Autism and apraxia_will he ever speak?

[smettoh]

I am a mother of a 4 year old boy diagnosed with Autistic Spectrum Disorder a year ago. I am interested to find out more about Childhood Apraxia of Speech and the targeted therapies as Imy son has this condition in addition to the ASD. My son is currently in specialised unit for ASD kids under 5. He has a lot of initiative to try and speak and communicate with us and his teachers but his speech consist of single syllables that are often inconsistent. When he was first diagnosed at the age of 3, we taught him PECS and he progressed through with PECS to phase 4 in 3 months. This reduced a lot of early frustration but he is at a stage that he is fed up with PECS and tries very hard to say what he wants but it comes out incomprehensible to us. His motor fucntion is otherwise normal ( i think) , althoguh he hates to write, draw, use scissors..what is his prognosis?

The problem is that the speech therapy he is getting is catered mainly towards the ASD and at age 4, he is not at all cooperative with the exercises. his main motivation for trying sounds is when he is at home and he is asking for things.. He tries so had to communicate but never gets it right. He has never been able to say the 'S' , 'T' , V, D, N sounds and has never had any really clear words spoken.. he says mama, papa, ar (for car), wa wa (for water) kaka (for duck) , ig (for pig) etc..

Is there hope for us?? The other thing is that he now hates using PECS becasue a lot of things he tries to say or want is not in his PECS book (there are already 100+pictures) and he is so fed up with sifting through the pages. We are thinking of buying something like the Springboard or Vanguard which is an electronic voice assisted device..but I don't know if it will stop him speaking at all?

your help and experience is very much appreciated..


This discussion is related to Apraxia vs. speech delay.

[Sally44]

The thing that made my son speak was the fact that he uses echolalia.  Google that to see what it is.
At around 3+ he was still only saying two word combinations.  But at that time my daughter was bought a TV and video player.  From the moment my son saw his first video he was hooked.  He learnt the dialogue immediately and would repeat it for hours.  He still does that, but he also produces his own speech.  So the echolalia has actually helped improve his language, but it also means that he sometimes gives a false impression of speaking too well, when actually he is joining together phrases he has already seen on TV to express what he wants.
Have you spoken with the speech therapist about the possibility of signing, or whether there is another way of communicating that would be easier and faster for him than PECS.
Does your son have dyspraxia at all, or is just the forumulation of his words affected?  

[smettoh]

Thank you for your response..it is sooo frustrating to se him like this. Our view is that he cannot formulate the words that he thinking of..you can actually see him try so hard..I can say that if he ever reaches a level of speech of your son's - we would be so grateful and happy. I am clinging on to whatever hope there is that he is 4, and there is time, but we are constantly battling for more targeted therapies for him.

[Sally44]

I am not a professional.  I am a mother of a 7 year old boy with ASD, semantic pragmatic disorder, disordered speech, auditory processing problems, auditory memory problems, sensory integration disorder, dyslexia as well as problems with attention and focus.  So I know what it is like to have multiple diagnosis that overlap and make it hard to sort out the root cause of difficulties.
From your post it sounds like he is trying to communicate, but can't.  Some autistic children are not able to initiate communication or try to make their needs known for various reasons.  
Your son sounds like he is frustrated with the system available to him because it is too basic for the thoughts/needs he wants to express.
What would be useful to know is 'are his speech difficulties specifically down to being unable to forumulate sounds, or does it also affect his thinking'.  Does that make sense?  If he is more able to formulate ordered thought and 'think' about what he wants to communicate, but cannot translate that thinking process into words, then maybe a different system would benefit him.
I think a speech therapist who specialises in apraxia would be more able to advise you, and maybe test your child's ability to communicate through other non-verbal means.  I presume it would be beneficial to continue the programme of sounding out letters etc as he is still young and may well improve over time.  But, I also agree with you that at some point you have to invest time and energy into another way.  I am in a similar position regarding dyslexia.  For how long do we continue trying to teach whole words or phonics to my son before we move over to a voice activated computer programme?  However I also have to bear in mind that my sons speech is disordered with many pronounciation problems (similar, but not as severe as your son's), that would make a voice activated computer programme difficult to address.
Has you child also been assessed for Auditory Processing Disorder.  This is where sounds, including language, are heard and processed differently.  My son says 'puter' for computer, and 'posed' for supposed.  He says 'v' for the, bokano for volanco, globes for gloves, etc etc the list is endless.
So, at some point, a computer programme may be useful.  But also signing could be an everyday way of communicating.  Signing is also a system that is used throughout society.  It sounds like he has moved on from PECS, although those visual supports should continue to be used and be available in school and home, but for more sophisticated communication something like signing could be used as well as introducing computer aided communication programmes.