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How many children have/had speech apraxia?


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Jill,

I work in a skilled facility that has now decided to take critically ill pts. We have so many people on isolation when they come to us-but they are not my concern. It's the people who are not and them radomly you get an e-mail that they are now on isolation (and yes I've treated them for the last 4 days without anything but my labcoat-what's that doing for me? absolutely nothing!) I went to the ER myself in late August with URI/pneumonia symptoms. All I wanted them to do was r/o myco p. They sort of laughed at me when they learned I worked in long term care. They told me it's everywhere in that setting. Here I'm worried about all these MRSA postitive people & I have myco p. all around me...I feel like I should wear a mask daily, but that'd be weird. I hope everyday I am not bringing home something to my children. And on top of that, my husband is a dieititian in long term care-so we are both in that setting. Of course, he is not working in peoples face like I do everyday. However, these people do not get strep (or maybe not getting tested for it!) Seems like being around kids put me in contact with strep more frequently. You can't avoid germs so we just need to heal our kids.

 

I've been following your story in regard to IVIG & co-infections and such. It is so much to figure out-how do you keep your kids on your caseload straight when you have so much going on at home. I'm greatful to be able to take a break from kids for a while-but I do miss treating them. If I could only be assured my daughter would remain stable, I'd pursue some peds per diem, but I know, as soon as I do, she'll have a back slide.

 

Hang in there....Amy -----Are you going to the ASHA convention?

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I know it is a sin with ASHA in my backyard this year, but no, I'm not going. With the days I need to take off for my own kids, I don't want to miss my school kids for convention.

 

I need to keep working full-time to be able to afford the treatments she needs, but it is really taxing mentally to manage. Thank goodness we can come on here and pick each others brains....which doesn't mean I'm swaying in the wind with every post either!

 

I will say this...and I know there are many on here who also work in special education.....the numbers are absolutely skyrocketing year after year after year in ASD, LD, ADHD, ect....waaaaay beyond they incidence rates reported in the literature. Something is changing at an alarming rate....lots of variables to tease apart, but something has taken battle to the brains of the next generation.

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I know it is a sin with ASHA in my backyard this year, but no, I'm not going. With the days I need to take off for my own kids, I don't want to miss my school kids for convention.

 

I need to keep working full-time to be able to afford the treatments she needs, but it is really taxing mentally to manage. Thank goodness we can come on here and pick each others brains....which doesn't mean I'm swaying in the wind with every post either!

 

I will say this...and I know there are many on here who also work in special education.....the numbers are absolutely skyrocketing year after year after year in ASD, LD, ADHD, ect....waaaaay beyond they incidence rates reported in the literature. Something is changing at an alarming rate....lots of variables to tease apart, but something has taken battle to the brains of the next generation.

 

I feel the same way about ASHA-right in my backyard. I have friends in Philly I could stay with but we travel so much to CT to see Dr. B & I was just in Boston getting certified for Lee Silverman Voice Tx., that I'll have to pass on ASHA. Just don't have the motivation or desire to pull it together & go. Plus the ASHA dues notice came the other day, so not sure I can convince my husband to send them registration fees for the conf on top of those dues.

 

I agree the incidence of neuro. problems in the general population is rising beyond incidence numbers we have all heard before. For a long time I said to my SLP/OT/PT colleagues that I felt so blessed to have typically developing children when all it seemed like I did all day was evaluate kids with issues. I never suspected that my child could develop this at 4. I thought we could all breathe a sigh of relief when our kids turned three and did not show regression in skills suggesting ASD---boy were we wrong. But that is what I was taught just 10 short years ago in grad school....PANDAS and such-these acquired disorders must begin to reach the literature. Several of my friends work in the University setting with Grad students...I tell them about PANDAS all the time, although there has never been a direct speech correlation (that's why a survey might be a starting point)so that there may be some chance that news of it will spread.

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Question to the slp's....my son's early childhood slp and an OT that screened him said it's not uncommon for kids with speech disorders to have sensory issues and even some OCD. Is that true? That's how the originally tried to reason his OCD when it first surfaced and we had no idea what was going on. Obviously, it was PANDAS and not due to his speech.

