Gifted Issues Discussion homepage Forums Twice Exceptional Anyone with child that has Apraxia of speech?

Our little guy is aging out of Early Intervention next month and we're figuring out what's next (since we got the high functioning autism diagnosis back in January). His communicative speech is still very delayed though he has made a huge progress in how he communicates with us. He has been getting the standard EI speech therapy with a girl that's just freshly out of college and she certainly doesn't have enough experience to work with a child like him, but it's just a matter of another 3 weeks, so fine with me.

In the meanwhile, I have been trying to figure out what is REALLY wrong with his speech. He has a HUGE vocabulary that he has learned mainly from ebooks that are read to him (by Kindle and by all the kid's ebook readers), he likes to repeat the words while reading the books, he can READ a lot of words, some phonetically, some sight words ... but his big thing is communication ... actual TALKING to us and everyone else. He sticks to one word communication and even that's a big improvement (no more crying and tantrums). At the same time he LOVES to babble in his own way, usually in the evening. He has this whole conversation with you or with himself but it's not real words. It's sequences of mainly vowels and few consonants. It's like listening to some primitive African or Amazonian tribe. It's like words only make sense to him and he can formulate them when he sees them or hears them in a game / computer ... but can't put a sentence or even word together on his own. The more the therapist (or anyone) pushes him, the harder it is for him. I've asked the therapist a few times if she thinks there's something wrong with his mouth (muscle, etc) because he hardly moves his jaws when he talks, making the sounds even more muffled. Her only answer was to practice faces in front of a mirror ... he couldn't care less about a mirror!

So, reading up about all kinds of speech issues, I cam across Childhood Apraxia of speech and to me it sounds very much like what he has! Of all the symptoms I've read, he matches good 90-95% of them! Yet when I asked the therapist (just yesterday) what she thinks about him having Apraxia, she said absolutely not. Said that if he had Apraxia, he wouldn't be able to say the words at all. Not just have problems sometimes. .... but that is NOT what I have read in multiple sources???

He has an full evaluation (ST, OT and DT) this Friday done by our School district to see what services they can offer him once he turns 3, so I will bring it up there and I think I will get him a private evaluation through a place where DS4.5 goes for OT but wanted to ask here ... does anyone have a gifted child with Apraxia? if so, what were they like around 2 or 3 years of age? Both, my husband and I think that most of his problems are NOT autism related but caused by whatever speech issue he has.

My younger child has dyspraxia (sometimes called apraxia of speech in the U.S. if only oral motor is affected). It's a motor planning issue, getting your mouth to do timely what your brain is telling it to do. Kids with this problem can be anywhere on the intellectual level. Does he seem to know what he wants to say, but have trouble getting it out?

Hi,
Just to let you know, I also thought maybe DS had apraxia way back when, and the SLP said noooooo. I realized soon enough that he didn't have apraxia.
DS is just fine now, though pragmatic issues, and receives ST for this.
I hope you have good results from your childs upcoming eval

I am not a professional but what you are describing sounds exactly like a gifted child on the spectrum to me - huge vocabulary but no pragmatic language or interest in communicating with others. Avid interests - but entirely self centered/driven, with zero interest or tolerance for other peoples ideas, interests or activities.

I understand that you feel he's happy in his own world and only unhappy when in therapy - but to me that's kind of the point. While he definitely needs time to just be, and to be happy, he does also need to be learning the skills to function later...

His therapist doesn't sound that skilled so a full evaluation sounds like a good plan.

the problem is that some of those could be either Autism OR Apraxia / dispraxia OR both. I've been doing some reading on Apraxia / Dispraxia and how it differentiates from Autism and one thing that stands out for me is that with Autism the child is stuck on rituals versus with Dispraxia the ritualistic behavior is not there. He's never had any behaviors like that (unlike DS4.5 who has PDD-NOS diagnosis) and while he wants to do his own thing, he has no problems with transition. I've always said he's our "easy" baby. He's just very relaxed and goes with the flow. He IS very self directed.

Even his Developmental therapist and my older son's OT who've known him for about a year don't quite believe he's Autistic. They say gifted and very stubborn and with sensory processing issues (that run in the family). I would think that since he just turned 3 it's too early to evaluate his pragmatic language skills? But I'm not sure. It's one of the reasons why I'm getting an independent evaluation. ... we had DS4.5 speech re-evaluated couple months ago because I was worried about the pragmatic part of it and the evaluator said in the end that DS just has too much to say and makes it look like his pragmatic language needs help.

