What is this called?

[sweet2ndchance]

Ds has taken to repeating word chunks, and occasionally whole words, when he gets ahead of himself or is trying to remember a thought or a word that he wants to use. It is usually just the last syllable of the last word he said. He sounds like a broken record or a skipping CD.

For example, he will be telling me a story he wants me to scribe for him and he will get lost in thought for a second and just repeat the last syllable of the last word he said until he remembers what he wanted to say or until I stop him and coach him on remembering where he was in his story. But he might also do it when he is asking me a question, "Can I go outside...side...side...side...side...side... and play with the dog?" I wouldn't call it stuttering and I wouldn't call it echolalia either (I do that sometimes and I am very likely on the spectrum, on the high functioning end, but not diagnosed). Nor does it fit the typical definition of echopraxia either. It is almost like he is repeating syllables where another child might say "um" or "uh" repeatedly trying to get their thoughts together. I want to see if I can find some information on how to help him at home or if it is something he will just out grow.

Further testing and such is not something we can pursue right now but I'm fine with researching and doing what I can at home until we can get him tested. The problem is, I'm not coming up with much that really matches what he is doing. Is this just a kid thing that somehow none of my other kids did? At least not to the degree that he does it. They may have done it here and there, especially when they were tired and just trying to keep themselves awake. But this kid, he is my youngest of 6 kids, he does it literally during almost every conversation we have with him. Anyone know what this is called?

Short history if it matters:

- turns 7 at the beginning of January

- has a history of childhood apraxia but isn't in speech at this time, we do work with him at home though and expect him to start speech again in a year or two (he gets some speech in the summer)

- a history of dysphagia with silent aspiration (resolved for a couple of years now)

- lots of texture issues, both food and things that touch him

- No other dx's but I strongly suspect he may also be somewhere on the spectrum, we just don't have enough proof yet to force insurance to pay for the testing and don't have any affordable options near us to private pay. He is quirky enough to make people notice but not quite quirky enough to be for sure ASD. GP agrees and is helping us document.

- He is struggling more than I would like to see at learning to read. He actually has fantastic phonemic awareness, can and does encode words constantly  of his own volition to type or write them but he would rather walk on Legos barefoot than read something himself or try to decode a word. We use a lot of O-G influenced materials and lessons with him.

[PeterPan]

Yup, stuttering. I've seen discussions that it can flow from the apraxia. If you can get coverage, you might head to a good SLP for the apraxia and see what they think. http://www.apraxia-kids.org/wp-content/uploads/2019/01/Stuttering.pdf  

On the spectrum gig, maybe get more evidence by having the SLP run narrative language testing, pragmatics, and the test of problem solving while you're there. 

[kbutton]

I think it's called palilalia. It's often done quietly, but I don't think it has to be done quietly.

It's often outgrown. My son outgrew it. He went through a phase where he would do that and other similar things, but those little rituals didn't stick around. I think he had some situational anxiety, some frustrations with having a brother with ASD, etc. 

He does have mild apraxia. 

[lewelma]

It is called 'dysfluency'. Many verbal ticks are dysfluencies, and all of us have them in one form or another. My ds went to a specialist because his dysfluency was intake of breath instead of repeating syllables.  His was considered a 'secondary stutter.' So he was in some way conscious of his initial stutter and that people were uncomfortable with it, so his brain found a way to hide it.  But in hiding it, it made it worse and harder to get rid of. Most kids cannot get rid of a dysfluency beyond the age of 8 or so, at that point you work to mask it. It is considered developmental up to the age of 5 and as long as it has only lasted for 3 months or so. If these two conditions are not met, it is considered more pathological and is extremely unlikely to disappear without intervention. 

Edited November 30, 2019 by lewelma

[sweet2ndchance]

Thank you to everyone for taking the time to comment on this. Word-final atypical dysfluency ended up being the term that brought up the exact description of what my ds is experiencing. Why does this kid have to have the word "atypical" somewhere in every diagnosis/potential diagnosis he has? lol At least now I have a direction to go in my research and a term to describe what we are hearing. That always makes it so much easier when talking to professionals about him. Thanks so much!

[PeterPan]

Had you thought about going back for more therapy for the apraxia? My ds gets PROMPT, and he was down to literally just one sound that wasn't automatic (vocalic R, occassionally TH/th though he usually had that) and we were between therapists, had a hard time finding a new one, let it go. We just started back, and his whole VOLUME of speech, his EASE of speech has shot up like lightning. 

So if he got back into therapy with something that was working on the whole of the motor planning (PROMPT properly implemented, not piecemeal), he might get a whole speech boost that would clean up this dysfluency/stuttering. 

It's just something to look into. But admittedly, finding PROMPT implemented at the certified level, but someone who will do it for an hour straight and not just use it like a parlor trick, is hard to do. 

[sweet2ndchance]

The schools are the only "therapy places" within a two hour drive in our very rural area. I was very pleased with the SLP he had through Early Intervention at the public school when he was a toddler/preschooler/kindergartener. She did use some PROMPT techniques with him, her master's thesis was actually about childhood apraxia. The problem with fully implementing PROMPT with him goes back to the autism-like traits he displays. He is super friendly, but he does not like people touching him without his express consent. Once ds finally warmed up to her, he did make amazing progress but as the PROMPT therapy requires a lot of touching, he would become "touched out" and melt down quickly. He went from completely non-verbal when he started to "getting him to shut up is the trick" (lol) so despite the difficulties of using PROMPT with him and having to use  other avenues in addition to PROMPT, I think she did an amazing job with him. He wears us out with how verbal he is now. This dysfluency issue does not affect his speech volume, vocabulary acquisition, self monitoring for previously corrected speech or anything else in the least.

I am going to get in touch with his former SLP,  probably sometime during Christmas break since she is busy with mid year assessments up until Christmas break. She works with him still in the summer when she provides private services but if we pursued services through the schools again, she wouldn't be his SLP. I've met the ones who would be his SLP and I'm fine with them too. I will probably look into getting a full evaluation for him at the children's hospital three hours away. We've talked with them before and they are more than willing to assess him but being that it is a three hour drive and they don't have SLPs that come out to where we are on a regular basis, it would probably end up being for assessment only. Logistically, it would be pretty much impossible to go there on more than a monthly basis for therapy and even monthly might be pushing it.

I'm fine with finding things on my own to do with him to help in the mean time. It is much easier to find useful information when I have a name for what it is I'm looking for. ;)