Parent friendly signs of "soft signs"...
from a parent
Geng as posted to the Cherab Foundation
than not talking yet -you can look for any neuro "soft signs" even before
the trip to the neurodevelopmental doctor (developmental pediatrician
or pediatric neurologist) If your child has any of the following signs-don't
panic -all of them in almost all cases can be overcome -and the earlier
the intervention the better as always.
neurological soft signs -it's harder to diagnose a nonverbal two year
old - which doesn't mean you can't start appropriate therapy just in case
if apraxia is suspected -can't hurt and will probably help no matter what
the reason. Even a two year old with "just" a simple delay in speech can
be mentally stimulated to talk sooner while having fun with some early intervention speech therapy that may look lots like play
to the untrained eye. A big question is did he ever have sounds that he
lost -did he ever regress?
A neurodevelopmental medical exam will look at a number of things in your
son outside of communication skills, or receptive and expressive language
-including physical development and motor skills, thinking and learning
cognitive development etc.
Soft signs in apraxic children are typically mild -but in most cases there
-most of us just didn't know what they were because up till Cherab nobody pointed them out. I try to raise awareness because
if your child has any of the following -as a parent you will know
once pointed out-and so will the neuro MD you bring your child to.
When you run a large support group -you tend to see what is happening
in a group -so support groups are excellent for really getting to the
facts and the "norm" -and I'll get to the EFA
question in that regard too. I try to put the neuro soft signs in a way
that everyone will understand -and these soft signs are all based on my
son Tanner -who I and everyone including his first pediatric group all
thought was a normal baby other than he was just a late talker.
same child showed all the strong warning signs -we just didn't know -however
-all the soft signs were picked up right away by all the neurodevelopmental
MD's Tanner has seen once I insisted on taking him (his regular pediatrician
wanted to wait till three) -as well as by the PTs, OTs and SLPs too. I
could now kick myself that I didn't see them then -but how would I know?
That's why I want to let all of you know -to prevent it from ever happening
the following information that I learned from personal experience the
hard way costing valuable early intervention time while Tanner's brain
was the most malleable - the many children like him could be receiving
therapy younger and have a greater chance for success.
Here are a few quick parent friendly signs of oral
If you put peanut butter anywhere on his lips can he lick it off or does
he use his fingers? Did he blow out the candles on his birthday cake when
he turned two? Can he imitate funny faces? If you take his picture and
say "smile" does he smile?
Here are some quick parent friendly signs of mild hypotonia:
A child with hypotonia will feel heavier than a child of the same weight
without hypotonia (kind of like the difference between picking up your
child when he's fast asleep vs. awake) Hypotonia can be anywhere in the
body. Does your child appear to tire faster than other kids his
age walking in the mall etc.? Will you and your wife not dream of taking
him anywhere without the stroller because you know if you don't bring
the stroller you will be stuck carrying him because if you don't pick
him up he will sit on the floor crying with his arms in the air for you
to pick him up again? And since he's nonverbal -you will get looks from
people passing by, or perhaps even comments -that your child is
acting spoiled. When you pick him off the floor -it's not as easy
as it looks for you -or others that try! Most will say "wow he's solid!"
when picking him up. "Solid" is the word used by almost everyone
to describe your child when people pick him up come to think of it.
His body may look small and light -and many times both look like a cherub,
and feel a bit like a marshmallow -rounded and soft. He may sit
in the "W" position. If a child has severe hypotonia -he
may look a bit like a rag doll (those are the children however that are
spotted early however) -gravity just pulls them down. For a school
age child -look for the child who can't sit at the desk long before leaning
down on it. The child who when waiting on line will either lean
or sit down. The child (or adult) with rounded shoulders who is
always being told "stand up straight!" or "sit up!" etc.
Here are some quick parent friendly signs of sensory
This is tough because it can affect any of the senses -touch, sight, hearing,
motion, etc. So in a nutshell -Your child will seem to be bothered (or
even in pain) by something that others aren't and will not be bothered
by something most are if that makes sense.
Here are some of my son's signs that boy do I wish I knew this is what
he had when he was screaming and people were looking at me like "what
are you doing to that poor child"
Your child may insist on a certain color cup each time -and will throw
a fit if it's any other. My son for would carry a small cap from a pen
or some other small strange object around for hours -and if you tried
to open his clutched hand - he would freak out -even if
you thought he was asleep and tried to take the pen cap away so he wouldn't
choke on it while he was sleeping -he would wake up and freak out if he
wasn't 100% asleep yet. He wouldn't cry for shots - but would say "oww" and cringe if you patted his head or tickled his
arm. When Tanner was a baby (after the fevers and regression) his screams
when I brought him to public places like the store would sound like high
pitched extreme pain screams and he would stiffen his body -his eyes would
bulge out -and he would do this just once
in a while (Thank God) but when he did -he would cry till he fell asleep
in a sweat -with nobody being able to figure out what was wrong (my Aunt
has her PhD in nursing and my sister is a professional nanny -nobody had
a clue) Just strange stuff that seemed quirky. DSI can also be the child
that throws a tantrum like he's in pain -while you have no clue what he's
crying about. Why DSI happens to a nonverbal child who is too young to
let us know is a cruel joke -so it's important for us to know if this
is what your child has. The Out of Sync Child is one of the books most
of us buy when our child is diagnosed with any multi faceted neurologically
based communication disorder like apraxia.