I just realized one thing ... my initial post was from about 3 or 4 weeks ago ... we have had some improvements since ... last week, basically overnight, DS3(this was 2 days before he turned 3) went from speaking in single words to speaking in full grammatically correct sentences! He still doesn't talk much but is clearly capable of it. But there still seems to be the issue where he can pronounce words clearly and then the same words say again and you have no idea what he's trying to say. His private speech eval is tomorrow morning so I'll report back what they come up with!

Family myth:
My FIL did not speak until he was almost four.

First thing he said was:
"Mother, may I please have more milk in my cereal; it is tending to be a bit dry."

His mother:
"You spoke! Why have you waited so long?"

Him:
"Until this moment, everything had been just perfect."

There seem to be some kids who want to completely master a system (speech or otherwise) before they use it. I wonder if you 'll see more of these nothing....nothing....nothing...everything! moments as he grows up.

yes, that's definitely a possibility! I never heard him attempt to count ... until one day he started counting the pieces of hot dog on his plate to 19 (23 months). I never heard him attempt to / pretend to read ... until one day he started sounding out and reading words (28 months) ... never heard him try to say the alphabet backwards until last week he just started walking while reciting A - Z and then Z - A ... and thought it was perfectly normal (other than telling himself "GREAT JOB!" when he was finished! :)) ... he's definitely one of those kids who are hiding abilities and then take huge leaps! The only problem is, when he has any sort of evaluation he comes across as 6-12 months old ... 18 months at best in the paperwork I've seen because he simply couldn't care less what others think about him!

I ordered the book Einstein Syndrome over the weekend to read up on it a bit more. Not saying he's the next Einstein, I know there are kids on this board that are a lot higher up on the scale but he certainly seems to fit the Einstein syndrome child description quite well. Might be interesting reading no matter what!

MK- that's why they say the saying "if you've seen one kid with autism, you've seen one kid with autism" *because* it is SO different for every child.

My DS did not have repetitive behaviors, was fine with transitions also. He had very mild stimming- but maybe it was just "nervous energy"? ok, it was most likely stimming. No one except for the Pysch who Dx him has ever thought he had Autism. No one would ever even suggest it. Of course I have TOLD ppl and his therapist knows, they don't question it- it isn't their job... well, some HAVE questioned it. I think with mild or high functioning- whatever name you want to give it- it is just such a fine line or gray area....

Does my child being possibly gifted make him less aut? or does his autism make him come across as less gifted?? There is no denying he is s.m.a.r.t.

The point I think what many are saying-- an Autism Dx is NOT a horrible thing. It doesn't have to be. For us it was a means to an end- DS rec'd needed therapy ie speech, adaptive skills(he currently is getting this- mainly to tie in his pragmatics in social setting). I/we have not treated him any differently than another child. We expect no more or less from him. Wait, I am more patient with him! **that's a terrific thing***

*kids who are simply just HG etc also sometimes need social help! another gray area- and the HG kids do NOT get social or adaptive or speech unless maybe a Dx of apraxia-

You need to do whatever it is that you feel is right for your child. Just don't let the word "autism" freak you out much. It is just a word. It doesn't define your child. It doesn't define mine! My DS is all typical boy with a few quirks. Again, you wouldn't ever know he had a Dx. He's bright, fun, funny (loves to joke and make ppl laugh),super sweet, has tons of empathy for others, and cares about the future of our planet and humans in general- he is very spiritual all on his own in this aspect (can be a lil bit freaky even asking stuff he shouldn't even be aware of!- i think this is the gifted side with maybe the auts innocence?)

If your child isn't on the spectrum, that is ok too ;)~

cc6 ... I know it sounds like I'm against the diagnosis itself but I am not. I am open to it ... I just want to make sure that's what he really has and want to explore other possibilities as well. The diagnosis was based on a 30 minute evaluation. And when the diagnosis was made a lot of things I told the evaluators was taken out of context (I realized it reading the reports afterwards) ... such as when I mentioned he counts objects and recognizes numbers to 20 ... the report said ... "repetitive behaviors - rote counting" ... and other things like that. That's why I don't want to just go with that diagnosis and be done with it. Especially when it doesn't really help with the fine motor skills issue. The recommendations were mainly behavior therapy when what we're seeing is figuring out what is best Speech and OT for him. I hope that makes sense?

