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Apraxia and Behavior
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Apraxia and Behavior

My eight year old son has apraxia.  We assume that it is developmental.  He is a twin born at 29 weeks.  He did have a grade one brain bleed that resolved itself.  He was a very late talker.  He is now eight and in second grade.  He has made great progress with his speech but still struggles.  He's actually a great reader, but does struggle in school.  He likes school, but I have the most behavior problems related to homework.  We've always struggled with his behavior.   He behaves fine in school, parties, etc. but home includes a lot of defiance, yelling, and now hitting.  We recently had him place in a partial hospitalization program primarily for hitting our other kids and now most recently us (parents).  The psychiatrist seems to be ignoring the apraxia and has determined that he has bipolar disorder which does run in my mother's family.  Is it common for kids with apraxia to have behavior problems even when speech is improving and is it common for kids with appraxia to be misdiagnosed with bipolar disorder?  I'm very concerned that we're going down the wrong path here, but this doctor is very determined to convince that the behavior is not related to the appraxia and instead related to bipolar.  
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I would question the diagnosis too,  kim,  because he's able to behave fine in public and at school.  That doesn't sound like bipolar disorder to me at all.

It sounds like he's holding it together as best he can in public and then releasing his frustrations and tensions when he is in a safe environment,  home.

I wouldn't allow this doctor to diagnose him with bipolar.    If you literally mean he behaves "fine" at school - meaning the teachers don't ever bring up behavior issues and agree he's cooperative and pleasant in the classroom,  this may pass as he matures.
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Is it common for kids with apraxia to have behavior problems even when speech is improving  --  your words

Our nephew was also diagnosed with developmental apraxia.  He did not have any behavioural issues other than frustration with those not understanding him.  He was two years of age when he was diagnosed (and speech therapy began immediately); today he is going on eight years and the apraxia has all but disappeared.  He is doing so well (the speech issues are almost non-existent) - how early did your son begin therapy?  Just wondering ....
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My son has sensory integration disorder and motor planning (dyspraxia) is present.  Behavior issues are a hallmark sign of sensory integration disorder and it is situational.  It is a developmental delay.

I wonder if your boy is holding it together at school and then falls apart in his safe place and with his safe people (home and you).  What kinds of therapy does your boy do?  In occupational therapy, a child learns various coping skills to deal with disregulation (emotional outbursts and self soothing issues).  

Would your son respond to something like a stress thermometer in which he could see if he is escalating in his anger/frustration, sadness?  My son has used this for a couple of years now and it has been really beneficial for his understanding what is going on inside of him and being able to choose alternative ways to vent this emotion.  

Also, some kids do really well with some physical activity right before home work.  I'd do this with your son, then give him something like a big piece of bubble gum or licorice (I know you probably think I am nuts but these are soothing techniques for the nervous system), a hand fidget and some quiet time.  Keep homework time less stressful and have a reward of getting to do something he enjoys after.  Praise him big time for completing anything.  

I agree that it sounds less likely to be bipolar as it is only at home.  good luck and peace

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Listen to your heart too and don't just follow blindly what the doctor says. I think if a kid is having difficulty with his education,  he can have behavioral issues. I'm sure it is really stressful.  

I wonder too like specialmom, if he holds it together for school and then releases it all at home. THat's hard on you too I know.  

Could you get a 2nd opinion on the bipolar.  Aks the speech therapist too if kids with apraxia have behavioural issues, I would think it owuld be pretty common.
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Read this. I think his behavioral issues are related to the apraxia.  I would get a 2nd opinion on the bipolar.  I know a family memeber had it but that does not make it written in stone he will have it and also remember bipolar in children is still a CONTROVERSIAL diagnosis. It did not exist 10 years ago...  Just do your research....
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More topics » Apraxia of Speech
Apraxia of speech is a motor-speech programming disorder resulting in difficulty executing and/or coordinating (sequencing) the oral-motor movements necessary to produce and combine speech sounds (phonemes) to form syllables, words, phrases and sentences on voluntary (rather than only reflexive) control.  Many children are able to hear words, and are able to understand what they mean, but they can’t change what they hear into the fine-motor skill of combining consonants and vowels to form words. This difficulty combining consonants and vowels into words upon direct imitation is called apraxia of speech.  The severity of apraxia of speech can range from mild to severe.  

Children with developmental apraxia of speech generally can understand language much better than they are able to use language to express themselves. Some children with the disorder may also have other problems. These can include oral-motor weakness or dysarthria (a speech disorder that is due to a weakness or incoordination of the speech muscles; language problems such as poor vocabulary, incorrect grammar, and difficulty in clearly organizing spoken information; problems with reading, writing, spelling, or math; coordination or "motor-skill" problems and chewing and swallowing difficulties. Without guidance these children often stop attempting to speak or verbalize patterns at rudimentary levels below that of which they are capable. This can further delay progress and cause frustration which may later develop into varying degrees of social and/or behavioral problems.  

Apraxia of speech is treatable with the appropriate techniques. Speech-language pathologists play a key role in diagnosing and treating apraxia of speech. It is not just a simple articulation or phonological disorder. There are several different approaches to treating apraxia of speech as no single approach has been proven to be the most effective. The program assigned will vary depending on the severity of the apraxia and the age of the child. The Kaufman Speech Praxis Treatment for developmental verbal apraxia is a highly effective program currently being used by Dr. Grossman and her staff of speech-language pathologists. The tool has proven to be a successful instrument in the evaluation of apraxia, determining treatment goals, and providing effective therapy. This is done through drill, structured and spontaneous conversation, and play using cues, prompts, and support.


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Thanks to all of you for your comments!  To answer some of your questions- my son has always been followed through Early Intervention through the state of Illinois.  He started Speech before he was two.  He started school right at age 3 at which time he received special ed services- OT and Speech as well as time with a resource teacher.  He currently receives Speech at home (one hour a week) and Speech, OT, and one on one time with a special ed teacher at school.  I've always been told that he's very intelligent- He's a great reader for example.  I think the Apraxia really trips him up in getting his thoughts to paper.  I've actually learned a little more about language processing and I'm planning on starting him in therapy with a psychologist to improve coping skills.  I'm also starting him in a social skills group.  But I think the biggest thing I learned is that there are other things in my family contributing to his stress.  I'm very happily married, but I think his relationships with siblings needs some work.  I've learned how much the other three kids get away with things leading to a lot of chaos in our home.  I think Josh has also been pegged with the "naughty kid" in the family status.  I've been watching how the other three treat him and it's not pretty.  I think I've misunderstood some of his behaviors not realizing that he doesn't process language like a typical 8 year old.  The good news is we've changed quite a few things at home and it's already more peaceful around here and Josh seems a lot happier.  It also seems likely that Josh's language issue is developmental and that he is already overcoming it.  Thanks again for all your comments!!!!!!
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I think it's great you're looking at his sibling relationships,  Kim.  

I read recently that sibling relationships affect how a child feels about himself,  and his social development much more than the parents affect that.  So that's huge.

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