but it is really intense.

She works him really hard and he has been a real trooper keeping up with it. It's a lot for him - he looks at us periodically for support and we're both at his side cheering him on. He accepts her touching his face and manipulating his mouth to get the right positions and pronunciation. That's a lot for a three year old, especially one with sensory issues. He fell asleep in the car on the way home, poor thing.

However, he is eager to learn. We've been doing his exercises at home and he seems to feel it's a game. He's already sounding more clear. I am really proud of this little guy.

Geez, Apraxia AND ASD?

We finally finished the pre-school speech therapy evaluation today. Of course, she still has to go through her notes and write the report, but it looks like the Little Man has Childhood Apraxia of Speech (I just say apraxia, cos I'm lazy like that. Or maybe apraxic myself. Ha ha.) Now, he's too young for her to pin that diagnosis on him, so all it will say is "motor planning speech disorder" or something like that, with recommendations. She recommends DAILY speech therapy.

All I can think about right now is, how do we accomplish that without either of us quitting our jobs? The only thing I can come up with on my own is to hire a driver to take him from daycare, to his appointments and back. Anyone else have any ideas? Because I'm at a loss.

Not that it would hurt, but we can't just go with any speech therapist, we need to work with one who specializes in motor speech disorders. I think I'll wait for the report before I start letting my head explode though.

And I realize I should explain this in lay terms to those who never studied linguistics: apraxia means his muscles work in his mouth. It means his brain has words in it, but when he tries to use his mouth to produce a word, the signals in his brain become all uncoordinated and his muscles don't move in the correct way to make a correct utterance. So basically, he is unable to say everything he wants to say that is in his head. Learning to write/type will probably help him express himself.

The other overwhelming thing to me is to think, gee, he's both ASD AND apraxic. Like, holy hell, there is no God! Seriously, who would do that to someone? Especially a kid! Argh, I just need a few moments of "why him? Why me? Poor him! Poor me!" and then I'll have to let it go or it will depress me. There are many days I believe he is more resilient and determined than I am.

But at the same time, I can pat myself on the back for my instincts and my fight. I've said it many times here I believed he had either apraxia or dysarthria (see, my degree was not wasted!) and I've managed to keep searching for answers. A mama knows her child.

A Twinge of Sadness

In our continued effort to get all our evaluations updated, the Little Man had a speech therapy evaluation yesterday. Only we didn't finish because after an hour, he started to shut down. So we need to go back. I wasn't counting on it and I should have. It means I need to take another day off work.

On the plus side, he loves "playing" with the speech therapist, so it's not so bad.

I can't help it sometimes, when we're sitting there observing yet another specialist ask him all sorts of questions and testing his knowledge, to feel a little sad for him. Your average three year old just gets to go to the park or daycare and play. No one tests them for hours on end and makes them perform. They just get to play and be themselves. Yet almost weekly, this guy is poked and questioned and observed...and he takes it like a trooper. He doesn't know any other life. For all he knows, all kids have to go through this.

I'll admit I have moments when it just seems like life is unfair. But at the same time, he is so strong and so determined and I am so proud of him. He gets frustrated, but he doesn't give up. He puts up with so much more than a neuro-typical has to and keeps smiling.

Mama On A Motherly Instinct Mission

The Little Man had an Occupational Therapy (OT) evaluation yesterday. We had seen one before at the Children's Hospital in the feeding clinic, but I didn't like the way they work (wanting me to bride him to eat good foods by using things like chocolate and ice cream). Not only that, but the psychologist there isn't great with autism and they don't really "believe" in sensory issues - it's just not their thing. So rather than butt heads, we thanked them for their time and stopped going.

Fast forward to us applying for the QC disability allowance and needing a real written evaluation done. I've already learnt that if you want something done around here quickly, you need to go private. Luckily, we have private insurance to cover most of this. The QC government gave me a month to supply them with evals in OT and speech therapy - I luckily managed to get that extended by calling, but all this stuff needs to be done. So I went to the semi-private clinic he normally goes to and got a new OT there. She actually works at the Children's (so again, not a big believer in sensory integration issues) but she did a total developmental assessment on him.

