As the colder, darker months arrive, our bodies are designed to slow down, rest deeply, and repair. Nature wants us to be conscious of this shift — yet most families power through with busy schedules, screens, and stress, leaving our natural rhythms disrupted. While everyone struggles with sleep sometimes, children with autism are especially affected. Up to 83 percent of people with autism experience sleep problems. One study noted that, “Insomnia is the most common type of sleep problem in individuals with ASD and often includes prolonged sleep onset latency, extended night awakenings, and early morning rise time.” (1) Sleep deprivation doesn’t just cause crankiness or brain fog — it disrupts detoxification, focus, learning, and even speech development. (2) This post explores why circadian rhythm is essential for healing, how sleep supports mitochondrial function, and simple ways to align your child’s rhythm with nature this winter. How Much Sleep Do Children Need? Children require much more sleep than adults because their brains and bodies are growing rapidly. According to the National Sleep Foundation, kids who are three to five years old, need 10-13 hours of sleep. And kids six to thirteen, require 9-11 hours. (3) That’s almost half of a 24-hour day! Unfortunately, between screens, modern lighting, and disorders like autism and ADHD, most kids aren’t getting the restorative sleep their developing brains need. What Is Circadian Rhythm? Circadian rhythm is your body’s internal 24-hour clock. The miraculous suprachiasmatic nucleus (SCN), located in the hypothalamus, is the master regulator that tells every cell and gene clock in the body what to do. It is controlled by light and darkness. The original human was designed to be outside in the sun during the day, fueled by cortisol in order to be awake and alert. Natural sunlight contains blue light too, but it’s balanced by red and infrared wavelengths. At night, when it gets dark, cortisol goes down and melatonin is supposed to go up. This transition is what allows us to relax in the evening, and then naturally fall asleep. However, artificial blue light at night from LED bulbs and screens. and more time indoors during the day, has completely disrupted this process. For example, the 455 nm bright light coming from an iPhone tells our time clock that it is noon and to release cortisol. This creates a problem for our body’s communication network if it is dark outside. Think of it like an airport where all flights (body processes) are timed perfectly — but one delay or storm can throw off the entire schedule. Artificial light, late-night stimulation, or irregular routines can quickly cause “flight delays” in your child’s system, leading to trouble falling asleep and then worsening their symptoms the next day. Why Sleep Matters for Healing Sleep is when your child’s brain and body perform their deepest repair work: Damaged cells are repaired (autophagy). Old cells are replaced (apoptosis). Cell division occurs, which helps leaky gut. Myelin, the protective coating around neurons that are vital for speech and attention are built. The brain detoxifies through the glymphatic system, clearing waste and inflammatory buildup. Circadian Rhythm, Light, and Mitochondria Mitochondria are deeply connected to the circadian clock. Their energy production, antioxidant balance, and repair cycles all follow daily rhythms. Light directly influences mitochondria. Artificial blue light can increase oxidative stress and lower ATP. Red and near-infrared light, found found in sunlight, boosts mitochondrial health. Research shows mitochondrial dysfunction is common in autism, impacting how cells create and use energy. Addressing circadian alignment and natural light exposure can support healthier mitochondria — and, in turn, healthier brains. (4) To support this premise, there is currently a clinical trial at the University of Texas that is studying if “infrared light stimulation can improve cognitive and behavioral outcomes for those with ASD by increasing mitochondrial bioenergetics.” (5) Also, Josh Madsen D.C. of Infinity Neuromotor Development Center has three United States locations that are currently using transcranial photobiomodulation for autism, ADHD, and other neurodevelopment disorders. To learn more about his light-based therapies like Low-Level Laser Therapy are being used, check out Documenting Hope’s recent webinar noted below in the sources. (6) Ways to Restore Circadian Balance Naturally While not everyone has access to lasers and red light panels, here are a few ways to naturally support circadian rhythm and your child's sleep: Morning Set a consistent wake time. No screens first things in the morning. Go outside at the beginning of each day. Within 30 minutes to 1 hour of waking, move and eat breakfast with protein. This sends an appropriate “wake” signal to the brain. Evening 
