I am hoping the wise members of this forum might have some information to share about dysarthria.

If you have been following our saga you will know that my DD10 has been diagnosed with just about every possible LD, most labeled as "severe". Dyslexia, dysgraphia, dyspraxia (motor apraxia), math disability, visual perception issues, CAPD, fine motor deficits as well as eosinophilic esophogitis and migraines. She no longer qualifies for an anxiety diagnosis and migraines are under good control now that she is in a supportive school environment - OOD in a spec Ed school. Migraine meds were having significant cognitive impact so we have been weening her off them. (Now down to 30% of her original dose with a plan to try removing them completely this fall if the migraines stay under control.)

With migraines, anxiety and school situation all under control I have been focusing on trying to figure out whatever may be underlying all of this. I find it hard to believe that one kid could get so lucky as to have all of this going on without something connecting it all. This led to the CAPD diagnosis and VT for the visual perception issues. The audiologist from the CAPD eval had concerns about DD's speech and connected us to an SLP at her state flagship university. Still awaiting the report but if I understood her correctly at the time of the eval there is an obvious motor speech component and she is going to diagnose dysarthria.

I am trying my best to understand this as reading up on it makes it look like dysarthria is usually the result of a stroke or major head injury. With further research I came to a site that listed 150 possible causes of dysarthria. With no medical background I found the list confusing and overwhelming.

DD was a superstar as a baby/toddler/preschooler. MILES ahead of agemates in everything but fine motor/ hand-eye tasks so any concerns I raised were summarily dismissed by our pediatrician. She said her first words a few days after 6 months old. By 7 1/2 months could identify her colors but always dropped the first sound (ie "een", "ed", "ooh", etc) and the pattern of dropping initial sounds continued as she spoke more. She used very advanced words so her articulation issues were chalked up to using complex words adults weren't expecting to hear from such a little person and then words that were too advanced for her mouth to form developmentally. In school SLP's had their hands tied by being able to only work on "grade level sounds" even of the need was clear. She makes both vowel and consonant errors and the first part of a sentence or longer is hardest to make out. Articulation problems combine with the LD issues affecting her ability to both encode and decode, use voice to text software, etc. Now it is severely affecting her socially - my absolute spitfire extrovert has become shy, reserved and socially uncomfortable with anyone she hasn't known for years. She is a musical theater kid and is now old enough for "real parts" instead of just ensemble but despite being extremely talented as an actress her speech is basically unintelligible. Kinda makes it hard to be cast in a part with lines...

So any input or experience? I have finally gotten a developmental ped to accept her into his practice and if she is diagnosed with dysarthria the neurologist will likely take a closer look to see if we can find an underlying issue. (An MRI 3 years ago was clear, as were numerous EEG's.) Everything was put on hold while we tried to get the side effects of the migraine med under control.

At some point there was a thread that discussed a 2E link between dysgraphic kids being diagnosed with eosinophilic esophogitis. This makes me think that maybe there is someone else who can relate to this crazy combination. I am thinking the dysarthria is a big clue. But to what? I have no idea. Hoping someone here may have some interesting ideas.

Thanks in advance.

Not a medical professional, but, might there be some connection such as motor difficulties->poor sphincter seal->reflux->trauma to esophagus->eosinophils? The same motor difficulties could be behind the dysarthria, dysgraphia, and dyspraxia.

And I saw some citations that mention birth trauma as a possible origin of dysarthria. Kind of like how CP can impair motor functions, but leave cognitive functions entirely intact.

I also saw references that said that the prognosis is quite good for children, with good speech therapy.

Thanks aeh - I do think all of it is somehow connected just not sure how or where we look for that connection.

I just spoke to the SLP and we do indeed have a dysarthria diagnosis. It is probably not related to a stroke or major head trauma (thank goodness) but could have been there prenataly. While maybe not perfect hopefully she can make significant improvement with correctly targeted interventions. DD has had years of speech services in school with no real effect so the need for an accurate evaluation is clear.