He needs some fine motor skills tweaking, but is mostly age-appropriate (3 years) which is great news. Because of that, we probably won't qualify for the disability allowance, but I don't care at this point. What was really helpful was having her confirm my Motherly Instincts (so useful when you listen to them!) about him really needing to focus on language and social skills.

It's just so annoying out there, with some many businesses trying to make money off of parent's fears and uncertainty - the whole, "if you don't do something right now and do it really intensively and spend eight hundred million dollars on therapy, well....."

No, I know my kid. I know him better than anyone. Crazy intensive ABA therapy would stress him out more than do good. He has problems speaking, maybe apraxia, maybe dysarthria, maybe both. It doesn't matter what, but that's what needs to be worked on. He's a good kid, a bright kid, a quirky kid, but one who is capable of learning and wants to learn.

So really, the OT just reaffirmed my instincts and strengthen my resolve to find a speech therapist who will go into his daycare maybe once or twice a week and work with him. I'm a mama on a mission, a clear mission, to continue to follow my instincts.

DisAbility - There Must Be An App For That

The Little Man got approved for the Disability Tax Credit, much to both my surprise and joy. He qualifies until 2027. This also means we can open a Registered Disability Savings Plan. We're also allowed to claim as of 2010, so we'd have to resubmit our taxes.

Still haven't heard from QC (not surprised) to see if we are entitled to the Disability Supplement. It would be weird if Canada approved and QC did not, but weirder things have been known to happen. Anyway, it should help because therapy is stupid expensive. It's just weird that the CLSC didn't deem him disabled enough for free services, but the government does. Everyone is reading the SAME report! But whatever. I can't complain. Just have to keep truckin'.

Anyway, I got a 3rd call from an "autism company" - for lack of a better term - these people who like trying to make money off of worried/stressed out/desperate parents. They create these special "programs" off the top of their heads and then try to tell you they're the best. My fault for the initial inquiry I made, but now she keeps calling me. If I wanted her services, I would have called back, no? She was actually still in the running until this last call where she clarified that a speech therapist does NOT in fact work with the child, an "interventionist" does. This interventionist of hers has a degree in Social Science. She does not have a degree in Speech Language Pathology. I was told this was an advantage because it "saves you money!" No, it's not. I explained that I'm happy to save money by buying cheap socks, but speech therapy is not something I want to skimp on. Really lady? And what the fuck does a social science major know about autism?
Next!

I'm like 99% sure he's got apraxia. I got an iPad and downloaded like, 3 million free "autism apps" and he's having fun with them. Visual focus is not an issue for him, but active listening can be. Although, I should compare him with neurotypical 3 year olds for that; he's probably not out of the ordinary. He understands everything. It really only seems to be a production issue. I'm gonna look and see if there's an app for that! LOL

He's a week away from his 3rd birthday, which blows my mind. Time flies! It feels like just yesterday his little bald head lay next to me in bed in a puddle of my milk.
He's so lovely. He's like, magical or something. I can't explain it. He just speaks to my soul.

Why Me?

The Little Man is almost 29 months old and still makes no two-word utterances other than, 'oh oh' or 'oh no.' If we ask him to make a simple sentence like, 'dada up' he says only either 'dada' or 'up.'

I have days where I want to stick my head in the sand and wish he would wake up the next day suddenly talking. Believe me, the irony in the fact that a linguist has a child who cannot speak is never lost on me. But in some ways, I guess I'm best suited to recognize we needed help and to have an idea of what to do. Even then, it doesn't make it any less frustrating. Part of me wishes I could do more playing with him and fewer exercises. Yes, we still play, but interspersed in that are OT exercises for his mouth and speech therapy. Other mamas don't have to think about intregrating those things into their days. But I guess we all have our issues and I don't want to fall into the, 'why me?' trap. It's hard though, I won't lie. Still, the more we do, the more he improves, though slowly.

Today at lunch he ate half a ham sandwich and a pack of mini Oreos. He's finally chewing and enjoying food. It might not seem like much, but it's a big deal for him and us. I was so happy to clean off his Oreo-covered face and hands. 'That is what a normal 2 year old should look like!' I said. Just happily eating a sandwich and cookies. When it has been such a struggle to get to 'normal' or everyday activities, it's such a celebration.

