Diagnosing Apraxia in Toddlers

By Pam Marshalla

15 month old boyQ: 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.

4 thoughts on “Diagnosing Apraxia in Toddlers”

  1. I often get concerned about ethics when I hear of very young children like this being over identified as needing speech therapy….is someone trying to take advantage of insurance or medicaid reimbursement?

  2. Hi Pam,
    I attended a workshop by you in Boise ID several years ago and purchased the book on Apraxia at that time. Would it be possible to get the e-book for 2.99 or is that just a deal with Amazon?
    Thank you

    1. Hi Debbie – The ebook is sold exclusively through Amazon and any joint deals that they are offering on the ebook are for only through Amazon as well. I’m sorry!

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