Question
I am presently working with a 6.4yr. old (semi) verbal male who attends a private Kindergarten three days a week. He has received private Sp. therapy for 2 yrs. and was labeled as dyspraxic. I have worked with him for almost 1 school year, and have these
Answer
You have described a complicated and puzzling case. The child's diagnosis is "dyspraxic", yet the child can produce sounds with modeling and his oral-motor skills are intact. As I read more about his behaviors, I developed several alternative diagnosis based on the presenting characteristics: auditory processing system is compromised or underdeveloped=Central Auditory Processing Deficits (CAPD), yet he can segment and blend sounds; receptive and expressive language skills are below chronological age level=language delay with possible cognitive deficits, yet he can identify letters and read simple picture books; social skills are deficient and he perseverates=Pervasive Developmental Disorders (PDD) or Autism Spectrum Disorders (ASD); yet a pediatric neurologist ruled out this diagnosis.
You asked if there are any other recommendations and the prognosis for developing oral language. My first recommendation is that I would have the child evaluated by a team of professionals who can determine the child's functional skills within the medical and educational settings. I'm not sure you have an accurate diagnosis or at least, a complete diagnosis of the child's disorder(s). A child development team should be comprised of at least the following professionals: pediatric or developmental neurologist, psychologist and pediatrician; educational diagnostician; audiologist, and speech-language pathologist. A comprehensive and wholistic evaluation by the team may yield more or different information about the child's condition, and that information will help determine the child's prognosis.
Dr. Paula S. Currie is the Head of the Department of Communication Sciences & Disorders at Southeastern Louisiana University. She has more than 25 years of experience working with individuals with a variety of communication disorders and teaching undergraduate and graduate students in speech pathology programs. She has authored several books and given numerous professional presentations on a variety of topics.
Margaret Fish, MS, CCC-SLP
Margaret is a speech-language pathologist working in private practice in Highland Park, Illinois, with over 30 years experience as a pediatric SLP. Her primary professional interests are in the areas of children’s speech sound disorders, language disorders, and social language development. Margaret is the author of the book, Here’s How to Treat Childhood Apraxia of Speech, now in its Second Edition. She is a frequently invited speaker at local, state, and national workshops. Her workshops and writing focus on providing practical, evidence-based ideas to support clinicians working with children with CAS. Margaret serves on the Professional Advisory Board for the Childhood Apraxia of Speech Association of North America (CASANA) and is a topic area advisor for the SpeechPathology.com Advisory Board.
Related Courses
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Based on the textbook Here’s How to Treat Childhood Apraxia of Speech (CAS): Third Edition, this course discusses the most current research regarding the nature of CAS, best practices in evaluation, and effective treatment approaches, along with considerations related to motor learning and co-occurring challenges. It provides a holistic overview of the complex needs of children with CAS at various stages of development.
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'Nice overview of DIR floortime; I work with adults in a behavioral health facility so I'm brainstorming ways to adapt the model to that population'Read Reviews
The DIRFloortime® framework can be used not only with children with autism, but with a wide variety of ages and diagnoses. This 4-hour master class describes DIRFloortime principles and concepts such as Functional Emotional Developmental Capacities (FEDCs) and relationship-based intervention. Case studies provide examples of goals and therapy activities, including virtual experiences, for various populations.
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