Apraxia vs. dyspraxia

Apraxia.  Dyspraxia.  I've seen them used interchangeably for so long, I thought they were the same thing. It seemed to me like dyspraxia was the British term for apraxia.  All the information about dyspraxia seems to come from the United Kingdom.  But I'm beginning to realize, there's a difference.  Basically it comes down to this:

Apraxia:  No motor planning.  Effects speech and can effect oral movements.

Dyspraxia: Difficulty with motor planning. Effects gross and fine motor skills, can impact understanding and speech.

You can read more about the difference between apraxia and dyspraxia here.  

This new information is a little overwhelming, but yet things are making sense to me regarding Kiddo.  He has to be trained how to speak, how to make every sound, how to combine those sounds into words, how to combine those words into phrases, how to combine those phrases into sentences, and so on.  It's not just difficult for him and will come to him with practice, but rather that it is impossible for him without therapy and lots and lots and lots of practice.  Therefore he does have Childhood Apraxia of Speech.  He completely lacks the motor planning in that area.

But, as I read the symptoms of dyspraxia, I was shocked by how many of them Kiddo struggles with:

"Particular symptoms or signs of dyspraxia in babies and toddlers can include:

• Hypertonia or hypotonia.
• Delay in reaching developmental milestones.
• Difficulty performing physical activities such as climbing stairs, running, hopping, and jumping, when compared to other children of the same age.
• Difficulty chewing solid food.
• Difficulty with pincer grasp and holding a pencil/drawing. Drawings may appear immature for the child's age.
• Difficulty performing daily activities and self-care tasks such as getting dressed.
• Taking longer to acquire new skills.
• Falling over a lot or appearing clumsy.
• Problems grasping the concepts of 'on', 'in', 'in front of', etc.
• Difficulty establishing relationships and with social behaviour.
• Anxiety or agitation.
• Delayed language development or problems with speech.

As well as the problems above, particular symptoms or signs of dyspraxia in school-age children include:

• Difficulty participating in group situations - being much better one-on-one.
• Problems with maths and writing, including having trouble copying things from the board in school.
• Disorganisation.
• Difficulty reading.
• Poor concentration and listening skills.
• An inability to follow instructions.
• Avoidance of physical education in school or physical activities with friends.
• Anger and frustration."    (Taken from http://www.patient.co.uk/doctor/Dyspraxia-and-Apraxia.htm)

Once I realized that a lot of Kiddo's difficulties are related to dyspraxia, I've been able to find a lot more research to help him.  And two books I've been reading have been awesome, enlightening, full of activities and ideas for working with Kiddo and building up his motor planning in other areas, particularly in his fine and gross motor skills.  Two books I've found really helpful are:

*Understanding Motor Skills in Children with Dyspraxia, Autism and Other Learning Disabilities by Lisa A Kurtz. 
*Dyspraxia: The Hidden Handicap by Dr. Amanda Kirby.  

Another thing I've found really helpful, on the biomed side of things, is that Omega 6's are recommended for motor planning.  I've been giving him only Omega 3's, which has done wonders for his speech, and so I went off on another research frenzy.  Yep, research indicates that Omega 6's, particularly from evening primrose oil or borage oil can help with motor planning and are recommended for children with dyspraxia.  So, I immediately ordered a bottle of fish oil that contains the Omega 3's & 6's as well as Vitamin E.  We'll see if it makes a difference.

And, just had to share this random tidbit: I discovered that Daniel Radcliffe (the actor that played Harry Potter) has dyspraxia.  He was terrible at sports and struggled with things such as writing and tying his shoe laces and was discouraged about not being good at things that came easily to his peers.  His parents got him an acting audition, not really expecting that he would get the part, just bragging rights among his peers about getting an audition.  Obviously, he got the part.  You can read more about it here.

Progress Report

Speech: Well, the kiddo's vocabulary just keeps growing and growing.  His newest word is circle (said more with a "k" sound like "kakel").  His two word phrases keep popping out, mostly an adjective with a noun, such as " re ba" (red ball), "wha kakel" (white circle), "tee ca" (three cats).  He also uses phrases to express things he wants, which I am so excited about.  These include "eeee pee" (eat please), "mo dree" (more drink), and "bo pay" (go play).