Edited by Vickie
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Vickie,

Certainly we see kids that have speech & sensory issues-Is it common? In my experience-no. From 2003-2009 I worked as an evaluator in a large early intervention (b-5 yr old primarily) and did about 100 evals/year & twice as many screenings. I oversaw a dept of 15 SLPs so in total we probably did 400-500 evals/year. Sensory problems are increasing no doubt, but I saw many more pure speech/language delays than anything else-percentage wise. When kids demonstrated sensory concerns on eval or their parents reported these at home, we had them screened by one of our OTs-usually with a sensory questionairre. If they got a certain score, they came back for an OT eval. But this was by no means the norm. Honestly, when we saw kids that screamed SENSORY PROBLEMS we were always thinking along the lines of ASD. I did not know about PANDAS then, as my daughter was just in her initial exacerbation & had just been dx when I left that position.

 

Now the OCD-I find this very strange. I can't say even say I can think of one who had OCD behaviors, with the exception of a few dx ASD kids (who were school age children I treated in the same setting). I have never seen or heard of any correlation there.

 

Jill, hoping you'll weigh in on these. We do have another SLP on the forum from VA, but I'm sorry I can't recall her name. Love to get there input too!

 

Amy

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Vickie,

Certainly we see kids that have speech & sensory issues-Is it common? In my experience-no. From 2003-2009 I worked as an evaluator in a large early intervention (b-5 yr old primarily) and did about 100 evals/year & twice as many screenings. I oversaw a dept of 15 SLPs so in total we probably did 400-500 evals/year. Sensory problems are increasing no doubt, but I saw many more pure speech/language delays than anything else-percentage wise. When kids demonstrated sensory concerns on eval or their parents reported these at home, we had them screened by one of our OTs-usually with a sensory questionairre. If they got a certain score, they came back for an OT eval. But this was by no means the norm. Honestly, when we saw kids that screamed SENSORY PROBLEMS we were always thinking along the lines of ASD. I did not know about PANDAS then, as my daughter was just in her initial exacerbation & had just been dx when I left that position.

 

Now the OCD-I find this very strange. I can't say even say I can think of one who had OCD behaviors, with the exception of a few dx ASD kids (who were school age children I treated in the same setting). I have never seen or heard of any correlation there.

 

Jill, hoping you'll weigh in on these. We do have another SLP on the forum from VA, but I'm sorry I can't recall her name. Love to get there input too!

 

Amy

 

I think it depends on how broadly OCD is defined....if you think of OCD issues as ones with difficulty with the gear shift of the mind....ones who have difficulty shifting focus, difficulty letting things go...many more kiddos would get caught in the OCD net for these broader OCD-like behaviors. They are not as obvious as the hand-washing, evening, locking overt OCD behaviors, but are the same underlying "mental-stuck" behaviors. Then yes, marked increase as they go along with the biggies....ASD and ADD/ADHD.

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My son didn't have sensory or OCD when he was first screened by them at age 3. Nor did he have any when they first started therapy at age 4. That's why I knew the new problems weren't associated with his speech or "expected". But I was surprised when the OT told me that it's not uncommon. That statement just always stuck with me...hence why I asked.

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Vickie,

Certainly we see kids that have speech & sensory issues-Is it common? In my experience-no. From 2003-2009 I worked as an evaluator in a large early intervention (b-5 yr old primarily) and did about 100 evals/year & twice as many screenings. I oversaw a dept of 15 SLPs so in total we probably did 400-500 evals/year. Sensory problems are increasing no doubt, but I saw many more pure speech/language delays than anything else-percentage wise. When kids demonstrated sensory concerns on eval or their parents reported these at home, we had them screened by one of our OTs-usually with a sensory questionairre. If they got a certain score, they came back for an OT eval. But this was by no means the norm. Honestly, when we saw kids that screamed SENSORY PROBLEMS we were always thinking along the lines of ASD. I did not know about PANDAS then, as my daughter was just in her initial exacerbation & had just been dx when I left that position.

 

Now the OCD-I find this very strange. I can't say even say I can think of one who had OCD behaviors, with the exception of a few dx ASD kids (who were school age children I treated in the same setting). I have never seen or heard of any correlation there.

