Motor-Speech Disorder Not Otherwise Specified

Not quite apraxia, definitely not dysarthria, it looks like Noah has landed with Motor-Speech Disorder Not Otherwise Specified.  Pure apraxia exists in children without other neurological compromise, and one of the features of apraxia is inconsistent errors.  Obviously, since Noah has Down syndrome he is not without other neurological compromise, and most of Noah’s speech errors are consistent, so we can’t quite land on apraxia.  Motor-Speech Disorder is the umbrella under which apraxia and dysarthria fall under; the NOS is a relatively new addition to the group.

The biggest part of the apraxia dilemma is that there is no official criteria, so a child presenting to one SLP may be diagnosed according to her criteria and not be diagnosed at a different SLP based on her criteria.  This is the kind of stuff that drives a momma whacko.

The good news is that since apraxia is a motor-speech disorder, and since PROMPT is all about addressing oral/motor/speech issues, the fact that Noah is landing in motor-speech disorder NOS versus apraxia means the treatment is the same regardless.  So, I continue to think we’re in the right place as far as treatment goes.

There’s not much literature out there on MSD NOS now; although Marcus (Noah’s SLP) says there is research currently being conducted.  So in time we’ll have more information – I’m fairly confident the research will tell us PROMPT (tactile cueing) is the right road to be on.

As far as Noah’s progress, Marcus says he is doing well.  He is able to produce more accurate sounds and I think his jaw sliding is improving.  Marcus is starting to add concepts like positional words into their sessions, so Noah is getting language as well as speech practice.  I’m so anxious to see carryover from Marcus’ sessions and my work with Noah into his natural language routine.  That is coming so very, very slowly.  In theory, it will happen in time and practice as we continue on with speech therapy.

One bright spot to our week – Noah has started saying “Caelie” and “Leah.”  He has done it a few times on his own without any prompting.  This is a huge distinction in my eyes – being able to mimic a word is great, but it’s not really communication.  Having Noah run towards me shouting “Caelie, Caelie” since he knows we’re going to be meeting her for lunch is definately communication.

I’m so thankful for the little things along the way that show me he is moving foward.

10 thoughts on “Motor-Speech Disorder Not Otherwise Specified”

    1. Yeah, uh we’re working on Tee Tee. Is that close enough? Well, be consoled by the fact you are the only one besides daddy and me who he has a sign for.


  1. Not otherwise specified….story of our life! 😉

    As for the “organic” communication…well, that is worth celebrating! I’m so glad to hear he is doing that, it’s such a crucial and important step! Yay Noah!

  2. My guys have DS and were diagnosed with Apraxia… guess no one saw the rule about no coexisting neurological compromise. As you mention, it got us PROMPT and we’re making progress… that’s what counts! I’ve always believed that a diagnosis is only as valid as the effective therapies, services and/or treatment it gets you to ensure progress.

    1. Thanks for chiming in. I think the SLPs who refuse to diagnose kids with Down syndrome with apraxia are probably stuck with in-the -box thinking, in some ways required by their training and national organization affiliation. I have in a way given up on getting the apraxia diagnosis for Noah, at least while we are with his current SLP who is a fantastic PROMPT therapist – as long as he is getting PROMPT and making progress, I’m settling for treating the apraxia at home and integrating PROMPT.

      I’m looking forward to reading your blog and following y’all’s progress.


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