Dear Diary: I don't want to go to bed

Thursday, November 20, 2008

I don't want to go to bed

What's new with Alex?

He doesn't want to go to bed.

It's been almost a week since he decided to make our life a little more exciting by defying us, when asked to go to bed, he will cry inconsolably, throw himself at me or jump on the spot with frustration. It's getting very stressful for me to see him acting unAlex-like.

He used to go to bed at 6:00pm. Happily and willingly go to bed as long as we read him a book. Those days are over and the new Alex emerges.

I told Mrs Dunn, his teacher at Rainbow on Tuesday about the changes in Alex. The temper tantrums and the throwing himself at me or the floor when he doesn't get what he wants. I asked her if there were any child in the nursery or Rainbow that does that, perhaps Alex saw that and copied the behavior. She said "No .... definitely not. We do not tolerate tantrums at Rainbow and none of the children does that".

She said it is actually a good thing as Alex has always been a passive child and to be able to think for himself is a positive sign. Easy for her to say .... and I told her that. She laughed.

So, I guess I should trust her and see how long this behavior will last.

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What is Autism Spectrum Disorder

Autism is a lifelong developmental disability. It is part of the autism spectrum and is sometimes referred to as an autism spectrum disorder, or an ASD.

The word 'spectrum' is used because, while all people with autism share three main areas of difficulty, their condition will affect them in very different ways. Some are able to live relatively 'everyday' lives; others will require a lifetime of specialist support.

The three main areas of difficulty which all people with autism share are sometimes known as the 'triad of impairments'.

* difficulty with social communication;
* difficulty with social interaction;
* difficulty with social imagination.

It can be hard to create awareness of autism as people with the condition do not 'look' disabled: parents of children with autism often say that other people simply think their child is naughty; while adults find that they are misunderstood.

All people with autism can benefit from a timely diagnosis and access to appropriate services and support.

How common is Autism?

Autism spectrum disorders are some of the most common developmental disorders, with up to 1 in 100 school children affected, compared to:

1 in 500 affected by cerebral palsy
1 in 3,000 affected by cystic fibrosis
1 in 4,000 affected by juvenile diabetes
6,000 children received a diagnosis of autism in England and Wales in 2005, compared to:
1,300 diagnoses of childhood cancer including around 360 of childhood leukaemia.

In total, more than half a million people in the UK have an autism spectrum disorder, with a new diagnoses being made four times an hour every working day.

Boys are four times more likely to develop autism than girls.

What are the types and causes of apraxia?

There are two main types of speech apraxia: acquired apraxia of speech and developmental apraxia of speech.

Acquired apraxia of speech can affect a person at any age, although it most typically occurs in adults. It is caused by damage to the parts of the brain that are involved in speaking, and involves the loss or impairment of existing speech abilities. The disorder may result from a stroke, head injury, tumor, or other illness affecting the brain. Acquired apraxia of speech may occur together with muscle weakness affecting speech production or language difficulties caused by damage to the nervous system

Developmental apraxia of speech (DAS) occurs in children and is present from birth. It appears to affect more boys than girls. This speech disorder goes by several other names, including developmental verbal apraxia, developmental verbal dyspraxia, articulatory apraxia, and childhood apraxia of speech.

DAS is different from what is known as a developmental delay of speech, in which a child follows the "typical" path of speech development but does so more slowly than normal.

The cause or causes of DAS are not yet known. Some scientists believe that DAS is a disorder related to a child's overall language development. Others believe it is a neurological disorder that affects the brain's ability to send the proper signals to move the muscles involved in speech. However, brain imaging and other studies have not found evidence of specific brain lesions or differences in brain structure in children with DAS.

Children with DAS often have family members who have a history of communication disorders or learning disabilities. This observation and recent research findings suggest that genetic factors may play a role in the disorder.

What are the symptoms?

People with either form of apraxia of speech may have a number of different speech characteristics, or symptoms.

One of the most notable symptoms is difficulty putting sounds and syllables together in the correct order to form words. Longer or more complex words are usually harder to say than shorter or simpler words.

People with apraxia of speech also tend to make inconsistent mistakes when speaking. For example, they may say a difficult word correctly but then have trouble repeating it, or they may be able to say a particular sound one day and have trouble with the same sound the next day.

People with apraxia of speech often appear to be groping for the right sound or word, and may try saying a word several times before they say it correctly.

Another common characteristic of apraxia of speech is the incorrect use of "prosody" -- that is, the varying rhythms, stresses, and inflections of speech that are used to help express meaning.

Children with developmental apraxia of speech generally can understand language much better than they are able to use language to express themselves. Some children with the disorder may also have other problems. These can include other speech problems, such as dysarthria; language problems such as poor vocabulary, incorrect grammar, and difficulty in clearly organizing spoken information; problems with reading, writing, spelling, or math; coordination or "motor-skill" problems; and chewing and swallowing difficulties.

The severity of both acquired and developmental apraxia of speech varies from person to person. Apraxia can be so mild that a person has trouble with very few speech sounds or only has occasional problems pronouncing words with many syllables. In the most severe cases, a person may not be able to communicate effectively with speech, and may need the help of alternative or additional communication methods.

How is it diagnosed?

Professionals known as speech-language pathologists play a key role in diagnosing and treating apraxia of speech.

There is no single factor or test that can be used to diagnose apraxia. In addition, speech-language experts do not agree about which specific symptoms are part of developmental apraxia. The person making the diagnosis generally looks for the presence of some, or many, of a group of symptoms, including those described above. Ruling out other contributing factors, such as muscle weakness or language-comprehension problems, can also help with the diagnosis.

To diagnose developmental apraxia of speech, parents and professionals may need to observe a child's speech over a period of time. In formal testing for both acquired and developmental apraxia, the speech-language pathologist may ask the person to perform speech tasks such as repeating a particular word several times or repeating a list of words of increasing length (for example, love, loving, lovingly).

How is it treated?

Children with developmental apraxia of speech will not outgrow the problem on their own.

Speech-language therapy is often helpful for these children and for people with acquired apraxia who do not spontaneously recover all of their speech abilities.

Speech-language pathologists use different approaches to treat apraxia of speech, and no single approach has been proven to be the most effective. Therapy is tailored to the individual and is designed to treat other speech or language problems that may occur together with apraxia. Each person responds differently to therapy, and some people will make more progress than others.

People with apraxia of speech usually need frequent and intensive one-on-one therapy. Support and encouragement from family members and friends are also important.

In severe cases, people with acquired or developmental apraxia of speech may need to use other ways to express themselves. These might include formal or informal sign language, a language notebook with pictures or written words that the person can show to other people, or an electronic communication device such as a portable computer that writes and produces speech.