Other than that, I don't have a problem with my child being Autistic if that's what he is. I find people having a lot more patience with him when I disclose it (like Emergency room at the hospital, etc.) ... it's like a magic word that suddenly gives more patience to everyone around.

But the lack of certain movements of his mouth (along with serious lack of skills when it comes to his hands) ... there's definitely something that needs to be checked out. When I mentioned it to the speech therapist he had with EI her response was have him make faces into a mirror (he smiles / laughs but does not stick his tongue out at all (tried like once!), doesn't make any other faces like other kids do, can't pucker his lips.

He had a small birth defect where there was a small hole in his bottom jaw bone. So it just makes me wonder, if there was a defect in his bone structure, no matter how small, how do I know for sure there isn't something wrong with the muscle structure as well?

Mk13, I think you're doing all the right things - researching what you can, thinking through the evals your ds has already had, asking questions, digging for a deeper understanding of what's up. FWIW, I think that it's a good idea at this point to seek a really thorough eval again, from either a pediatric neuropsychologist or a developmental pediatrician.


Our neuropsychologist has a chart that shows how symptoms overlap between autism spectrum disorder, developmental coordination disorder, and ADHD - there is *quite* a large amount of overlap, but each diagnosis also has very distinct characteristics. How those characteristics play out in any one child is going to be very unique and individual, but there are markers that are used to differentiate between ASD/DCD/ADHD.

Our ds13 who is dyspraxic has some symptoms that could fall under an ASD diagnosis, and he's had a few people here and there over the years suggest that he might be on the ASD spectrum. Two of the people who've wondered are friends of mine who live far away from me and who are parenting children who have Aspergers. We primarily communicate via email, and when they listen to my descriptions of what's up with my ds there are times when they see commonalities in things that their children have experienced, so they naturally wonder, hey, that sounds like Aspergers - because that's what they know. DS also had a counselor he was seeing a few years ago who wondered if he might be on the autism spectrum - burt she was a counselor, not a psychologist or psychiatrist who could make a thorough diagnosis; she was a counselor who had a large percentage of her practice made up of children with Aspergers and who had never worked with a child with DCD before. When she raised suggested we have our ds go through an autism spectrum eval with her office psych, it coincided with the same timeframe our ds was already scheduled to go through an updated eval with the neuropsych who he'd seen for his original DCD diagnosis - so I had an opportunity to get her input on the situation before putting ds through yet another eval. Our neuropsych also diagnoses ASD and ADHD, so she showed me the part of ds' eval that showed clearly, to her, that he is *not* on the autism spectrum.

It sounds like the eval you had previously was brief (30 minutes) - you might post what surveys or criteria/scales/etc were used to diagnose and compare that to what other parents here who have children with ASD diagnoses had included in their children's evals. My gut feeling is that 30 minutes with only parent input and the brief in-office-30-minute observation by a dr/psych isn't enough to diagnose autism - but that's just me. My ds' diagnosis of DCD was much more involved and has also evolved over time as he's grown and we see the different ways it impacts his life.

Last thing - re the sudden development of speech out of nothing. My ds didn't talk, didn't babble, didn't really make sounds much at all for the first three years of his life, then overnight he started talking in complicated, complex sentences. Like a previous poster mentioned, at that time, we thought he was just a kid who's personality wanted to know fully and completely how to do something before he tried it. There are kids like that; maybe that's your ds. OTOH, making no sounds, no babbling, then suddenly talking as if he's mastered it - those are also symptoms of ds' DCD.

Which doesn't mean your ds has DCD, or autism, or anything. I do think, in your shoes, I'd be questioning and researching just as you are.

Hang in there!

polarbear

MK- I understand, I just meant that aut dx allows for all therapies, and you would qualify for the fine motor and or gross motor. No matter what the childs Dx, he should receive appropriate therapies etc for whatever he presents with.

I forgot to add that my DS also seemed like it was a processing thing- like he wanted to say it but didn't? idk. I thought maybe "auditory processing disorder" but no that wasn't it. I remember also becoming obssessed with idea he had something wrong with his tongue of all things! As a parent, early in any Dx, you kinda go thru the motions until you come to what you feel really fits... And you'll find that space too, and no matter what Dx your child ends up with (or doesn't), what really matters is that you are giving him ways to cope with whatever things he does present with. Do I make any sense?

