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Old 01-10-2012, 12:33 PM   #1
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Apraxia and PROMPT therapy

My little one had another speech eval today. She will be 3 in April, so we are getting an independent eval in preparation for the IEP referral.

Today's eval said she would diagnose her with apraxia. On the intake history, I had written down that she's been tested for this, that, and the other (including apraxia) and they have all been ruled out and we have no diagnosis yet. So at the end, when she said she would diagnose apraxia, I was surprised. I thought we had already pretty much ruled that out last year!

Last year, the state eval had said that there are some features consistent with apraxia, but others that were not, and the Duke eval had said that she did NOT think that Sweets had apraxia.

This eval said she would recommend a therapist trained in PROMPT therapy for apraxia, which I'm sure my current therapist is not since she's in her training year. We are getting ready for transition to IEP, and I am not sure if/what she will qualify for under the school system because I know it is harder to qualify for that than it is for the early intervention that she's in now. And I don't know if the school can provide a PROMPT trained therapist either.

I have some concern that the evaluator was biased to apraxia and PROMPT because there are very few therapists around who are trained in PROMPT, and she is one of them. Not to say that she's necessarily trying to drum up business, just that she may have bias towards what she works on a lot.

We are going to get a 2nd opinion at Duke in Feb, and the school system will do their own eval for the IEP too, so we will have a few opinions to go on.

If you know anything about apraxia diagnosis or PROMPT therapy, please let me know! Thanks.

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Old 01-10-2012, 01:24 PM   #2
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Re: Apraxia and PROMPT therapy

My LO just turned 4 and is pretty much nonverbal. He was diagnosed with severe apraxia but has his appointment with the specialist (took over a year to get in...) on the 27th for a final confirmation. He made very little progress at all with traditional speech therapy over the course of a year but has made some more progress with PROMPT. He still isn't talking but can now make good attempts at vowel sounds and some consanants and is able to finally say "ma" (still can't say "Da" do does an "a" sound instead. We will be losing our PROMPT therapist in the fall when he qualifies for kindergarten which is a huge problem for me right now so I'm trying to figure out how to pay for private sessions next year which will be tough since he gets 4 sessions/week right now. Our insurance won't cover much of it because they are out of network so I'm kind of freaking out a bit.
My son's apraxia is very severe and the PROMPT has been helping him but the progress is agonizingly slow; I don't know if he'll ever be able to effectively communicate verbally but if your DD does hae apraxia, it might not be very severe at all and she may do fine with other types of speech therapy. I just know that the PROMPT is what works for my LO right now.
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Old 01-10-2012, 03:17 PM   #3
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Re: Apraxia and PROMPT therapy

My son has recieved PROMPT therapy for apraxia with very good results. It is what worked the best for him though he continues have lots of difficulties.

Also I believe they say it is difficult to diagnose apraxia at 2 years of age and there would be a more accuarate diagnosis a a later age.
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Old 01-10-2012, 04:01 PM   #4
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Apraxia is a very specific diagnosis with a specific treatment that often goes unrecognized with people lacking experience. Some hallmarks include inconsistent speech sound errors (the different between always saying w instead of r, or saying almost anything except r), context specific correct articulation (they can say 'see you later' but can't say any other 's' sound), atypical development patterns (being able to say complex sounds like 'ch' but not basic ones like 'b'), and demonstrating increased difficulty as words get longer. Progress in therapy is slow, because it is a motor planning deficit, and the approach is completely different. So its worth figuring out. Can you get a second second opinion or is that not possible? How is her progress in therapy?
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Old 01-10-2012, 07:37 PM   #5
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Re: Apraxia and PROMPT therapy

We have an appointment for a 2nd opinion in Feb. She has been getting speech 2x45 for the last 15 months. She has certainly improved much in that time, though I don't know how much of it is specifically due to the therapy. She seems to me to improve in spurts - she will be pretty slow at gaining for several months, and then start saying a whole bunch of new things in one month, and then plateau again.
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Old 01-10-2012, 09:01 PM   #6
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Re: Apraxia and PROMPT therapy

I have worked with a few apraxic kids, and when we use traditional therapy methods, the make almost no progress for long periods of time... I had one child who's primary consonant was 'ch' at age 3 (VERY atypical), so the child would say things like "Cheye Choe Choo ta Chore" for 'I go to the store'. I had another one that sounded like they were speaking gibberish. I had another that was mild, but after a year of therapy I was unable to even stimulate some sounds except in specific words.... get the second opinion. Read over everything, let is sit for a few days. See what you think, and pick who you trust most. But keep an open mind to all the possibilities.
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