Q: One doctor says my two-year-old daughter has apraxia and another does not believe so. Can you tell me what is going on here?

I am afraid that you have entered the “apraxia twilight zone.” The subject of apraxia in children is a controversial and confusing one.

First, some professionals insist that apraxia in children does not exist. Others insist it does. Since we have no formal way to diagnose the problem medically (e.g, no CAT scan) the diagnosis is made via behavioral description.

Second, it would be fine to diagnose an apraxia via behavioral description except for one huge problem: professionals do not all agree on the characteristics that identify the problem.

Your physicians may be coming to different conclusions based on these reasons. In either case, one thing that most speech-language pathologists seem to agree upon is that it is too early to make the diagnosis in a child only two years of age. This is because while many average two-year-olds are quite verbal, some remain relatively quiet and don’t become big talkers until three or four years of age.

A two-year-old who doesn’t speak much may have no problem whatsoever, or he may have a huge speech-language problem that is just now beginning to show itself.

The best advice I can give you is to have your son seen by a professional speech-language pathologist who specializes in children. Don’t depend upon a physician. A medical doctor may be very good in the diagnosis of ear infections and broken toes, but he or she is not qualified to make a diagnosis of speech delay or disorder.

Have your physician make a referral to an SLP for evaluation in the private sector. Or call your local school district and request a speech and language evaluation. The schools are mandated to provide this service for preschool children.