 Dim lights and use lamps. Circadian rhythm friendly lighting in heavy used areas. No screens after dinner or wear amber blue blocker glasses. Set a consistent bedtime and chill routine. If your child has a hard time going to sleep, try to gradually shift their bedtime to earlier in 15 minute increments. Go to sleep and eat earlier since it gets darker earlier. If your child has a hard time relaxing, check out my favorite simple, calming energy practices. Give Their Bedroom a Light and Technology Makeover Lamp — incandescent bulb No electronics or screens Make sure there’s not a strong EMF source on the wall behind their headboard. If they have an alarm clock, film it on slow motion with your iPhone. Is there flicker? If there is, buy a battery alarm clock, dim the display, or take it out altogether. Blackout curtains if needed — a dark room is important. If there is road noise, etc., try using a light fan to help block it out. Red or amber night light if needed. Final Thoughts: Embrace the Dark More darkness during the winter gives us the potential to produce more melatonin and therefore, allows the body to have more time for rest and repair. This is why winter can be very supportive to health when you become more mindful of how circadian rhythm works. Melatonin isn’t just a sleep hormone—it protects the brain, calms inflammation, and recharges the mitochondria. It’s one of nature’s simplest, yet most powerful, ways to support health. With melatonin supplementation being used now more than ever, it is evidence that our circadian rhythm has been seriously derailed. Supplementation can help some people get a better night’s rest, but it’s not a solution for everyone. The supplement quality and dosage is important. (7) Also, unless melatonin supplementation is done in a strategic, temporary way with other circadian rhythm practices put into place, I’m personally not a fan of using it for children as a permanent solution because of possible hormonal effects, especially during the puberty years. (8) Want My “Favorite Products” List? I’ve created a list of my favorite products to make your home more circadian-friendly — from orange bulbs to blackout curtains and kid-safe red night lights.
 💌 If you’d like the PDF, click here to request . If you cannot access the link, you can also email me at tstarling@simplyholisticsolutions.com . Sources: (1) “Sleep in Children with Autism Spectrum Disorder: A Narrative Review and Systematic Update,” by Schwichtenberg, Janis, Lindsay, Desai, Sahu, Kellerman, Chong, Abel, Yatcilla. Current Sleep Medicine Reports, November 3, 2022. https://link.springer.com/article/10.1007/s40675-022-00234-5 (2) “Sleep Restriction Affects Children’s Speech,” American Academy of Sleep Medicine. June 12, 2007. https://aasm.org/sleep-restriction-affects-childrens-speech/ (3) “How Much Sleep Do Babies and Kids Need?” Sleep Doctor. July 23, 2025. https://www.sleepfoundation.org/children-and-sleep/how-much-sleep-do-kids-need (4) “Biomarkers of Mitochondrial Dysfunction in Autism Spectrum Disorder: Systematic Review and Meta-Analysis.” Frye R.E., et al. (2024). https://pubmed.ncbi.nlm.nih.gov/38703861/ (5) “Vanguard Grant Will Support A New Study on Use of Infrared Light to Treat Autism Spectrum Disorder,” by The University of Texas at Austin, May 9, 2024. https://liberalarts.utexas.edu/news/vanguard-grant-will-support-a-new-study-on-use-of-infrared-light-to-treat-autism-spectrum-disorder (5) “Autism Research Project with Non-Invasive Near-Infrared Light Stimulation,” https://clinicaltrials.gov/study/NCT06203938 (6) “Transcranial Photobiomodulation for Autism, ADHD, and Other Neurodevelopmental Disorders with Josh Madsen DC,” by Documenting Hope. October 21, 2025. https://documentinghope.com/webinar/transcranial-photobiomodulation-for-autism-adhd-and-other-neurodevelopmental-disorders-with-josh-madsen-dc/ (7) “New Study Questions Ingredient Levels in Some Melatonin Supplements,” by Jeneen Interlandi. Consumer Reports. February 17, 2017. https://www.consumerreports.org/melatonin/study-questions-ingredient-levels-some-melatonin-supplements/ (8) “What is the relationship between melatonin and puberty?” https://www.droracle.ai/articles/38579/what-is-the-relationship-between-melatonin-and-puberty (8) "Could long-term administration of melatonin to prepubertal children affect timing of puberty? A clinician's perspective." Boafo, Greenham, Alenezi, Robillard, Pajer, Tavakoli, Koninck. Nat Sci Sleep. January, 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6362935/ “Blue Light Impact in Children.” American Optometric Association. https:// infantsee.aoa.org/Affiliates/InfantSEE/Documents/Blue-Light-Impact-in-Children.pdf “Children with Autism: Sleep Problems and Symptom Severity.” Sage Journals. September 27, 2012. https://journals.sagepub.com/doi/abs/ 10.1177/1088357612457989 “Circadian Rhythm & the Gut Microbiome.” https://pubmed.ncbi.nlm.nih.gov/ 27793218/ "The Inner Clock: Blue Light Sets the Human Rhythm," Wahl, Engelhardt, Schaupp, Lappe, Ivanov. J Biophotonics. December, 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC7065627/

