Dyspraxia vs Apraxia, should you be worried? | www.agentsofspeech.com

Hello, welcome to Monday Lives. And you see, today I am in a hotel room, and that's because I'm a different city, seeing some kids. So without getting into all that, it's more of a private matter. So we're here to talk about dyspraxia and apraxia. And I'm gonna have a lot more to talk about after this week because I've more therapists working here. I'm learning with them as well, obviously. And I'm learn, I'm. I'm going to be able to work with a bunch of different students. So this, after this week, I'm going to have a lot more to talk about. I'll probably share on social media and also most importantly, on the email list. So if you haven't, go to agents of Speech.com, sign up for a newsletter. I, I send out letters periodically, emails periodically, and I talk a lot about different things that I learned and stuff that I, I hope will be useful for you. Okay, so let's talk about dyspraxia and apraxia. What's the difference here? Because today what happened was the, the therapist asked me, hey, hey, Ming. This kid looks like from my experience, it should be some form of dyspraxia or apraxia. Which one do you think it is? So that in itself, that question has a few questions. Problems. Right. So is there a difference between dyspraxia and apraxia? From a dictionary, yes. But when we are diagnosing a child, usually from a speech pathologist or a speech therapist perspective, we use apraxia of speech. Okay. And we don't use dyspraxia. Dyspraxia is like the partial, is like the umbrella term for apraxia. Right. And from our perspective, we just use apraxia speech as the term to use. So if you ask me between what's the difference and whatnot, it doesn't matter. Okay? It really doesn't matter. It might matter to some people to meet, we just call aos, same as the brand name here, Agents of Speech, also aos. Very funny. Anyways, so when he asked me that, I thought to myself, why is he asking this question? How come it's obvious that both of them don't have aos, don't have apraxia. And this particular speech. Not speech therapist. He's a, he's an AB therapist with some speech training. How come he's saying that? And I'm listening to a lot of parents and they're asking me as well, oh, I heard of Apraxia. Is my child apraxic? First of all, I want to tell you the. Let me just search it. I don't want to guess. Right. Prevalence rate of. Let's say apraxia of speech. Right. Is very low. So I'm just reading from Asha, right? So let. Let me. Let me just share my screen, right? If I share my screen, you will see. You will see here. Apraxia of speech. All right, Prevalence. Let me just prep. Prevalence means how often does it happen? Right? It's here. CS means childhood apraxia of speech. They call it childhood because there's acquired apraxia speech where, you know, the someone has a stroke and it creates apraxia. So that's how we, like, distinguish between acquired, like, adult form or, you know, like a kid could have a stroke and also have apraxia, but we don't know about that because it's still developing. Anyways, so CES, childhood apraxia speech is estimated to occur 1 and 2 per 1000. That means 0.1% to 0.2% of the whole population. So I don't know if you guys saw that. I think I didn't share my screen. But anyways, that's something that you need to remember. The rate. The chance of your child having apraxia of speech is so low. You know, it's like. It's very, very low. Okay. And to have so many people think that it would happen to the kid is. It's very, like, alarming and also great because we're having. What's that called? A. A better way of, like, what's that called? Awareness. That's the word. Right? People are speaking up about apraxia, about autism or whatever. But I think there is a misunderstanding about this. All right? Certainly, if you've seen a child with apria, you will start to know. Oh, that. That's what it means. So let. Let me just break down what it means. Like, I wanted to tell the therapist, but my Indonesian is very bad. So people throw motor planning coordination in the same phrase. It's different. Guys, I don't wanna. This is not a channel. Agents of speech is not a place where we discuss diagnosis. There are a lot more people with PhDs who are a lot better at than me at describing these things and telling you what it is. But motor planning and coordination aren't the same things. I won't get into, like, what it is, but motor planning is to do with apraxia. All right? And that means maybe we have the word in our minds, but we cannot Plan our muscles in order to say the word or the sound. Okay. And it's very different from being able to plan the movement of the mouth and being called. Being able to coordinate it to do so. All right. As two different things. And don't even talk about muscle weakness and all that stuff. And whether we need to do oral motor or not, we have a whole video about it on. On the YouTube channel and also on the Facebook page if you, if you just search for it. Okay, I'm not here to bash or motor or whatever, but let me get to the point. So the point is, guys, the apraxia is very, very. The prevalence of. Of such is 0.1% of the whole population of children. You know, that's very low. Okay, that's. First point. Second point is that apraxic child is very hard to