Here are some quick parent friendly signs of motor
planning problems in the body:
Just like with speech -your child may be able to do something once and
then appear not to remember how to do it again. His actions look forced
or planned -he's slower because you can see he's thinking before each
movement. His development is a bit off in that he can do many things advanced
-but for some reason can't seem to do certain simple things that a much
younger child even should be able to do. Again -just doesn't make sense.
Then you have to know if movement problems are from weakness (hypotonia)
or motor planning (apraxia/dyspraxia) -just like with speech. Again -it
could be a bit of both -and again -both are neurologically based.
Update 2003 -Not just autism -according to
Dr. Geier, there is a much higher 30% rise in speech disorders in our
children in the past ten years.
2001 U.S. Department of Education statistics showed in children born in
1983 there were a total of 7,801 cases of speech or language impairment.
Among children born in 1994, this number had risen to 211,984 cases (an
approximately 30-fold increase)"
Mark R Geier MD PhD who compiled the stats above, is vocal in helping
raise awareness to the 30% dramatic rise in children in the US with speech
disorders in just the past few years. Outside of his recent papers,
there is virtually no awareness to the rise in speech disorders. In speaking with Dr. Geier, he told me that the rise in autism was small
in comparison to the rise in the numbers of children with speech disorders.
to lack of awareness -too many of our late talker children with multi
faceted communication impairments, that are not autistic, are labeled
PDD, or PDD NOS.
does multi faced communication impairment mean? Read above -whether
you want to call it apraxia or not -it's children that are late talkers
who are not "just starting to talk" like we all pray they will
-and in most cases -they are children that also have one or more of the
neurological "soft signs" listed above. Apraxia and autism
two different examples of multi-faceted communication impairments.
There may be some aspects that overlap or co-exist. It's more common
to find apraxia in an autistic or PDD child than it is to find autism
or PDD in an apraxic child. You need to treat the symptoms and not
the labels however.
is the strange name diagnosis that has been the best kept secret for years
-and it's probably far more prevalent than autism. Try doing a search
on the (American Academy of Pediatrics) AAP website for apraxia.
I did one in February 2003 and I came up with "No documents matched the
can you have a pediatric condition rising in what appears to be epidemic
proportions in some areas (like NJ where there is an apraxic child on
almost every block) and yet complete and total silence?
Autism is on the rise - so is apraxia -with and mostly without autism.
Just like sensory integration dysfunction or mild hypotonia -both which
could be found in most apraxic children -apraxia co-exists in a large
amount of conditions, syndromes, disorders and impairments, including and outside of autism and PDD...and it also stands
alone as the child who is as one mother of a four year old just said to
me "so normal I could smack him"...except he can't talk. (other than "ma"
"da" and 4 other "words") Some
late talkers may have hard signs of neurological problems such as myelin
delays. Due to the
apparent "pocket areas of more kids with apraxia -(for example
more children with apraxia in the suburbs around NYC than in NYC even
though the parents in the suburbs see the same MDs in NYC) As
an inventor -I suspected there is some type of environmental damage that
is affecting our children's myelin. I came to this conclusion based
on the fact that almost all the children in our group once on the right
formula of Omega 3 Omega 6 EFAs started to talk within one to three weeks of given just a few drops of
fish oil a day -which sounds crazy -but it worked. I came up with
the myelin/EFA therapy based on the fact that EFAs have very strong remylenating
properties (and OK so I watched the movie Lorenzo's Oil)
then presented my theory on why I believe that our children have some
type of subtle myelin delays and why EFAs are helping our children's speech, focus, behavior/mood and movement to
PhDs, MDs and the Cherab grouplist starting in 2001. Due to one
of my postings I was told -I was called into UNDNJ
hospital by the hospital attorney Fred Kipperman Esq. in 2001 to do
a presentation about my theory to a panel of neurodevelopmental MD's (including
pediatric neurologist Xue Ming MD PhD) on why I believe that most
of the late talkers today do have some type of myelin delay whether it
shows up in the MRI's or not. Apparently they had the same idea
for autistic children -and did find that even though myelin delays don't
show up on the MRIs in all cases -they do quite often "show up in
the lab" Read a recent front page article about the groundbreaking work UMDNJ is doing here. It makes me feel
good to know that EFAs are now taken seriously by some of the top neurodevelopmental
MDs in the world- I just wish they would acknowledge this for more than
autism. It would be one thing if they didn't know.
back to the soft signs...
you want an accurate diagnosis for your child -please do not supplement
your late talker with any EFAs before a neurodevelopmental exam. Children with signs of apraxia
or autism, PDD or even certain syndromes after the "right" omega
3-6 formula of EFAs are no longer presenting with the symptoms -leading
parents are professionals to conclude that either their child was repeatedly
misdiagnosed -or if you look at the group -almost 100% of the children
in our group show the same positive changes in the same one to three weeks
once supplemented. And the even better news is that the positive
surges in most cases do not stop. EFAs appear to help the brain
"rewire" somehow. Perhaps soon we will know how.