22q and speech issues: VPI or apraxia?
I have a 26 month old son diagnosed with 22q (VCFS/DiGeorge). His speech is severely delayed, currently he has the consonant sounds "M" "B" "D" "P" and the short volwel "A". He has no long vowel sounds. He is just starting to form word approximations using various combinations of the consonant sounds he's capable of saying. He also uses ASL to communicate, currently has about 100 signs. We speak/sign, never allowing him to sign without vocalizing. He is capable of imitating some sounds, i.e. a motorcycle, some animals, etc. He does a lot of grunting with inflection and syllable changes to communicate his needs. He has been in speech therapy since he was 11 months old. His verbal expressive has been evaluated at approx 9-12 month level, verbal receptive at approx 14-19 month level.
Several of his therapists have suggested that he has apraxia, but my research has revealed that it is commonly misdiagnosed in VCFS children, when they instead have a compensatory glottal stop with VPI. He does not appear to use any compensatory methods to speak, he just doesn't have enough sounds. It's hard to tell if he is hypernasal, again he doesn't really have enough sounds.
We have ruled out a submucous cleft, but not an occult submucous cleft. He does have a mild conductive hearing loss, bilateral (but incomplete) canal atresia/stenosis, and has PE tubes placed to allow for drainage of fluid.
He is seen by Dayton Children's Hospital and Cincinnati Children's Hospital. Cincinnati's VPI team says they won't see him again until he is at least 3 years old. But in the meantime, his therapists are treating him as if he has apraxia or an oral motor issue because all signs point to those issues. I have provided them with Dr Shprintzen's book and other published research, but my son does not seem to quite "fit" the "typical" 22q speech issues.
We are not sure where to go from here. I have been researching apraxia and VPI extensively, but again he appears to be somewhat atypical. Does anyone have any suggestions for other webpages, books, or specific therapists/drs we could be consulting to better understand my son's speech issues and how to treat them?
I recomend you to contact the CDRC team at Doernbecher children's Hospital OHSU.
Best wishes
Kirsten
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I am not familiar with 22q... but I was reading something else on the internet doing some research and ran across your question. When I read the consonant sounds your son is making it reminded me of my son. My son is now 2 years, 8 months (born 1/22/07) so they seem to be of similar age. These were the only sounds he had as well until about April of this year. Then the therapist he had already been seeing for 6 months begain pairing sounds with gestures and he added 3 more sounds. Still the sounds were very slow in coming and it was like pulling teeth. I knew he had hypotonia (low muscle tone) but he had been keeping up completely in terms of running around, jumping, following his brother etc. What I didn't know what that the muscle tone in his face was as bad as it was. I brought him to a new therapist in June (Debra Beckman - beckmanandassociates.com) who is located in Maitland Florida - just north of Orlando. She did a COMPLETE assessment of his entire mouth - lip strenght, tongue strength and position, cheeks, etc. He began seeing her once a week since this past June. I could go on an on in great detail about all of this, but I'm trying to just give you the basics. Anyway, he went from basically the sounds you listed above to now being able to say almost all of the sounds of the alphabet and has added about 25 new words that are discernible by others (he's added other words that aren't so discernible by anyone but mommy). Other therapists had even told me they were doing the Beckman method of oral motor therapy but had made no progress with him. Now that I see Debra I realize their approach was way off. PLEASE make sure somoene's done a full assessment for you. Feel free to contact me at NotefrmSue@aol.com if you want to ask me more about this. I just sent another mom to Debra a week or two ago and she had also been through everything under the son in terms of therapy/doctors etc. Her son is making rapid progress with Debra already. I'm not saying you have to see Debra. I don't know all of the details about your son....but it breaks my heart when I hear of kids not being able to talk. Debra said she has had grown adults brought to her who couldn't talk and she has helped them and now they do after all that time.
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my son was born deaf and he got implanted when he was 2 years old, after traveling around the state to get him the best speech therapy available so he can speak . we discovered that the speech therapy was not the isue and that he had some oral motor problemes. He's 8th speech therapist had referred us to see debra and since our first session we started seeing improvements and since then my son has been doing great. we started having some miner issues lately, so we just took an appointement for next week
I hope this can be helpful to you i had referred her to a friend who has an autistic child and he is doing great. I hope that you get a chance to see her and that your child will benefit from her as our kids did. good luck
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Hi, just reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
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Hi, just reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
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Hi, just reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
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HI I was ust reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
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ust reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
- Report Abuse
- Was this helpful? Yes
ust reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
- Report Abuse
- Was this helpful? Yes
ust reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
- Report Abuse
- Was this helpful? Yes
ust reading through questions and saw yours, I hope you have found a solution to your sons speech problems since this was posted in July. But if not, I'd like to sum up my daughters journey w/ speech. She to has VCFS and had only M and N consonant sounds at 24months. SPT also told me it was apraxia - I went to 19specialists before she had the official diagnoses. I myself would not stop until something was done. Everyone kept telling me it was articulation, and oral motor even the ENT I went to said she would eventually grow out of it, after doing a nasondoscopy! Be rest assured you do have a diagnoses,and thats 1/2 your battle, now getting the right help for your son is next!!! The key word here is RIGHT, the best advice I could ever give someone that has similar speech problems is to make an appt. with a craniofacial surgeon, they will perform a nasondoscopy to determine the extent of his VPI and can give you some hope in what the next step should be. My Nicolette had a velopharyngeal flap 2years ago, she is speaking much better now, but has taken a long time and intense SPT, she is still not completely understood by her peers, but I think things can only get better with years to come, If it weren't for the VPF she would heve never spoken. I hope this helps, let me know your status and if I could be of any other help to you, I am a couple years ahead of you :)
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