When my son was a little less than a year into speech therapy, his speech started consistently getting worse instead of better. From the beginning, his apraxia was always one step forward and two steps back. I would see a little progress, and then the next day it would be gone. But never had it stalled out completely. Our SLP’s solution for this regression was to start over with the Kaufman Cards Kit 1 that he had been working on since he began speech therapy. She also suggested I stop working with him at home because she thought he was burned out and shutting down. I remember driving home that day — my eyes full of tears in a numb daze — wondering what to do next. I was doing all the “right” things … apraxia-specific private speech therapy two times a week, preschool three mornings a week, daily speech drills and games at home every day. But it wasn’t working. Life with apraxia felt like a full-time job. And having two other children with busy schedules, laundry, chores, etc. made me feel like my life was spinning out of control. Also, the internet in 2012 was young that time, and there was very little information on Childhood Apraxia of Speech. But around that same time, a window of opportunity opened. I was blogging about our journey with apraxia back then, and I stumbled upon the work of Dr. Claudia Morris who mentioned that gluten sensitivity may be a possible contributing factor to apraxia. But I was still skeptical … and distressed. He already had multiple food allergies and the thought of taking more food out of his diet felt impossible. What seemed more impossible though, was continuing on a path that seemed to have no end in sight. If you're reading this, chances are you're navigating similar waters—overwhelmed, searching, and hoping for answers that actually help. Let’s explore one of the most asked-about dietary changes for kids with apraxia and autism: going gluten-free. What Is Childhood Apraxia of Speech? In my own words, Childhood Apraxia of Speech (CAS) , is a motor speech disorder where a child’s brain knows what to say, but the mouth, tongue, and jaw can’t move correctly to make the words come out. The messaging in between the brain and the mouth get lost, and speech is scrambled, making errors inconsistent. Frequent, intense speech therapy is necessary in order to build a strong and consistent brain-mouth connection. Why Parents Are Exploring Dietary Changes for Apraxia Two-thirds of children with autism also have apraxia, but to my knowledge, the stats for how many children with apraxia also have autism is unknown. (1). Most of the research concerning alternative, add-on support like diet changes and nutritional supplementation has been done in the autism and ADHD population. In the 2024 study, " Reversal of Autism Symptoms among Dizygotic Twins," one of the interventions used was a "gluten-free, casein-free diet that was low in sugar and no exposure to artificial colors, dyes, or ultra-processed foods." (2) According to the book, “Healing the New Childhood Epidemics,” by Dr. Kenneth Bock, approximately 65% of kids with autism show improvement on the gluten-free, casein-free diet. Similar results are also seen with the ADHD population. (3) Apraxia of speech comes in all shapes and sizes, and the amount of time it takes to get out of speech therapy varies. One problem parents have, is that private speech therapy with a single diagnosis of Childhood Apraxia of Speech, typically is not covered by insurance, or coverage is limited and isn’t 100%. Free, public school speech therapy is an option, but sometimes due to heavy case loads, there is group, not individual therapy. Or, the SLP isn’t a specialist in apraxia. Some parents are turning to holistic support for apraxia to see if other interventions can be used with speech therapy in order to accomplish better, faster results. Like me, they feel like their child’s diagnosis is running their life and also see the logic of supporting the whole-child in order to optimize the health of the brain and body. Others see glimpses that their child’s brain is capable of producing speech and question why the words don’t stick. For my case in particular, I noticed speech surges after my son ate chocolate or did a Pulmicort asthma breathing treatment. This showed me that there was more to his puzzle, and I wanted to try to unlock that potential on a regular basis. The Connection Between Gluten and Brain Function Gluten is a protein found in wheat that can create an inflammatory response in people who are sensitive to it. It is possible for gluten sensitivity to affect both the gut and the brain. In these cases, gluten triggers an immune response where the body views this protein as the enemy and creates antibodies to fight it. When this occurs, cytokines are released, which