diagnose. All right? It's super hard. If you go, like, I don't know about you, but if you go, from what I heard, go to the United States. Not everyone is comfortable with giving the diagnosis for apraxia. I am not comfortable with giving a diagnosis of a child below three. Apraxia of speech. It's very difficult to give a diagnosis because it entails a lot of things and you have to do specific tasks. I'm not going to go in here. My previous boss was doing a PhD on that. He knows a lot more. So I. I was able to, like, just listen in and be. Be a fly on the wall and read some of his stuff. And. And I kind of know getting to that diagnosis is very difficult. I'm not. I'm not, like, super smart about this. I'm an interventionist. I'm not like a. I'm more of an interventionist. I like to teach children more than I assess children. So, you know, like, it really takes a lot of testing to know. So does it matter to you? Well, yes and no. Right. Sometimes we always, like, try to find a label and whatever. I know, like, I've said this many times about, like, whether finding, like, having a label on your child is not the most important thing. But, you know, like, at the same time, I'm not discounting it, right? It is important. It's my job to give a diagnosis. But how important is that diagnosis within your child's whole, whole person? Like, if you and the therapist said today, oh, I see, you're being very holistic. It's not really being holistic, man. It's like looking at a communication profile of a kid and then to think, oh, what's the Most important thing here is it the speech, is it the language, is it the social whatever, right? But we cannot do everything in one go, correct. So therefore, we need to find the, what we call a lead domino. Like the thing that will topple and push everything in one way. So believe it or not, it's actually play skills that is most important, that will give a basis for you, like a system for you to teach a bunch of stuff. Like, and if play skills is not attainable at the moment, then the best thing I would say is to create a routine or create a structured environment for a child to learn new skills, right? That means using rewards. That means using, like token boards and whatever. If you don't know what it is, just search it up, like token economy. It's more of a ABA behavioral therapy thing. Okay, so if you ask me, is, is my child apraxic? Impossible to tell you. If anyone tells you through your descriptions over the Internet, then you know you're doing. That person is doing you with a disservice and being very unprofessional. It's not because we want to, like, protect our, our bottoms, you know what I'm saying? We're not. I'm being child friendly here. You know, we all want to save our asses, right? But at the same time, it's not about that. It's that I really don't know. It doesn't matter right now. If your child doesn't aren't able to do this and that, then we'll go for it. And apraxia is, in children is so difficult to understand. The reason is because, like today, for the two children that I saw, I know it's not apraxia because of a very simple fact, because their errors in speech. Actually only he. The other one doesn't even have a speech disorder. When he speaks, a pattern emerges, right? A pattern emerges that is very consistent. And you can see that he can actually make the sounds if he wants to. And there's no, like, stopping, there's no pausing. There's no think, like trying to say it, but cannot say at that time. The imitation is very fast, very, very, like, on point. But the errors are very consistent, right? So he would leave the last sound of a word. For instance, when he said like eat, he would go E, like that without the T, right? And he did that for multiple words at different levels, like within a word, within a sentence, within a phrase. All these tell you that this is what we call phonological process, right? It's a process that us professionals, professionals Call final consonant deletion. Okay. A lot of parents know this. A lot of teachers know this as well. So does it mean that if it's final, like if delete the last consonant doesn't mean it's not apraxia? Well, not really. But at the same time, if you can see a child consistently making these mistakes and are fast in imitation, and most probably it's not because apraxia, like one of the, the two things, the golden keys to seeing it is number one, when you tell the child to imitate, after you do you see any. Some sort of like pausing, what we call groping, like facial grimaces, like trying to find the correct sound, you know, like inconsistent errors that come out whenever they try. Right. That's something you can, you can look at. Second of all is that when they do. What's that called, what we call ddk. I don't want to say what it is. Right. It's just stupid. It's like saying like whatever. Like a bunch of non word sequences that have a certain pattern to it. When they, when you tell them to imitate it, they go bonkers. They cannot do it. You tell them say papa pine, they can't do it. Or you say tell them to say like, or whatever, whatever. And then they go or whatever. So those, you can take a look at it like that's just 12 of the tasks that we use for looking at apraxia. And yeah. And even if your child has apraxia of speech, how do you make it so that they