He has learned to say the "ss" sound, and the "sh" sound, so I often hear him tell little brother "shhh", and when he is counting, both six and seven are said as simply "ss".  (wa, boo, tee, ma, ta, ss, ss, a, my, ta).

Something tells me I'm going to need to be his interpreter for quite some time, but I don't mind, I'm so happy to hear him expressing himself, and I know he's encouraged when I understand what he's saying.  I can see the frustration when he says something that I don't understand, but more often than not, I either know what he's saying or can quickly figure it out.

Not only are there new words, but new skills too!  Kiddo's very first smiley face!

Little brother (13 months) is beginning to talk too!  He says "go" (though it's usually "go go go!"), "mama", "dada", "da da" for all done, and I think once or twice I've heard him say "ba" for ball.  He also does the signs for "more" and "all done."


Gross Motor: Right now, kiddo goes to physical therapy (PT) once a month.  I try taking the kiddos to playgrounds often, and since the spring, kiddo seems much more eager to attempt new things on the playground, his climbing has become much more coordinated, and he now is able to run.  He still has a hard time with stairs, (even small curbs), climbing things (ladders, taller steps like they have at Chick-fil-a play places, etc) and he is unable to jump or pedal a bicycle.  It's so awesome to see such progress with his speech, but honestly discouraging to see his gross motor skills not developing as quickly. Anyone have any suggestions of things we can try?

As for little brother, I took him a few times for private PT sessions when he was around 10 months since he was getting around doing "the worm", not standing upright even if we supported him, and not able to get up into sitting by himself from his belly.  PT seemed to help him a lot, to go from doing "the worm" to sitting upright on his own, then to crawling and then pulling to standing.  Once he was pulling to standing we stopped going to PT, and now he is cruising and crawling like a champ, and occasionally even standing without support for a few seconds.  I'm hopeful he will start walking in the next month or two.  :)

Cruisin'!

Fun Happenings: Just a few fun things the kiddos do together:

1) During bath time the other day kiddo was drumming on his little brother's back, and I told him not to touch his brother, so he started throwing foam letters at him instead.  He learned that they stick to little brother, and now he loves putting them all over little brother.  Little brother doesn't mind, and when he stands up in the bathtub, kiddo quickly sticks one letter on each butt cheek before I can sit little brother back down. :)

2) Both kiddos love crawling down the hallway together, giggling nonstop.  I love watching them play together.  Here's a short video of them crawling out of a blanket fort I made them...

Biomed, Phase II

I took kiddo back to see our doc who is helping us with supplementation that will help the kiddo's apraxia.  I posted before about the supplements he recommended for kiddo in Phase I of our biomed journey, and also how he took blood so we could figure out what he is deficient in and supplement those areas.  From all my research, children with apraxia tend to have severe deficiencies in 5-10 areas, usually zinc, iron, omega-3s, B vitamins, magnesium, carnitine, and Vitamins B, D and E, and he said that Phase II of our biomed journey would be to start supplementing specifically in the areas he is deficient in, or increasing the supplement if we were already giving it to him.

So, I went in to the appointment, expecting a laundry list of deficiencies and the supplements I needed to add to our daily regimen of supplements he is already on.  But...

His blood work revealed he was within normal range for every area!  Seriously.  The only one the doc noticed was low, but still within normal range, was carnitine, which we have been supplementing.  But, everything was within normal range!!  Which means, no need to add anything else, his body is absorbing nutrients properly, unlike a lot of children with apraxia and autism.

While that was awesome to hear, I must admit it was also a little disappointing.  I was expecting something else we could give kiddo that could possibly help him continue to make progress.  The doc then suggested we add more carnitine.  I'm giving him 600 mg of Acetyl L Carnitine daily, and the doc said we could bump that up to 1,000.  He agreed with me from my report of kiddos' progress, that it seems the carnitine is what he's responding to the most, and by increasing it, we may see even more progress, which would be awesome.