*I'm going to study DCD more myself b/c this is also something sounds much more like my DS than autism. He had 2great years of outside NPA service for OT- mostly gross motor ie balance coordination, core muscles, but also the intrinsic muscles his palm. He still gets sooooo tired crampy from writing. He really improved alot, and also b/c I did what was suggested at home and just really encouraged all motility etc..

He's still not going to be a star athlete- then again haha who knows? But he's not so clumsy... tripping over his own feet. Actually he is super fast and a natural hurdler- go figure! (i've had 2 different times where pro's approached me re: his natural gait for it LOL who KNEW their was a natural hurdling gait? wowza! hahaaa)

Also, MK- I hope I not come across as suggesting your kiddo is Autistic? I have no clue. And so I am sorry if I came across that way, not ever my intention. Heck, I'm STILL trying to figure it all out, even while being accepting of DS- how does that even make sense either? %/

cc6 - no worries! I am glad to hear everyone's opinions and experiences! To me that's worth more than anything any doctors can tell me. Quite honestly, when an outsider looks at my son, I have no doubt they must see him as autistic. And I was the one initially seeking the diagnosis because I thought it fit. But at that point I had no idea about all the other disorders that could mask as or coexist with ASD diagnosis.

polarbear - thank you for your thoughts here and on my other somewhat related thread I started couple days ago. Just wondering, when your son was little, was he seeking a lot of deep pressure input? DS loves to be squeezed and loves to rub against us a lot, especially with his face. Just like if you imagine a cat or dog would do. My husband and I joke about it that we have our little human puppy . I wonder if he does it to feel more sensation in his face maybe?

I just find it incredibly frustrating to see how my son is supposed to be getting this "one size fits all" treatment and I KNOW it's not what he needs.

thank you! Looking at the diagram, I would think he'd fit more in the Dispraxia/DCD category than Autism but it's really a tough call to make when it comes to the imagination and social areas, that's something that will just have to sit tight and wait till he gets a little older.

What is "one size" about what he's getting?

FWIW, I see it as Mum3 does; to me (over the internet, where one cannot diagnose anything even if one were qualified), your DS sounds like gifted/autistic. Many or even most autistic people have comorbid conditions, so the combination gifted/autistic/apraxic is certainly possible, as are any other combination of exceptionalities.

Have you been to a neuropsychologist yet? Or the kind of autism clinic that can do a really thorough workup? You are spending so much energy fretting over the diagnosis. But it is very reasonable to treat symptoms and work on language skills and behavior while seeking further information.

DeeDee

MK13, I think some of this may not become clear for a few years, possibly until he's in school, and that was the upside of the older approach where they would not give a diagnosis to higher functioning kids until 6-7 (well that was the case here in Australia). The disadvantage of delayed diagnosis is that early intervention is useful and needs a diagnosis to get funded access...

I think the fact that neither of your kids are in school yet means there are things you just don't know about what developmental challenges, that you don't see as a real problem now, might look like later (if they are not addressed now). I do not mean that to sound at all condescending, which I am sure it does, but I couldn't think of a better way to say it. My intention is not to condescend, I am purely reflecting on the things I didn't know that I didn't know with my eldest child.

And I guess I should make it clear that I come from a perspective of: my child with Aspergers did not get diagnosed until 10 years old, partly because she is mild / very high functioning (and a girl), partly because of what I didn't know back then, partly because of all the other things I thought it might be along the way and partly because of all the things that I failed to take as red flags when she was small. When she LOVED to swim, was able to learn swimming with me 1:1 (by that I mean that I stood in the water while she self taught, but would not tolerate my instruction) but melted down over swimming lessons - I blamed the lesson structure/teacher and pulled her out and kept doing "what works for us". When her first daycare/preschool experience failed - I pulled her out after 2 weeks, blaming the preschool (and yes there WERE issues, I wasn't completely wrong, I just failed to see my child's part in the problem until years later). I could write an essay on the stuff that I normalized along the way, and some of that normalization came from personal mindset, some came from the style of parenting books I chose to read (books like "Raising Your Spirited Child" for example did give useful strategies and added to my parenting tool kit, but they also reduced my inclination to see a problem with my "HIGHLY sensitive" child)... Along the way to Aspergers we visited SPD, CAPD, Dyslexia, EF disorder, Visual Spatial learner, developmental co-ordination issues etc... Until finally I started seeing that most of these disorders are absolutely valid conditions but I no longer believe that most of them are free standing conditions (most of the time), perhaps if you have just one, but especially when you have a cluster of them that they are more likely SYMPTOMS of a more global neurological delay or disorder, a disorder that makes sense of it all clustering in one child. When you have a child with sensory issues, attention issues, processing issues, social issues and and and... then you need to start asking "What pulls all of this together?".

