Today I was called in to consult on a little 2 year-old girl who has been receiving services from a Birth-3 provider. I usually ask parents to have all the reports and current goals for me to get an idea of the background on their child. Once again, a child had been labelled “apraxia” and the parents wanted to know what I thought. Personally, I have seen very few children who truly have apraxia in the 35 years that I have been in practice. I have seen many that initially I thought had motor planning difficulties but they settled into therapy and began to show progress and were eventually dismissed.

This little girl was using some 3 word sentences, imitating what I was saying and also had the advantage of just getting tubes put in her ears a few weeks earlier. The parents noticed a dramatic improvement in her speech and ability to imitate. Fluid in the ears and temporary hearing loss can contribute to slow progress and a need for medical intervention.

I gave the parents several suggestions for how they were to respond and talk to their child–not a lot of questions or requests for her to say words, but modelling the words and phrases for her, turn off background music and tapes during your talking play time and talk in 2-3 word phrases during your play time. I offered some suggestions for therapy as well as increasing her frequency of sessions. I am careful not to be invasive when recommending ideas to other therapists because I know that they are doing their best and usually a very good job as in this case. But, sometimes it is helpful to take a step back and view the child through different eyes.