are willing to communicate with you? Because appreciate the speech can be very stressful. Right. When you know the word and you can't say it and you do it like on a daily basis 90% of the time in your life, what does that mean? That's going to be super difficult for you to actually want to communicate. So it's okay if your child cannot say anything and you teach them to say I don't know, or like just use a gesture or just sign it out because that keeps up the, the motivation to communicate with you instead of trying to push, instead of trying to push that person like that your kid to, to say it. Because the more you like, there's something really funny about apraxia speech in which I haven't like, it's so difficult to find people with aos. You don't, you don't, you don't have enough experience with it. Especially like junior speech therapists. It's very difficult to find enough data points. But from what I know, at least I'M gifted in a way that I was working under someone who was researching of such. I would say that is quite, you know, it's. You can see that the more they, they practice a sound, the more they fatigue and ignore. They cannot do it. Right. That's number one. Number two is that apraxis of speech. Children, when they say something, they will always go back to the most frequently used words. If they've practiced something for a lot of times and you tell them to say something different, they will actually go back to the word that they were practicing before. And that's like a kind of like a recency effect. That kind. Okay, I know I'm throwing a lot of jargons to you guys this like tonight, but at the same time, I want you to know like my thoughts about it. Not like I'm like some industry breaking like news. Like most speech therapists know this stuff, but you know, like they don't take the time to. Or we don't have the time to tell you this kind of stuff because, you know, we see clients 45 minutes and then there are slots. We only have 15 minutes left to write documents, explain to you a little bit, and then get you to go outside and pay. You know, it's that kind of transactional relationship. That's why this is how I started doing the lives. Trying to answer questions that I get a lot and trying to make it easier for you to understand. Right. So, so that, you know, if someone finds this video somehow and decides to watch like 14 minutes of me talking, they get what they want, right? So I would say at the end of the day, don't over obsess about whether it's dyspraxia, apraxia. There's the whole, you know, like Internet has made a lot of subjects into like an over intellect and you know, like over intellectualization, whatever. Even the word sounds crazy, right? You have a word for everything. You. It's like, you know, if you go to. What's that called? If you go like web md, right? And you look at the stuff, it's like looking at like the horoscope, it's like, oh, yeah, I do have this symptom. I do have that. I do have this. Do I have whatever that we're looking at? Like, it's like the other day when I was checking out, do I have flat feet? You know, like, do I have that? Is that why I always get so tired from walking and standing? And then I didn't know until I checked it out with the doctor scanning my Foot. It turns out that it's like I'm not flat footed. But you know, the arch is very, very, very mild. That's why it's just very easy for me to get tired. But what I mean is it's very easy to go online and check. Oh, you're trying to validate something, right? You say, does my child have apraxia, like symptoms of autism, whatever. And they're like, oh, that's a check, that's a check, that's a check. And you're trying to validate it towards it, right? That is a very, very like dangerous thing to do on the Internet. Okay? So don't guess, go to a professional. Go to someone who won't, you know, with, with a lack of a better word, you. Because at the end of the day if I don't know anything, I won't, I will say I just don't know. Right. But you know, for, to, to some extent a lot of people will, you know, try to say something even if they're not 100. Sure. Just to make you feel that, oh, I, I'm a professional, I know my stuff, whatever. Okay. I actually think that's rather uncool to do. So if you ask me something I don't know, I'll just say I don't know. Right. So feel free to leave any comments at the bottom at the comment section. Ask me questions for things that is outside of my pay grade of which is like, to do with like research and whatever. I don't know, I'll try to find it for you. But what's, what's the point if it's not something you can act upon it, right? That's the thing. Actionable tips only, not crazy jargons or trying to intellectualize stuff that you don't want to know about. You know, who would want to know about like the, like the DDK rate of apraxia child. What was the norm of a six year old kid? How fast can they like say a certain word or how many times do they pause within a sentence? How many instances of facial grimaces was the norm of speech sound acquiring? Like when do you acquire certain sounds? What and what are the errors? So on. Leave it to the professionals to care about this stuff, man. Like, you know, like I went through two years, two and a half years of masters just to learn a bit of it, you know, I didn't even learn 