And it sounds like your child really does have major social issues (which you perhaps aren't perceiving that way yet because things are fine at home when it's just him doing his thing and having a nice time and learning lots of stuff that interests him). Again I am not a professional or an expert, but every time you try to explain why you think he is not on the spectrum I read and think "What you just described sounds exactly like a gifted child on the spectrum to me".

I agree that the speech therapist he's had doesn't sound that useful, that the assessment sounds poorly done (1/2 an hr shocks me, and I too have been pissed at things I have seen mis-interpretted in my kids reports). But I think the answer to that is to get a proper full assessment done by an expert you respect and then see where you go from there. And also coming back to the start of my post - it may be that he is borderline enough that you won't know for a few years, but the intervention you do now will hopefully make a big difference later - assuming of course that it's decent intervention!

the "one size fits all" comment was in terms of therapies we were recommended by the evaluation team that did the initial diagnosis and by what the school district is offering. His IEP meeting basically looked like this ... "oh, he has Autism diagnosis. So he qualifies for this this and this and will be receiving this this and this|" (part of which I declined and part we will be doing). But again, nobody addressed my concerns regarding the way he speaks and regarding the possible reasons behind his motor issues. If he does in fact have Autism but there may be a possibility of Apraxia / Dispraxia my understanding is that the approach to speech therapy is somewhat different in kids with Dispraxia. I just put him through 9 months of speech therapy that clearly wasn't working for him and he just hated it. The last couple of months turned into DS seeing the therapist (nice girl ... definitely not a bad person!), crying and repeating "bye bye! Go away!" over and over. With both boys all together, we've been through 5 speech therapists, 2 physical therapists, 3 OTs and 1 developmental therapist. Speech for both of them was a complete disaster. They would shut down and stop responding to the therapists (with the exception of the school therapist that DS4.5 has and who is the same person that will be doing ST with DS3 starting probably in 2 weeks through the school district).

As for the diagnostic eval he had, that WAS through a major Autism center. That's why I was surprised that they would come to a diagnosis after seeing him for such a short time. It was a team of therapists and a neuropsych I think who was watching from behind the wall. The therapists team was writing up the report somewhere in another room while the neuropsych was talking to me. He did say that DS has signs of giftedness as well as Autistic traits, he did ask about family history (a lot of the quirky things in both our boys definitely come from me as I was the same way as a little kid), my education, etc. And then basically pointed out that DS3 might turn out just like me. Then he left, the team of therapists came back and gave me their report, saying he has High functioning autism and in most areas ranked him 1.5 - 2 years behind. I pretty much felt like they were telling me he won't most likely talk and needs to learn to communicate through pictures and go to autism school. So I was leaving the place knowing that's just not my child! We will have another re-evaluation sometime before Christmas. So we'll see.

DS4.5's evaluation was much more detailed. We went to Children's 3 times, did receive PDD-NOS diagnosis but also were referred for further testing to confirm or disapprove the diagnosis. We're on a waiting list for that one.

DS4.5 is also the clumsy kind of child, with poor fine and gross motor skills (walked and reached many of the physical milestones even later than DS3) but his problems look nothing like when I watch DS3' face and hands. They are basically lacking movement. I'm looking a preschooler trapped in a 1-year old's body. That doesn't seem right, which is why simple Autism diagnosis does not satisfy me.

MK13 - one thing that I am struck by in your last post is that your DS may very easily have BOTH speech (physically forming words) and language (pragmatics of social communication) issues going on at once and the speech therapists you have been seeing perhaps are either not distinguishing the two (lack of skill on their part), or are failing to communicate well with you about what they are seeing/treating and how/why (lack of communication with you). I can certainly get how frustrating it must be that the therapy you are being offered is so distressing for your children and I don't subscribe to the idea that it doesn't matter if it's traumatizing them, it must be done this particular way because that's what we do with autistic kids... I would be stopping seeing those practitioners too. But quality of the current services is a different issue from whether there actually IS a speech or language issue that needs to be addressed (in a way that works).

