Another Vocabulary Word: Apraxia

Charlie’s appointment with the developmental pediatrics clinic yesterday was so-so. It could have gone better. On the other hand, it could have been worse. I have been given a new word to learn and digest: Apraxia.

The day started when Charlie met with the speech pathologist for her evaluation.

The speech pathologist was thrilled with Charlie’s feeding progress. When she was evaluated last April, she would not allow a spoon to pass her lips. Yesterday, Charlie happily munched on crackers and sipped juice through a straw. I proudly rattled off the list of foods Charlie will eat. We discussed my concerns that she often chokes and does not eat enough solid food to meet her nutritional requirements.

During the second half of the evaluation, the speech pathologist assessed Charlie’s speech delay. From what I understand, Charlie should have more words and the few words she has should be clearer. However, her receptive language (her understanding) is great. The speech pathologist mentioned the word apraxia.

The occupational therapist was the next to assess Charlie. During the evaluation, she placed a peg board with pegs in front of Charlie. I had not tried anything similar with Charlie and I wasn’t sure she would be able to do it. Much to my surprise, she followed the OT’s cues and placed the pegs in their holes. I was ecstatic.

Charlie tested slightly below her adjusted age which is a huge improvement over her past OT evaluations. I am proud of Charlie’s progress. A year ago, I was elated her hands had finally opened and she was strong enough to hold a light toy. I did not dare to hope that Charlie would be where she is today. There was too much heartbreak at stake.

Next, Charlie saw the developmental pediatrician. He further discussed apraxia with me and suggested, if at all possible, Charlie receive speech therapy twice a week. He mapped out the obstacles I face such as insurance coverage and finding an appropriate therapy program to provide services.

Also, we discussed whether or not Charlie needed another set of AFOs. He didn’t think it was necessary but wanted to see what the physical therapist suggested. Charlie has hypertonia in her ankles and hypotonia in her knees and hips. We finished our meeting with a discussion about changing from Early Intervention services to private center based services.

Finally, Charlie was assessed by the physical therapist. Overall, Charlie did really well (for Charlie). The physical therapist recommended that Charlie have shoe inserts rather than AFOs.

We finished the long day by fitting Charlie with her new inserts.

Overall, I’m delighted with Charlie’s progress in the PT, OT, and feeding part of the speech evaluation. Although, I’m a little crestfallen that her speech delay is more complicated and of greater concern than I had expected.

Now, I  have the task of implementing the clinic’s recommendations while navigating the obstacles of insurance and available services. It feels a little overwhelming. However, I am chipping away at things a little bit at a time. Hopefully, things will be in place before I know it. Day by day is all I can handle right now.



About Rebecca Wood

In May 2012, my pregnancy ended three and a half months early due to severe early onset preeclampsia. This is my collection of thoughts and media. It is an attempt to document and discuss our experience of navigating the post NICU world. View all posts by Rebecca Wood

9 responses to “Another Vocabulary Word: Apraxia

  • Rachel Z

    Do you qualify for early intervention services? In our state, we can get speech, physical, OT and feeding therapy for free until age 3, and they will come as often as we need them to. We have thought about doing private therapy as well, but right now I love our early intervention team, and I don’t have to fight with insurance to get the visits covered.


    • Becca

      We are currently receiving early intervention. However, in our area they will not provide services more than once a week. Also, our area’s play based parent coaching model is not what Charlie needs. Although, it really depends on insurance coverage and what is available what we end up doing.


  • Nicole

    I have twins (former 25-weekers) who are now 27 months old. Our son’s issues are quite different than Charlie’s, but our daughter’s challenges sound similar (doctor saying things like, “too few words,” “not clear enough,” etc.). Although we just started speech therapy for her in January and she has already made a lot of progress, I really think that her speech development came along on its own because she started saying much more the week before we started our speech therapy sessions! So now it looks like all of her progress is due to therapy, but I honestly think a lot of it is just due to the fact that she’s finally ready! So please be encouraged that Charlie is doing well. I’m actually amazed to read her story and see her doing things that my twins are just now doing. From where I sit on the other side of this computer screen, she really seems to be doing so very well! Especially as you list the challenges she was dealing with a short twelve months ago! Remember…many children haven’t had to overcome the tight fist, the tone issues, and the other things that Charlie has been working so hard to overcome. So her speech is something that will probably begin to flourish once she can spend more energy on it (and not on feeding issues, standing issues, OT issues, etc.). May you be encouraged today! Even as all the snow continues… 🙂


  • A Miracle In the Works

    Thinking of what an amazing mama you are to help Charlie along!!


  • Julie W.

    Thanks for posting more about Charlie’s speech. I have commented before about my 24 week twins delayed speech (they are 16 months adj, so very close to Charlie). Our speech therapist (once a week through EI) mentioned apraxia last week in reference to one of my boys. He doesn’t really talk, and just babbles a small amount with mostly the same syllables. He does say mama and ba for ball. She did say it’s hard to diagnose and separate from oral motor weakness issues, so we haven’t changed anything yet. Please post more on her speech therapy, especially if they are using any useful techniques that I can ask our speech therapist about! I’ll let you know if we come across anything too!


    • Becca

      It’s a deal! I will certainly post more as we move forward with therapy.

      I’m so glad this is helpful. It is the reason why I post.

      Keep my updated with how your little one is doing!


  • Laura

    Hi there! I am a mom to a late-term preemie who is now five. He also has Apraxia (childhood apraxia of speech or developmental apraxia). He was/is fairly severe and has some feeding issues that he is overcoming. He was non-verbal until 3.5 and now doesn’t stop talking! It’s a long journey but amazing! I blog about it often on my web site but feel free to contact me with questions. Good luck!


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