100% of it. I had to learn on the job, you know, like excruciatingly through like running reports and trying to make sense of stuff whilst asking my seniors, you know, so leave that to like the profession professionals and focus on the stuff that you can do of which is interacting with your kid a lot more, not trying to stress them out. Make sure that they're, they're willing to communicate with you. Like keep the motivation high. Is there an alternate way for them to say something similar? But even if it's not at your standard, can you make it so that they will do it? Right. So last thing I want to talk about is the same as a kid I just saw before, before dinner, before this life and he is non verbal, right? But for the longest time I didn't know how much it was struggling at the home, right. So I took a look and I realized that there is a speech sound disorder going on. And whenever like that kid sounds like more of a than than than the kid I saw before. So it's getting a little bit confusing now. But anyways, what I mean is the focus of the therapy for him was actually just to keep on getting him to engage in a routine with us. And what I mean is for everything we play with him, we have to add value to the thing that he likes. For example, if he likes to play in the trampoline, how can we add value to the kids play routine? Can we make it a little more fun for him? Is there effects that we can do? Is there anything that we can do? Like most of the time when parents play with the kids, they're subtracting value, they're taking away the fun. You know, they're making it difficult for the, for, for the child to have fun because you keep on forcing, not forcing, like trying to get the child to talk in order to continue with something that it was already happening for free in their lives. You know, like they, they could have played that toy. When you're not at home, why, why are you trying to charge them and make them talk when you're not trying to make it fun for them and you're not adding value to the, to their lives, right. So that was what I told the parent and the parent also saw I can't speak for her. I say that finally we can start to see some sounds coming out. And those sounds are not perfect at all. But it was at the same tone. So we, we could deduce that he was actually imitating and then we will know, oh, this is actually his true ability. Right. And therefore his speech has a huge problem here. Right. But at the same time how do we get a child to get better at Speech. The only way to get good at something is to do that thing, right? If you want to be good at writing, sit your, sit your butt down and start writing. If you want to get good at talking on a camera, like I, I wasn't good in the beginning, now I think I'm getting a little bit better is to sit down and talk, right? And how to get good at teaching is to go teach it. So how do you get good at, like speech sounds is to practice it and keep on talking. There's no amount of chewing like chewy tubes, no amount of blowing horns, no amount of like blowing bubbles or whatnot that will help your child to start talking, all right? It just doesn't work that way. All right? I've talked about this many times. Don't fall into the trap of buying apraxia kit when your child isn't even apraxic, all right? That's first thing. Second of all, so what if, you know, like you get a plastic red triangle that's made of acrylic or whatever, and you slide it under on the, on their lips and make like that. So what? How can they use it in real life, right? How many times can you do it is about the reps, all right? So at the end of the day, you have to remember these things, focus on the things that you can do and add value to your child's play. And then teach them words that they can use in order to communicate that they want more of it. Give you a concrete example. And I'm going off. Okay? So for the child I just saw, we discovered that actually the mom knew all along. I just didn't know is that the only things that would make him happy are physical activities. So what I mean by physical activities is like swinging, bouncing, jumping on the trampoline. And then I realized that he likes tickle, but tickle is a little bit too stimulating. So what we do is like we would play with, we would spin him around, right? We'll go upside down. And then we would also like play with his hands and his feet by swinging him a little bit. I always talk about this, right? So these things really help them. And we built a routine. Deal. One, two, three, go for everything. And that's for a non verbal child, all right? And if you say, oh, my child has words already, but it just doesn't use it with me, right? Go watch that video and the YouTube about like, oh, my child can sing 1, 2, 3, whatever, but won't talk, okay? That's when you should do these social routines. To get them to use words that they already have. Right. It's about language use. Right. Use of language at the correct time or whatever. So I'm throwing too many concepts tonight, I'm sorry. But anyways, that's all I have for tonight. If you have any questions, put it in the comments section. I will try my best to react like talk to you guys about it, but this week is going to be difficult for me because I, I, I'm on, I'm on a trip. So I'll see you guys next Monday, all right?