I do wonder with the IEP meeting to what extent the generic "these are the services children with Autism get..." is supposed to be followed up by the actual practitioners figuring out what KIND of speech/OT/etc is most beneficial for this particular child?

Finally, I would have thought that "A preschooler trapped in a 1 yr old's body" falls directly inside the "pervasive developmental delay" category? ASD is not only one thing, it's a group of issues all of them on a spectrum, your two sons may have different subsets of those issues, and each issue expressed in quite different ways, thus both sons can then seem very different and still be on the spectrum (just as two gifted children can be very different but still both be gifted). For example - you can see both hyperlexia OR dyslexia with Aspergers, you might see under responsiveness OR over responsiveness to sensory input (and one child may be under sensing in one area and over sensing in another). One child may express their motor development issues through clumsiness, another through limited motion... But all of the issues still fall inside "pervasive developmental delay".

I am pretty sure that the Speech therapist we had through early intervention (done as of last week) had limited experience with children like my son. When I offered advice on how to approach him because clearly, I know how to approach him, she still wouldn't follow. She would push simple things like wanted him to say "open" or "open gate" (gate to our playroom where we did the therapy) and he would refuse to repeat it. The more she'd push the more frustrated he got. To me it looked like he simply did not want to say it because he did not want that particular action happening. ... I got him to say it very easily and since then any time he wanted me to open a door for him or gate, he'd say "open" or "open please". Or I'd ask him "do you want me to open the gate" and he says "no" or "yes open". But he refused repeating things after the therapist or engage in what she wanted him to do. I work with him every day through activities HE wants to do and I just take part in them and he's usually just fine with it. In fact he doesn't want me to go away and wants me to keep playing with him. ... I didn't know it had a name until I came across "floor time" approach to therapy. He responds to it much better.

He's freshly three and still can't walk down the stairs. He will scoot down but takes him a long time to think through how to tackle the first one or two steps. After that he just keeps going. He has learned to walk upstairs finally just recently. He can climb ok, he can get down from high places ok but the look on his face when he's sitting at the top of the stairs looking down, it says "oh, what to do? what to do?" He just gets stuck and can't plan those first moves. On the other hand, he has GREAT balance! Go figure! So definitely some sort of motor issue going on.

I do trust the place where I'm taking him for the speech eval in the morning and they know me and I know they will take me seriously. So, should THEY say they don't see any motor issues I am suspecting, I will have some peace and will just keep on working with him. He is improving every day in all directions so I am quite happy with his progress at the moment. I told my husband just today that I feel like DS3 has jumped from being a 1year old to being at least a 2year old in a matter of one week! If that isn't progress, than what is?

I'd say that that is a matter of course when dealing with gifted/autistic-- because most people who have autism also have cognitive delays, the gifted/autistic combination is rare, especially when you get to a kid whose giftedness is really out there.

At some point I looked at the statistics and concluded my DS's combination of gifts and deficits is somewhere between 1 in 25,000 kids and 1 in 50,000-- which means that none of his teachers or therapists will likely have encountered one like him in their career.

I will say that it *is* possible to find people to help; but as you note you may have to work hard to find the right people. We have found some people who were flexible in their approach from the beginning, and some who became flexible as they learned to understand DS. But yes, we have had to do a lot of explaining.

As for the 1/2 hour eval: not remotely appropriate. I would expect about 5-6 hours, including a complete ADOS, Conner's behavior checklist, and Vineland adaptive skills questionnaire. They didn't do their job; you can call them to find out why not, or you can seek an evaluator who will do the job correctly.

Hang in there,
DeeDee

So today's evaluation was definitely a step in the right direction! This therapist was new at this place, only started couple weeks ago but is an experienced, retired therapist who does it part time and clearly enjoys her work. 4 questions about his eating habits and watching DS eating banana was enough for the her to see there's definitely something off with his mouth and the way he eats and talks. She said she hasn't seen enough to pinpoint the reason but it's either tactile (not wanting any food / tongue touching the back parts of his mouth) or motor problems, in which case the hands and other coordination problems could be related. It could also explain why he does not want to use utensils and does not want us feeding with utensils because then he's losing control of where exactly he puts the food in his mouth. When he's feeding himself with his hands, he keeps it all upfront (kind of like a squirrel) or when he's eating banana, if I make him to take a bigger bite, he'll use his fingers to push it aside and doesn't use his tongue to move the food around. The tongue thing points more towards motor issues.
When he makes sounds, the simple letters names and phonic sounds he makes there in the right places in his mouth but when he starts saying words and sentences it's all produced again only in the very front part of his mouth. FINALLY someone noticed what I've been seeing all along!
So, independently of what the school therapists will be doing, we'll start seeing this lady as well and work on the feeding and oral issues to see what the problem really is. And we might get DS4.5's OT check out the hand mobility issue to see what she thinks about it.

