Speech Therapy - the diagnosis & progress

I have been really reluctant to talk with anyone about this.  I think in large it was because I was still in shock that there was actually a diagnosis.  I also didn't have the answers to the questions that people would start asking if I shared what was going on with Abby.  I am not hiding from what we found out, but I am certainly trying to come to understand it better so that Brian and I can be the best possible advocates for Abby now and in her future.  I guess in my eyes, putting a label on it made it that much more real and that much more difficult to accept.  Having a diagnosis meant that our gut feelings were right all along and all of those people who chalked it up as being a late talker, or a 2nd child syndrome were just wrong.  For Abbigail's sake, as well as for Brian and me, though I have finally decided it was time to talk about her speech therapy that she started attending in late October - the diagnosis & the progress she is making. 

Abbigail was diagnosed with Childhood Apraxia of Speech (CAS).  Childhood Apraxia of Speech is a motor speech disorder. For reasons not yet fully understood, children with apraxia of speech have great difficulty planning and producing the precise, highly refined and specific series of movements of the tongue, lips, jaw and palate that are necessary for intelligible speech. Apraxia of speech is sometimes called verbal apraxia, developmental apraxia of speech, or verbal dyspraxia. 

I have had many feelings and emotions in reaction to the news. At times I feel quite fearful about her future; other times I wonder how this happened to her or even if I did something to cause Abbigail to have apraxia. I even feel sad sometimes when I think that she may have to work harder than other children to do something that seems as natural as learning to speak.

The average expressive vocabulary for children aged 24-28 months is 200-300 words.  It is also expected that children in this age group will have names or labels for preferred objects, toys, pets, etc.  At present, Abbigail's expressive repertoire contains only 20-25 words and does not include a variety of labels.  The use of 2-word utterances typically emerges between the ages of 18-24 months.  At this time, Abbigail does not use 2-word utterances with the exception of "no more."  Abbigail also does not refer to herself using her name, although in the last week or so has added the word "me" to her vocabulary and uses it quite often when she is talking about herself or her possessions.  Furthermore, for children in this age group, the use of CVC (consonant/vowel/consonant) words and other syllable structures with final consonants are used.  Presently, Abbigail's words have a beginning sound (depending on the consonant) but do not have an ending sound.

Expressively, Abbigail demonstrates many positive behaviors - she is engaged with others and uses eye contact appropriately when she interacts; she is very willing to attempt to imitate sounds; she already has positive pragmatic language skills and she is VERY expressive in other ways (body language, etc). 

So for the last 6 weeks, Abbigail has attended private, individual speech-language therapy sessions 2 times per week with Ms. Amy.  Starting in January, we will increase this to 3 times per week.  Not only have we seen some very positive changes in Abby's verbal expression, we have also learned some of the techniques & verbal cues that are very helpful for Abby to see and hear when she is trying to say/learn sounds and words.  We are hopeful.  No one can totally predict Abby's ultimate success at becoming a verbal communicator.  The act of learning to speak clearly is typically long and challenging for children with apraxia of speech, but Abby can and will make great strides and much progress with speech therapy.  But with all of that said, she is improving.  Making small steps.  Adding more sounds.  Saying more words.