This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Q: I received a referral for a 15-month-old diagnosed by a private SLP with apraxia. The child has excellent receptive language and produces 10-15 words. I was told that the child was an “automatic qualifier” coming in with the diagnosis of apraxia. I have huge reservations with this and do not feel as if the diagnosis was made appropriately in just in one session and not over time. There are no indications of motor difficulties elsewhere. Am I out in left field?
I agree with you: This is not an appropriate diagnosis at this time.
My main reason is that many perfectly normal children produce only 10-15 words at 15 months of age; in fact, many children produce NO words at this age.
One year of age is an average for first words. For example, my first daughter produced her very first word at 6-7 months of age, the second said her first word right at 12 months of age, and the third did not say a word until 17 months of age.
At this point this child shows no signs of speech apraxia. (Keep in mind that Childhood Apraxia of Speech (CAS) can occur without signs of global apraxia. But I still think that the other therapist is way off base on this.)
I would watch the child once or month or so at the very most, but this would not be therapy: It would be an on-going screening.
Also, if the parent is way over concerned and acting like a “helicopter parent” with expectations that are far too high for the child’s age, I might put them into therapy for a while to teach the parent how to back off. We don’t want stuttering to become an issue later on.