 In other news, the second blood test he had for celiac came back inconclusive, so we need to have a biopsy of his gut done. It's a quick procedure, but it's done under general anaesthesia, so we'll be at the hospital half a day. It's a three month waiting list, so we're just waiting.

You Don't Need to Talk to Lie

I was surprised today when after I caught my son pouring his chocolate Pediasure all over the floor, he lied when I asked him who did it. At first he just looked away and pretended not to hear me, but I asked again. I asked a few times. Finally he "said," "swish, swish, " which is his way of saying, "drink." Even without being able to talk, he was still able to lie. I told him, "no, the cup did not make the mess, you made the mess!" and he started giggling. He's cheeky that one!
Still, it's impressive and it shows he understands. Also, if you agree with this small study it's also a mark of intelligence.

In health news, he has grown quite a bit in the last two months. His EEG was normal. I told the psychologist I wasn't interested in using her techniques to get him to eat (bribe him with chocolate or ice cream to make him eat other foods) and she seemed to be offended and left the room. We're working solely with the OT right now and that's helping a lot. We have to commit to doing strengthening exercises with him daily, but it's worth it! They seem to be working!

We go back to see the speech therapist in April and we'll decide then if we need to get a specialist in dysarthria or apraxia. In more positive news, he has started verbalizing, "hi" and "bye" again. He used to only say them to my dad and when he died, he stopped. It's been just over a year and I finally get to hear those words out of his mouth again, though much quieter and shyly. I hope he does not believe that saying those words makes people he loves disappear. This is one thing I have had a very hard time dealing with. I don't want my baby to worry or be sad. 

I Don't Ask for Much From My Baby

We met the other speech therapist today. To sum up, in her educated opinion, our child is immature, spoiled and a late talker. She put it more diplomatically than that, but that's the gist of it. Because his play behaviour is so behind (she put him at behaving like a 15-18 month old - which I agree) she believes there is "something else" but not ASD, luckily.
Also, because of his persistence in walking with his arms up, hands often clenched, and general clumsiness, we're looking at mild Cerebral Palsy.

And just to be clear, because I think people probably bring too many of their own personal issues into these things when they read my reports/updates/speculations:

**I don't love my son any less. I don't think of him any differently. He does not become a disease, disability or label suddenly. I don't care what he has or doesn't have, nor do I care how it was caused (since I can't change or fix that now), I only really want to know so we can provide him with the best care and opportunities possible.**

Well-meaning people have already said too many stupid things to me - it's not about me worrying or wanting him to become a genius with three Ph.D.'s and find a cure for cancer. I'm not thinking that far. I want him to be as happy and healthy as possible now, so he can reach *his* full potential, whatever that is.

You have to remember, he is my fourth "baby." I gave up all that shit about expectations a long time ago. When he was born, I cried because I was so happy he was ALIVE. And that's still how I see my life with him.

He's alive.

I don't ask for very much from my baby.

Plodding Along

We had the first adoption/fostering info session last night and it seems that my friend either misunderstood or was lying to me? Yes, we can have the kids in the same room, just not the same bed (quite reasonable to me!) and yes, we can proceed after a "traumatic" event like death in less than a year if we're ok with it. It's a case by case thing. It all comes out in the assessment anyway. I'm a little upset because I don't understand why she would lie to me, I really don't. It's not like we're in competition - from what I understand there are more than enough kids to go around. Good thing I didn't listen to her and kept going along with my own plans! Plod, plod, slowly plod....

I've also been occupied trying to find another therapist to do an assessment on Boo's speech. The first one didn't even look in his mouth. He has a little bit of an upper lip tie and a high hard palate. Helllooo? Can anyone try looking at that? I'm thinking there might be some apraxia(CAS) going on? It's tough also because he's under two and it's hard to get a diagnosis before two, but he's almost there, soooo...by the time I actually get an appointment, maybe he'll be two? I'm going private again cos I don't have time to wait for this shit. Plod, plod....
Don't remember if I mentioned this, but my mom gave him a complex command in French (go get my bag and bring it here) and HE DID IT! I was so surprised! My little dude is bilingual. *beaming with pride*
Makes the plodding more bearable.... :)

It's a lot of work being a mama.