So, as I said, definitely a step in the right direction!

DeeDee, those are some interesting statistic data!

I think depending on how things develop in the next year maybe two, we'll seek out another diagnostic evaluation if we see the need. He is supposed to be re-evaluated by the same people in about 8 months again so I am interested in finding out how that will play out given the initial diagnosis.

hi MK

LOL also had a few eating issues with my DS, who couldn't even blow a bubble or spit incl spit OUT gum/food/anything in mouth oh until maybe a year ago? Blowing bubbles came first. He was also very much a talker by then as well... never did learn why the blowing/spitting thing so difficult and if you see as issue and learn why? PLEASE share I'd like to know, even though every kid different...

ok, so I DID mention bubbles/spit thing to School OT- who very clearly stated it was NOT a school concern, it didn't impact his ability to learn curriculum etc, OT stated they did NOT do anything for oral eating etc type OT issues- she did say it was an OT issue, just not something she could work with DS on. *ST is one who gave me ideas for helping him...

Eventually, he got better with this. He still sucks at spitting out toothpaste, it sorta dribbles down chin? idk. if that is the only issue I don't care so much. I'm no longer concerned as much that he will choke on something b/c he can't spit it out when needed (he actually did do this and i had to pop it out for him, it had been lodged as evidenced by the piece of food flew across the kitchen!)

wow! deedee! those are amazing stats!
thanks for sharing them! our kids really are "unique"!!!

and probably why people don't see my DS as aut, because his intelligience and compassion, is what they pick up on so quickly,

and the general public incl many public school teachers and even yes I think- doctors- think of autistic ppl w/ low intelligience and no empathy etc

and it is very sad that ppl are so archaic in their thinking/knowledge...

yep, we've had couple incidents! He can't spit anything out either (or blow bubbles or any of that) so I have to watch for him getting quiet and his eyes popping out of his head to know when he's having trouble with food in his mouth! And when the few times I stuck my fingers in to dislodge the food I'd end up with deep bite marks. lol ... not intentionally but he just has that reflex ... something goes in - he BITES! and people wonder why I keep obsessing with not having anything small that he could put in his mouth around him even though he's already three. Fortunately he's finally stopping to chew on everything so hopefully I'll be able to relax a bit and he'll be able to get that stuff out of his mouth himself!

One of the reasons why I did go with the private eval was because I knew that the school therapists only really look at things that are an issue or may case an issue eventually at school. I feel like I finally have a little victory here! The big reason why I initially contacted Early Intervention were these same issues. My biggest concern wasn't the social part or the lack of speech itself ... I kept telling everyone "I think there's something wrong with his mouth and his hands!" The rest I knew can come and go with age (already having experience with the 4.5 year old who was a total disaster at the age of 2-3.5 and now has very few PDD issues that impact his life). It was the physical issues I couldn't figure out and finally feel like we're getting somewhere!!!

Now a "what would you do" question. Do I share the results of the evaluation today with the school? Or do I wait till I know what they pick up on and what they plan on doing??? I don't want them to think I don't trust them but I also don't want the rediscovering the wheel all over again.

Do keep in mind that they are back-of-the-envelope data done my me (NOT scientific), derived from % of children who have Aspergers and % of children who have IQ of my kid...

But I did find that thinking about it this way helped me be more compassionate to the professionals who were often baffled by DS. They were flying blind much of the time too.

DeeDee

I just wish they would admit it! lol The therapist that connected with DS3 the most was the one who openly admitted that she has NEVER met a child like him but she was very open to trying anything and everything with him to get him engaged on his level. And he was quite happy to see her every time!

I think the problem is that most therapists when they see a child with any form of Autism who does very smart things they think of those as splinter skills, so I've been told "oh, this is quite normal in kids with Autism" ... what they don't understand is that I don't believe he has ANY splinter skills. He's above his age in many different areas, not one or two or three special skills. And that's where the disconnect comes from. The therapist he clicked with called him "incredibly smart" and knew how to challenge him.