Let me try rephrasing my question to the forum - Has anyone had any experience with motor speech issues at all? Anyone have a kid with unintelligible speech who has also been diagnosed with other "dys" issues (ie dysgraphia, dyspraxia, etc.)? Early on in my journey someone here made a comment about looking for a connecting diagnosis, syndrome, etc if you get multiple diagnoses. I know there are other parents here who have reported dyslexic/ dysgraphic/ ADHD/ ASD, etc kids. Do any of you have articulation issues in the mix?

When DS was a toddler I was constantly googling "apraxia of speech"...I even joined an apraxia forum. I was more worried about his speech than his motor skills at that point. He was ultimately diagnosed with DCD. He is now 8 and still has difficulties with certain sounds and his prosody is a bit odd. Problems with motor skills are common with kids with apraxia of speech. If your DD was an early talker, though, that doesn't seem to fit very well.

DS has a subtle genetic abnormality and all the medical professionals like to pin his issues on that (a balanced translocation). I have the exact same abnormality, as well as other members of my family, but no one else has issues like DS. It is not an obvious abnormality, we had him tested at birth because I knew I was a carrier and it affects later fertility. The geneticist says that it can affect him differently than the rest of us carriers--there may be a microdeletion there that the rest of us don't have, etc. On the apraxia formum a lot of the kids seemed to have some sort of subtle genetic disorder. It may be worth a visit to a geneticist to see if anything stands out.

DS also has a borderline chiari malformation but I don't really think that ties in in any way. Interestingly, his first MRI was interpreted as normal, but then when he fractured his skull and the neurosurgeon went back through old records and looked at that old MRI from 1-2 years earlier, he said it should have been reported as an abnormality.

Again, no expertise or even family experience...but the SLPs and OTs I've worked with over the years, especially the early childhood ones, generally linked oral motor and other motor difficulties together. I.e., if there were reports of one, then they would refer to the other specialist to check on the other. (As in, artic issues, they would ask for an OT consult for other fine motor/motor coordination issues. Or OT issues in an elementary referral, they would ask about a history of speech delays.)

Being an early talker does not necessarily rule out apraxia, as language is not the same as intelligibility.

Got the SLP report. Along with Dysarthria we have also added Expressive Language Disorder. So we are now up to 11 diagnoses. It seems like she has everything but ADHD and autism. All things muscular (dysgraphia, dyspraxia, fine motor. Visual muscles, oral muscles...) and it seems like most senses (in vision therapy, CAPD and now motor speech.) Interestingly she has a very sophisticated palate - her favorite food is escargot! - and great sense of smell so I don't think we have a sensory processing issue. But I said that about CAPD and end up being wrong so what do I know?

Not a preemie - just the opposite. I was induced 9 days late. She really didn't like the pitocin and her heart rate dropped dramatically whenever they tried to increase the dose. After the team came crashing into my room for the 5th time I had a c-section. 9/9 apgars and a perfectly healthy newborn. I spoke with the OB who delivered her and he said any result of the heart rate drops would have been apparent at birth and would not be consistent with her good apgar scores or super healthy early development. He also said a prenatal stroke would have shown up in the MRI she had 3 years ago. He thinks there may be some yet unidentified syndrome connecting it all. He also suggested a local genetic specialist. I'm hoping the developmental ped will put the puzzle pieces together.

There are bits and pieces present in DH, me and grandparents but nothing like what is going on with DD. I still think the Dysarthria has to be a big clue. Ugh...

Oh what a ride. It just keeps getting more interesting...

She could have a mutation or something that no one else in the family has. I would consult with a ped. geneticist and see if there is any simple testing that can be done (like a karyotype) or maybe the geneticist will suspect something just by looking at her. Certain syndromes produce certain physical characteristics that may mean nothing alone, but combined they could mean something. DS has "cup-shaped ears" that can be a part of so many genetic disorders, but then I realized my dad has the same exact ears. He also has dimples in his shoulders that could signify something, but then I saw that Dh has "indentations" in his shoulders that aren't full-on dimples, but DS must have a more full-blown version. Anyway, my point is that a geneticist would be able to see things like that and there may be something that screams a certain disorder, and then they would know what to test for. In our case, it is a balanced translocation and they are all pretty much unique, except for members in the same family often having the same translocation (but there is always person who is "first" and no one else has it).

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