 

Jill, hoping you'll weigh in on these. We do have another SLP on the forum from VA, but I'm sorry I can't recall her name. Love to get there input too!

 

Amy

 

I think it depends on how broadly OCD is defined....if you think of OCD issues as ones with difficulty with the gear shift of the mind....ones who have difficulty shifting focus, difficulty letting things go...many more kiddos would get caught in the OCD net for these broader OCD-like behaviors. They are not as obvious as the hand-washing, evening, locking overt OCD behaviors, but are the same underlying "mental-stuck" behaviors. Then yes, marked increase as they go along with the biggies....ASD and ADD/ADHD.

 

Exactly...my daughter just shut down and looked autistic. Was it OCD? Yes. When she came out of her exacerbation, she told us things like, "I didn't think I was allowed to talk because of the feeling in my throat."

 

I really had a hard time wrapping my brain around OCD when she wasn't having compulsions. The ped psych we saw, told us definitely that OCD, can just be thoughts...compulsions are not needed for it to be considered OCD. Dr. L told us that it is hard for these children to do anything with the thoughts that are going around in their brains.

 

However, I do think that PANDAS goes beyond OCD, in that the brain signaling may be such that it isn't OCD, but more of just confusion or inability to process information. My daughter had so many different symptoms...short term memory loss, fine and gross motor skills declined...etc (you all know what I'm talking about)

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I was just googling speech, sensory, if they are common and came across this website http://www.cherab.org/information/adhd-speech.html

 

I was surprised to read that speech disorder are reaching an epidemic proportion. I had no idea! I did read this

As neurodevelopmental pediatrician Dr. Agin states, " We know that many children who have neurologic problems do not have just one problem, but multiple overlapping signs and symptoms. A child can have a speech and language impairment, sensory issues, ADHD, PDD...."

 

I wonder if that's what the slp and OT meant when they said it is common. Maybe I read into it too much.

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Thinking about OCD behaviors all day~realizing that so many parents including myself with my own daughter write these off as quirks their kids have. When I talk about my 6 y/o daughter's PANDAS symtpoms I think of her facial and vocal tics first, b/c it's just so black and white. But the movements like shoulder rolling, headstanding, and history of touching her thumb to each finger, doing all these things in threes often-those are probably considered OCD behaviors-is that right? These things would probably not come up in a first time speech eval, unless they were really interferring with the child's activities-in my own daughter's case she could do them and then move on. I know someone mentioned a book related to OCD-I think I will order it this weekend.

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With OCD, that is what often happens...once you give in to that urge/need you can just move on. It's when you aren't able to do it, are stopped from doing it that the anxiety occurs. With your daughter, if she has to do something 3 times and you tell her she can only do it once or not at all, what happens? Can she rather quickly get over it and move on or does it overtake her and she must do it.

 

As for speech and OCD, like you said, during evals and therapy it may not be seen. A lot can be hidden. My son quickly learned to hide his OCD even at 5 years old. Also, parents may hide it. A speech disorder is one thing, but having a child with possible OCD comes with a lot more stigmas. I can't remember what the slp saw that had her realize what was going on. I was also open with them with what was going on at home, though.I know the itinerant (sp?) teacher noticed he was acting different in the classroom, but I think with the slp, she began to see he was refusing stickers that she gave at the end of sessions ( I can't remember why, possible contamination fears), I think he always wanted to walk the same route back from the speech room to my meeting place upstairs and got upset if she went a different way. Little things that can easily be overlooked.

Edited by Vickie
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I recommend reading any of Oliver Sack's books. I just started reading The Mind's Eye and it is great. Also, recommend his book on music, although the name escapes my mind right now. I his books, he talks a lot about strange cases of speech loss, partial recovery and spontaneous recovery due to damage of the brain via stroke, injury or infection.

 

And yes, my son lost his speech at age five due to pandas. It started out that he wouldn't talk much, then couldn't remember the names of things and searching for the right word to finally mutism. He had three ivig's this summer and is doing wonderfully. Language is all coming back. He is now 8 years old. His behavior is amazing. He is the sweet little boy I remember. His pandas doctor said the words will all start coming back but it will take a while. So far, so good!

 

That is AWESOME!!!!

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