Tuesday, March 1, 2011

A Few Boog Answers?

At speech therapy this morning, I happened to glance over at Ry's goals sheet and notice that, oh my gosh, there's actually something written in that normally blank diagnosis box.


Ry's speech therapist never discussed a diagnosis with us, but there were two things written there: oral phase dysphagia and mixed receptive-expressive language disorder.

I'm not upset, because she did his re-evaluation a few weeks back and since then has been out sick, so I'm sure the substitute just didn't know to discuss the diagnoses with us. I am, however, surprised and happy that some component of his delays are being called something I can actually tell people, though, "He has sensory processing disorder, mixed receptive-expressive language disorder, and oral phase dysphagia" is quite a mouthful. I'm not sure how one even pronounces "dysphagia"...I digress...

For those of you who don't have degrees in speech pathology, here's what Dr. Google has to say about oral phase dysphagia and mixed receptive-expressive language disorder:

Oral phase dysphagia: Definition:

It is the inability to manipulate food and liquids in and through the mouth as a result of chewing difficulties, weaknesses and discoordination of tongue, and/or reduction in labial and buccal muscle tension and tone.

There are two types of oral phase dysphagia: apraxia of swallow/reduced oral sensation and reduced labial tension/tone, out of which I'm betting he has the former (who said he had apraxia of some kind, like a year ago, oh yeah, that's right, ME! Mama's intuition, baby).

Mixed receptive-expressive language disorder: In general, mixed receptive-expressive language disorder is characterized by a child's difficulty with spoken communication. The child does not have problems with the pronunciation of words, which is found in phonological disorder . The child does, however, have problems constructing coherent sentences, using proper grammar, recalling words, or similar communication problems. A child with mixed receptive-expressive language disorder is not able to communicate thoughts, needs, or wants at the same level or with the same complexity as his or her peers. In addition, the child often has a smaller vocabulary than his or her peers.

Children with mixed receptive-expressive language disorder also have significant problems understanding what other people are saying to them. This lack of comprehension may result in inappropriate responses or failure to follow directions. Some people think these children are being deliberately stubborn or obnoxious, but this is not the case. They simply do not understand what is being said. Some children with this disorder have problems understanding such specific types of terms as abstract nouns, complex sentences, or spatial terms.

Yup, well, he doesn't tend to understand a lot of what's said to him and he doesn't talk, so that seems to fit. Unfortunately, the prognosis for mixed R-E language disorder is not so good. Even with early intervention, he'll likely have problems communicating all his life. How much progress kids with this disorder make, though, varies widely, so we'll just have to wait and see how the Boog does.

I still think these are only part of the picture, because I'm convinced he has apraxia, since it often presents with major speech AND fine motor delays and he has both. He has motor planning problems all over his little body, and apraxia seems to fit that.

It will be interesting to see what UT Hearing and Speech says when we get him evaluated there. For now, though, more puzzle pieces always make Mama happy :).


  1. Yay for some labels to google!! I think part of what makes Ry's case hard is that it seems obvious that it's not just one thing. I hope that regardless of what "others" have done, that he'll be able to continue to grow healthy and happy in his uniquely boogish style.

  2. I totally agree! The specialists and therapists keep looking for one over-arching condition to connect all of his little oddities and delays but it's pretty clear at this point that there are no big picture conditions left to test him for.

    At least we have parts of the puzzle now and we now know that his language disorder means it's much more likely he has ADD as well, so we can keep a lookout for that.