Labeling Toddlers with Apraxia or Autism

By Pam Marshalla

Q: My son is 2 years and 2 months, and he jargons mostly. His therapists can’t seem to figure out if this is apraxia or autism. Why is this?

It can be very difficulty to determine if a child has autism or apraxia when they are under three years of age. This is because so many of the problems overlap. Both disorders cause the child to be non-verbal or minimally so. Both cause much refusal to follow directions and answer questions. Both cause children to have difficulty speaking on demand and imitating sounds and words.

I always tell parents this: Time will tell. It’s not what he’s doing today that matters. It’s how he changes over time, how he shows us he learns. The key to treatment is to find his strongest learning channels and teach to those.

For example, some of these children show a very early interest in the alphabet. To me these children are showing us, “This is how I learn best. This is my strongest learning channel.” Making cards with pictures and printed words may be the best approach to language learning and phoneme acquisition. This technique can be effective whether the child carries the label of apraxia or autism. It depends upon the child.

Many therapists do not care what label the child carries, and they try to avoid assigning a label too early. The label is only necessary for the purpose of payment. What the therapists are concerned about is how your child learns. They are trying to find the best strategies to help your child gain speech and language skills. Since he is only two years old, the therapists will want the freedom to try all kinds of different methods so that they can allow the child to show them how he learns best. If the therapists lock in to only one etiology too early, they may deny the child the very techniques that will help him.

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