Often they can't admit it because their experience doesn't include the outliers, so it's hard for them to recognize an outlier when they are faced with one. Yes, DS's strange talents were referred to as "splinter skills" when he was younger. Yes, it drove me crazy; but this misjudgment didn't do him any harm. Over time, the judgment problem has gotten much better as the therapy team has simply had to come to grips with the reality of the academic gifts. They can't argue with the test scores.

All the same, I have to say that I am glad we didn't put the giftedness *ahead* of the disabilities, either. DS really did have a ton of autistic challenges that needed to be worked on, and it was very, very helpful to have our expert team and ABA therapy in which to do that work. It was highly beneficial to spend the early elementary years working on the deficits, so that we are better positioned in late elementary and middle to let him soar. Had we failed to take advantage of those therapies, and just excused his difficult behaviors by saying how gifted he was, everything would be much harder than it is now.

DeeDee

I think of DS as gifted first and autistic 2nd.
He was born gifted.
He reached all milestones early, spoke early etc.

He regressed @12mos. *if he infact is autistic? This is when Autism said "hello".

Like DeeDee, we focused on what were his deficits. His intellect helped him immensely- I don't deny this and we embraced this aspect of him. And still do.

Now he is really just deficit in the Pragmatic Department... he has a wonderful SLP, and then there is life. Life is a wonderful teacher.

*above I said, IF he has autism, because as I've mentioned, even though I am okay with Dx, and we have certainly taken advantage of all the therapies that were open to DS because of that particular Dx-- no other professionals other than the Pysch who initially Dx'd DS has thought he was Autistic.

Only now am fully comprehending that giftedness in and of itself will often present with a child lagging in speech, fine motor,social, etc, and that often these kids are misdiagnosed as "autistic" or "adhd" etc....If back when, I had been told, oh he is gifted, probably the line "don't worry" would have followed, and no therapy in sight other than enrichment- which I did on my own, just type of parent I am believing in enriching a kids life, and following their lead (many Professionals have told me I in fact was doing "floortime" or "play therapy"!! unbeknownst to me! Hey! Whatever works LOL But really that is just the kinda parent I am.

All that said---- I still am HAPPY with the Aut Dx because of all the help that came with it.

His Dx doesn't define him. Or any of our kids. Just like a child who is said/proven to be gifted? That child may still be a high school dropout (my brother!) and never live up to the potential that is there.....
Hugs

cc6 - I absolutely understand the "IF". I was gifted as a child (I think I lost all my giftedness when I gave birth to my two monkeys! lol) and I also have a lot of the same issues as both of our boys. And as far as I know, I'm not autistic. I'm just overly sensitive to too many things and tend to tune out a lot to compensate. I am 100% sure I'd be labeled autistic if I was a child now and going through an evaluation. But that still doesn't answer whether one or both or neither of the boys are Autistic or not. It just makes me always wonder. So finding an actual issue we can work on rather than keep guessing is a huge improvement.

I am late to this thread.
I have an apraxic child.

I think what you are asking is tricky.

Think of it as a spectrum in that some kids may be more apraxic than others. Because of this a child may hit aspect of apraxia and not others. Some kids are more apraxic than others. Kids that are apraxic Are often considered late talkers. My child was not.

Conditions such as SPD/sensory issues, CAPD can be comorbid with Apraxia. I believe attention issues can also be found comorbid.

Now, on the other side, apraxia can be comorbid with ASD.

Because of this, one can see overlaps between the two.
If a child is apraxic with sensory issues, that can be hard to differentiate.

Apraxia, because it is a motor-planning issue, one can also see gross motor or potential fine motor issues. Besides CAS, one may see oral apraxia.
Can your child lick his lips? Blow bubbles? Use his tongue to touch the side of his mouth?

In apraxia, communication often falls apart at the sentence level. A child may be able to do an individual sound or an individual word, but trying to say them all together, it falls apart. That falling apart may happen at a word level or at a sentence level.

Traditional speech therapy usually does not show fast improvement for apraxia. Apraxia therapy has much repetition, and often is multiple times a week.

Does your child have apraxia? Does your child have ASD? Does your child have ASD with apraxia? Does our child have Apraxia with sensory issues? It could be any, and it may take time to figure out the best diagnosis.

Of course, then when one adds giftedness to the Above....it just becomes convoluted super fast.