2 yr old w/ speech problem

Have a child with SM/Chiari? Share issues unique to children and their caregivers.

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2 yr old w/ speech problem

Postby evergreenmom » Tue Feb 16, 2010 7:46 pm

Hello all-

I am new to this site and desperately looking for info. My son is 23 mos old and barely speaks. He had surgery a year ago for craniosynostosis ( premature closure of the left lambdoid suture of the skull) and at that time he was found to have a cerebellar tonsil herniation ( chiari) which was likely the result of his skull bones not growing properly and constricting his hind brain during the first ten months of life. We don't yet know if he has syringomyelia- going for MRI on March 1st.

We have had my son evaluated by a speech pathologist who feels he may have apraxia of speech or dysarthria...trying to figure out which one and if Chiari malformation may be the cause...also wondering if decompression surgery would allow him to more easily learn to speak?

Please let me know if you know anything at all about either of these speech disorders...my son is very bright and wants desperately to communicate he just can't seem to figure out what to do with his mouth to make speech. He say a dozen or so words many of which only Momma understands... he has no trouble eating(lol) and does not seem to have any symptoms from his chiari at this point. Thank you for this place and for reading and advice...best wishes- Kristin
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Re: 2 yr old w/ speech problem

Postby DanielleC » Tue Feb 16, 2010 8:51 pm

Hi Kristin,
I know exactly how you feel. My son ( who is also 23 months) was diagnosed with syringomyelia 2 weeks ago. He really does not speak much. He has very few words (only my husband, the speech therapist and I understand). AND he has been getting speech therapy since he was 12 months old. My neurologist diagnosed him with oral Motor Apraxia-- even though he is young. He can understand everything-- he just can not form the words.

According to his doctor, his speech delay is not related to his syringomyelia. His syrinx is from T3-L1. (too low)
He is having another MRI this friday with contrast & a flow study to try to figure out why his has this syrinx. I am not 100% convinced that it has nothing to do with his speech.
Is he getting prompt based speech therapy? I know that is what was recommended for my son. He gets speech 3x's a week and we are trying to get it increased. repetition is best for apraxia.

Good luck with the MRI-- I hope you get some answers.
Danielle
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Re: 2 yr old w/ speech problem

Postby Becky1219 » Sat Feb 20, 2010 11:55 pm

I too know how you are feeling. A year ago, when Jack was your son's age, he was having tremendous difficulty with speech. His speech is still delayed, but has improved. He hasn't officially been diagnosed with Apraxia, though it has been mentioned. Apraxia does seem to fit Jack, since he has problems with motor planning as well. Jack has had speech therapy twice a week for the past year, only once a week prior to this. He also gets OT which also works on speech skills. We used a lot of sign language to help Jack express himself and it was very frustrating (still is at times) when he didn't know the sign he needed. Last August when Jack was 27months, he suddenly had a major increase in the number of words he could say. We had been working with a book for kids with Apraxia that his ST let us borrow. He now will use 2-3 word phrases, but his speech is very choppy like he has to think hard to get out each new word, or syllable for a long word. He sill uses some of his signs, but we haven't added any new ones in the last 4-5 months. He has come a long way in the last year. He turns 3 in May and will lose his current therapies. We are having him tested by the school system this week to see what speech services he will qualify for.

It is hard for me to say whether chiari is the primary cause for Jack. He also has meitopic synostosis (front suture on the forehead), decreased white matter, thin corpus callosum, hydrocephalus, CM1, SM, and TCS. All of these things make it hard to pinpoint any one of them. Also, Jack was born 10 weeks premature with EA/TEF(esophagus not connected to his esophagus). He was a very complicated case and wasn't connected until he was 8 months old, then he spent a full month on the vent again because of his weak lungs and decreased white matter. So, needless to say, he has had a long road to learn to eat which also greatly affects his speech since so many eating movements lead to speech movements. Though I really think the biggest issue is with processing to get the words from his brain to his mouth.

My advice would be speech therapy and signing to help alleviate frustration (speech therapist should be able to help with this).
Best wishes,
Becky
Becky, wife to Mike, mom to Logan 4/3/04 and Jack 5/4/07 30 weeker EA/TEF, bowel perforation, CM1, SM, TCS, hydrocephalus, metopic synostosis, thin corpus callosum, decreased myelin, and the many issues that go along with these
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Re: 2 yr old w/ speech problem

Postby Grindel » Mon Feb 22, 2010 4:44 am

My son had both apraxic speech issues and dysarthritic speech (spelling?). At age two he had very unusual speech patterns (including no verbs until after age 4). He could not answer any question without a visual cue. His speech was clearer when he had a visual cue as well. My son is now 7.5 and has had 4.5 years of speech therapy. When he was 5 his articulation was below the 2nd percentile. In first grade it was the 4th percentile. He had surgery at 6.5 years of age. His motor planning (apraxic issues) did not really improve, but his dysarthria (slurred speech) did. When he is tired or having an off day we hear more of it. Most experts have told me he has a very unique mix of multiple speech problems, yet doesn't fully have any one disorder. My son has a chiari malformation, but no syrinx or other skull issues. He also is on the autism spectrum, but doesn't have a full autism diagnosis. He has some severe autonomic issues, too. My son also has a psuedomeningecele. My son has auditory discrimination issues, cannot decode words (yet reads above grade level by sight), and is most likely profoundly gifted with significant learning disabilities. He has trouble getting the vowels correct on spelling tests, but pretty much has a photographic memory. His speech, academics, and everything else are like swiss cheese. There are unusual holes in his abilities everywhere. We used to say his abilities lay on the two ends of the bell curve - either below the 2nd percentile or above the 98th. His speech and balance were most helped by surgery, but neither is typical for his age.
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