Osteopathic manipulative treatment improves speech for child with apraxia

May 13, 2013

What would you do if you knew what you wanted to say, but physically, you could not put the sounds and words together to form a sentence? If you are like 3-year-old Charlie Lain, who suffers from childhood apraxia of speech, producing words is a daily struggle.

Apraxia is a neurological speech disorder that affects a child’s ability to clearly and correctly produce simple sounds, syllables and words. The most obvious thing that others notice is that the child is unable to speak, or has significantly limited and/or unclear speech. Apraxia is among the most severe speech and communication problems in children. Yet most people have never heard of the disorder. While it is not life-threatening, apraxia is certainly life-altering for children and their families. That has certainly been the case for the Lains.

Although Charlie was born as a seemingly healthy full-term baby, he quickly developed a respiratory condition called persistent pulmonary hypertension of a newborn (PPHN), which occurs when the baby’s circulation system does not adapt to breathing outside the womb. Because of this, he had to be intubated when he was just hours old, and he spent the first few weeks of his life in the NICU fighting against, and then recovering from, PPHN.

Charlie has struggled to make sounds since he was a baby and has been under the care of doctors and highly-trained therapists for almost two years. At the suggestion of his occupational therapist, Charlie’s mother, Jill, took him to see Sharon Gustowski, DO, a UNT Health osteopathic manipulative medicine physician, for an evaluation.

Signs of Apraxia

A Very Young Child:

Does not coo or babble as an infant
First words are late, and they may be missing sounds
Only a few different consonant and vowel sounds
Problems combining sounds; may show long pauses between sounds
Simplifies words by replacing difficult sounds with easier ones or by
deleting difficult sounds (although all children do this, the child with
apraxia of speech does so more often)
May have problems eating

An Older Child:

Makes inconsistent sound errors that are not the result of immaturity
Can understand language much better than he or she can talk
Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
Has more difficulty saying longer words or phrases clearly than shorter ones
Appears to have more difficulty when he or she is anxious
Is hard to understand, especially for an unfamiliar listener
Sounds choppy, monotonous, or stresses the wrong syllable or word

Source: American Speech-Language-Hearing Association

After learning about Charlie’s condition, Dr. Gustowski started helping him using osteopathic manipulative treatments (OMT). OMT is a set of techniques that gently guides muscles and bones back into place to reduce and eliminate muscle and joint restrictions that can interfere with normal function.

Dr. Gustowski found areas of on Charlie’s body that had muscle and joint tightness, including his hips, low back, jaw, neck and shoulders. These issues probably occurred around his birth and intubation for his PPHN. In Charlie’s case, Dr. Gustowski felt that using OMT on his head, jaw and neck helped him gain more control over the muscles he uses to plan sounds and words, most likely making it easier for him to speak. Likewise, removing tightness in his pelvic muscles and joints also is making it easier for him to walk, run and jump.

For the first time in Charlie’s life, he is able to communicate basic wants and needs with his family. Jill credits his intensive speech therapy program, in addition to Dr. Gustowski’s treatments, for his improvement. While Charlie has only been a patient at UNTHSC since January, Jill hopes future visits with Dr. Gustowski will continue to help him improve his speech and muscle tone.

Jill says of Dr. Gustowski, "She has a passion for children, and she is vested in

Charlie’s care. She is humble, knowledgeable and someone I could be friends with. She expects excellence from her students that join her during Charlie’s visits, and she is modeling for them how to care for young children. I am so thankful for everything she has done for Charlie and am excited to see what his progress will be down the road."

Many health conditions and disorders have special days to raise awareness. The first-ever National Apraxia Awareness Day will be held on May 14 to educate the public about apraxia and provide support to families who are affected by it. Many insurance companies, including Charlie’s, do not cover treatment for apraxia, so most of these families are forced to pay for speech and occupational therapies out of their own pockets. Thankfully, Charlie’s OMT visits with Dr. Gustowski are covered by his family’s plan.

"The body has an amazing ability to heal itself, and children especially demonstrate this because they grow and change so fast," said Dr. Gustowski. "OMT can help remove obstacles that are in the muscles and bones. It’s been fun working with Charlie, to see where his body needs a little help, and especially to see his progress. He is a bright, kind young man with a loving and supportive family, and that support is a very valuable part of the healing process."

To schedule an appointment with Dr. Gustowski, or any of our osteopathic manipulative medicine physicians, call 817-735-DOCS (3627).

For more information about apraxia, visit: http://www.apraxia-kids.org

(This story was broadcast on KLIF radio on May 14.)

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