I told him about how the magnesium glycinate he recommended for kiddo was causing teeth grinding and so I discontinued giving it to him.  He agreed that was the best thing, that there was no need to try it again, so that was a relief.  The teeth grinding was not only annoying but very concerning for us.  I spent hours researching each supplements' side effects, trying to figure out which supplement was causing it, and I spent a few weeks experimenting with dosages of the supplements he recommended for us until I figured out it was the magnesium.  I'm glad that's behind us.

And I'm so grateful to know that I no longer need to research supplements, biomed, etc.  Kiddo is where he needs to be nutritionally, and that takes one more thing off of my plate.  What we are doing is working, and we just need to continue it.  I can spend more time with both kiddos rather then researching supplements.  Such a blessing and a relief.

Have I mentioned before how much I like this doc?  He asked me to email him an update after a month of increasing his carnitine to let him know if it seems to be helping, and to feel free to email him any questions I may have. He admitted that he had no other suggestions for what we could do for kiddo, but that he'd like to see him again in a year, to do more blood work and just see if all his levels were still normal.  That he expects to see lots of progress when he sees kiddo next time.  A year folks.  Originally, we were going to meet every two months.  That's five less appointments I have to take kiddo to.  10 hours of driving time saved, time that could be spent with the kiddos at home or with a play group.  Again, another blessing and a relief.

God is so very good. :)

Speech Videos

I realized it's been a while since I've posted a speech video, so here's two for you. :)

Colors and Numbers: Kiddo loves telling me what color everything is, and now how many of something there is.  Well, if it's five or less.  He can count to ten with prompting, but 1-5 he has completely mastered.  He is one smart little guy and I can't wait to learn more about what is going on in that little head. :)

Vocabulary: I believe he now says close to 100 words.  He said about 50 when we went to CHAMP Camp in July, so I'm really proud of him doubling his vocabulary in less than two months.  And this time last year he only had one word (ow), so I'm excited about his progress.

I would say that of the 100 words he says, only about 20 he says precisely, but the 80 or so word approximations are slowly becoming more clear and closer to the actual word.  Here he is showing off some of his vocabulary using flashcards.  I personally would think practicing his words with flashcards would be boring but he LOVES them.

Progress with Probiotics

Our next step on our biomed journey was introducing probiotics (good bacteria, like what you find in yogurt) to the kiddo.  One of the websites I've been reading, biomedheals.com said this:

"There is a theory out there now that is applying to conditions like autism, ADHD, dyslexia, verbal apraxia, really a huge umbrella of conditions that are becoming way more common in our society. The theory is these children have lots of bad bacteria and yeast in their intestines. We are not suppose to have yeast in our intestines. Only in our stomachs. When yeast leaks out into our intestines it lines them and makes a coating. And why this is an issue, is because our stomachs only digest proteins. Everything else is digested in the intestines. And when there is yeast in there it blocks the intestines from absorbing all the wonderful vitamins our food contains. Which in turn, almost starves our bodies and brains from the fuel it needs. And when that happens, a lot of issues can arise."

So, realizing this made total and complete sense, and after researching more about probiotics I decided to try it.  Since the kiddo seems to be very sensitive to a lot of supplements I give him (sometimes he experiences rare side effects such as hyperactivity with fish oil, and teeth grinding with magnesium) I always introduce a supplement at a very low dose and if all goes well I increase slowly.  So I started at 1/8 of the recommended dose of probiotics for children, every other day.  The third day (his second low dose) he had massive diarrhea.  (Yep, bet you weren't expecting to read that.)  Hubster, kiddo, little brother and I were at a restaurant with my sister and totally not expecting to experience that.  Nothing quite like telling your waiter your son got poop all over the floor and also using up every last diaper wipe to clean the kid up.  I carried kiddo out minus his shorts (for obvious reasons) and he signed over and over again "silly" as we fled the scene.  About twenty minutes later, we had another case of diarrhea.  Fun times.

I did lots more research after the restaurant fiasco and read that high doses of probiotic can cause something called die-off, or basically when all the bad bacteria and yeast are killed simultaneously and therefore have to leave the body, and that there can be up to three pounds of yeast to be evacuated.  Yeah, disgusting and horrifying.

Needless to say, we took a break from the probiotic for a few days, fed the kiddo quite a few Pedialyte popsicles, and prayed that we had seen the end of the diarrhea.  We had.  

And we noticed two positive things immediately.