AboutErin E. Maio-Harrison, MA,CCC-SLP Expertise I am able to answer questions related to speech, language, cognitive, swallowing disorders in both children and adults. My focus area relates to disorders that are secondary to trauma (i.e., head injury) or disease, (i.e., Dementia) but I am able to answer basic questions (or find more info) about developmental disorders as well.
Experience I am a licensed Speech/Language Pathologist with 18 years experience primarily in acute care pediatrics and in-pt. rehab. I have also continuously moonlighted in geriatrics, primarily skilled nursing settings and have had private clients of all ages. My focus of practice is neurogenic communication and swallowing disorders.
Organizations American Speech & Hearing Association, (ASHA)
South Carolina Speech/Hearing Association(SCSHA)
Education/Credentials Masters Degree, Communication Disorders and Speech Science (CU Boulder)
Question We have 12 year twin sons. Both boys were born at just over one pound each. 13 weeks early. One of our sons was diagnosed with cerebral palsy at 18 months (Taylor). He had 10 words at the age of 18 months and then lost them. We are quite sure he may have been dropped by a caregiver at 18 months. He is still non verbal. We have had him tested for autism, mri and speech are in brain is fine, and his tongue has been tested, and doctors say it is not related to the cp. We have tried so hard. There was a suggestion that it might be trauma related. He is developmentaly behind but has all his receptive skills are there. We're lost. The cp is considered moderate to severe. But he can use a walker and ocassionaly you will hear a word slip out. Can you point us in a direction?
Mark and Christina
Answer Mark and Christina-
I am sorry this has been so frustrating for your family. To have intact receptive skills and no ability to verbalize suggests severe motor impairment. As you know from his CP, motor skills originate in the brain and include the nerves and muscles. Obviously, there is a breakdown SOMEWHERE so I am not sure what it means when you say the "brain is fine" or that the "tongue was tested". I am not sure what the doctors saw in his tongue movement that determined the pattern was unrelated to the CP but I would tend to believe them. Which brings us to the suspected trauma. I would think that a neurologist would be able to tell you if the movement pattern was consistent with a closed head injury. Even if the evidence is not visible on the MRI, the neurologist can often determine damage based on "soft signs", such as behaviors and movement patterns. In addition, language regression is not part of normal development, delayed development or CP. If autism has been ruled out, then I would look again for trauma or disease with an onset coinciding with the language regression.
If the occasional word "slips out", but not when he attempts a volitional movement (i.e., he can lick a popsicle but not stick out his tongue when you ask him to) then it sounds like apraxia.
I am guessing he has had speech therapy in the schools. I am hoping that in addition to verbalization they have supplied him with some sort of communication system (like a Dynavox or something). I cannot tell you if he will achieve speech at this point, but in the meantime, he needs a way to communicate.
If you have plateaued with the school therapist, you might consider looking for an SLP privately that specializes in apraxia (if that is what he has).
I am sorry if my suggestions are all redundant to what you have done to date. I am going back on vacation because I cannot keep up with the questions and my current work load but will review your response and follow up to you if needed.
Good Luck-
Erin E. Harrison, MA,CCC-SLP
Speech/Language Pathologist
