Sunday, May 10, 2015

Childhood Apraxia of Speech (CAS)

I learned when Mechal was only an infant to trust my motherly instinct. Mechal was 6 weeks old and something just wasn't right. The way she was spitting up was a little more projectile-ish and she was crying constantly. I took her to see our family doctor at the time. He looked her over and couldn't find any cause for my concern. He said to me, "I have learned through my experience that mothers often know best. If you tell me that you are concerned, I will order blood tests." I told him that I was concerned and he sent little Mechal for blood tests. We didn't get the blood tests back, before Mechal developed an extremely high fever. We took her immediately to the emergency room, where it was discovered that she had a urinary tract infection with E-coli. She had several tests including a spinal tap and was hospitalized for a week. Thank G-d, that story is well in the past, as she is now eight and a half.

In some ways, I am thankful for that experience, even though it was very difficult for me emotionally as a young mother. It gave me the confidence to listen to my inner voice.

Tehilla's speech was nagging at me. She is my third child. While Mechal was already speaking in full paragraphs at this age, Tzviel wasn't. He took his time learning to talk, but he made steady progress on his own timeline. So, when I was observing Tehilla, I knew something wasn't right. She wasn't moving forward. In many ways, she was moving backwards.

Now, of course, her medical history is pages long and like our family doctor said, "With her, expect things in  her development to take a little longer. She may need a little push of intervention to get there." But something was nagging me and after talking it over with a dear heart mom, I decided to take her to be evaluated by a speech therapist. I am so happy that I did that.

Today, Tehilla had her third appointment with our speech therapist, Ilana. Ilana has been evaluating Tehilla's overall development in speech from a development stand point, but also from a physical standpoint. The specific points that had been bothering me with Tehilla's speech were: she had dropped most of the words she had learned to say and never picked them up again, all of her words sound exactly the same and are only differentiated to us by her pointing, neurologically she seems advanced in her comprehension and ability to follow instructions, yet was not picking up new words. She is also eager to learn new signs and uses them, but is still not communicating through speech.

Ilana has observed her and has discovered that Tehilla has Childhood Apraxia of Speech (CAS). As I am just learning all about this, along with you, I will copy and paste the description from my online research:

"Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words."

Ilana had a long conversation with me explaining this in depth. She assured me that with intense treatment we will get Tehilla talking, but it would take a long time and we would need to be patient. We have submitted a request from our kuppat cholim (insurance provider) to allow Tehilla to get speech therapy three times a week.

At home, we are to move all of her toys and books up high where she can not reach them, so she will be forced to find a way to communicate with us what she wants. We also are to only put a little food on her plate, so she will have to ask for more. We also can't just give her what we know she wants, even though she will screech, but to force her to use her signs and sounds.

Ilana will work with her on specific sounds, and reinforce them by touching the area of her mouth that she needs to use. With G-d's help and a lot of work with our fantastic speech therapist, we'll get her talking.


  1. Soshana, my son got sick as a newborn and had some oxygen deprivation. . . nothing like Tehilla's, but enough that I understand your latest journey. My son is very bright verbally, but there are some "disconnects" between how he sees things with his eyes and the way his brain interprets them. . . this was also true for his speech. The brain is an amazing thing and thanks to "neuroplasticity" it can rewire itself, especially at a young age. Tehilla needs physical, occupational and speech therapy. That brain needs to be rewired! Don't be scared. My son is in his teen years now. We still have challenges, but he is very bright. You just need to be aware of what to do to help Tehilla in this aspect of her life, as you have already done with her health.

  2. A mother's instinct is almost never wrong – and you have once again proven the age old adage correct. Although having Apraxia of speech is deemed disadvantageous by some, as it tends to make the social skills of a child slower, there are many people who had Apraxia that were able to excel in life as an adult. A good example of which is Rhonda Rousey; she's very vocal about having Apraxia and how she was able to overcome it. It's proof that what you have as a kid cannot shape your future. I hope Tehilla the best, Shoshana! Good day!

    Brendon Hudgins @ MedCarePediatric

  3. Such a informative blog...I really appreciate your effort.It is very important to motivate any child.And this type of blogs are really very useful for understanding what actually it is.Most of the people face the speech problem so its is very good idea of spreading information.childhood apraxia of speech