can interfere with brain function. This may show up as trouble with focus, learning, and/or memory. (4) Often if someone is sensitive to gluten, they are also sensitive to casein, which is one of the proteins that is found in dairy. The “opioid excess theory” believes that some children with autism are not able to fully break down gluten and casein into amino acids during digestion. Instead, small peptides with opioid qualities are formed. These pass through the leaky gut, enter the bloodstream, and are thought to cross the blood-brain barrier and enter the central nervous system. Once they are in the brain, they bind to opioid receptors, which can potentially interfere with brain function. (5) Symptoms that may improve with the gluten-free, casein-free diet are: poor language skills, bowel disorders, mood disorders, hyperactivity, skin problems, insomnia, fatigue, and cognitive disorders. (6) While gluten (or dairy) isn’t a proven cause of apraxia or autism, it may act as an aggravating factor in kids who are sensitive to it. By reducing that potential source of inflammation, the body may become better equipped to heal, respond to therapy, and regulate neurological processes. Implementing a gluten and casein free diet was one component of my son’s healing regime, and we are a success story. And guess what?!? After I hired a new speech therapist who also integrated hand cues for motor planning support, he did not have to start over with Kaufman Kit 1 , and he flew through Kaufman Kit 2 . If you want to read more on what our results were like in real time, check out my 2013 blog post, “ Beating Apraxia .” (7) But because I did several things at once, I wasn’t 100 percent sure that the diet change was a primary factor in his improvement. After he tested out of apraxia, I tried adding dairy back into his diet by giving him a mozzarella cheese stick each day. This was not successful. In a three week time frame, he experienced a chronic stuffy nose, fevers, hysterical laughter for no reason, chewing on his shirt collar, and hanging upside down on the couch while watching TV or playing on the iPad. These reactions scared me, and I paused with the experiment and decided not to test gluten. What the Research Says About Gluten and Apraxia The research regarding Childhood Apraxia of Speech and the correlation with gluten sensitivity is limited, although there are a couple of pertinent studies to be noted: 1.) “Syndrome of Allergy, Apraxia, & Malabsorption: Characterization of a Neurodevelopmental Phenotype That Responds to Omega 3 and Vitamin E Supplementation,” Claudia Morris, MD and Marilyn Agin, MD, 2009. This study’s primary focus was on vitamin E and omega-3 supplementation for 187 children with apraxia of speech, but a few kids were also tested for gluten sensitivity. The results were as follows: High anti-gliadin IgG antibodies in 15 out of 22 (68%). “Ten children had HLA testing done and 100% revealed the presence of a gluten-sensitivity HLA genotype.” (8) If you are interested in learning more about this study and the gluten component, see this YouTube video [minute 19:20] with Dr. Claudia Morris . (9) 2.) “Childhood Apraxia of Speech: Exploring Gluten Sensitivity and Changes in Glutamate and GABA Plasma Levels,” 2024. This study included 120 children divided into three groups: Childhood Apraxia of Speech (30), delayed language development (60), and neurotypical children (30). The results were as follows: Children with apraxia had elevated levels of the anti-gliadin IgA antibody and glutamate, and lower levels of GABA. (More on glutamate and GABA in upcoming blog posts). There are multiple references cited at the bottom of this study if you’d like to do more reading on your own. (10) 3.) Anecdotal cases: There are also anecdotal cases both in the apraxia and autism communities from parents, doctors, and other health professionals that report improvements in speech on the gluten-free, casein-free diet. Is Gluten-Free Right for Your Child? Things to Consider Although there is evidence that removing gluten and casein has the potential to improve symptoms, it can often feel like a huge mountain that feels impossible for parents to climb. And there are certainly negatives: a child who has to eat different food(s) at school and parties, extra parental prep time, eating that feels more restrictive in nature, and speciality items that are often more expensive. Because of these challenges, I think testing, not guessing, makes a lot of sense. Knowledge is power, and having this information will help you to make informed decisions not only for a child's current speech struggles, but also to support their health as they continue to grow and develop. Also, speaking from personal experience … if things get hard and you want to give up, if you know for a *fact* not a *guess* that your child is sensitive to gluten, it will be easier to stay on track and dedicated to the plan. It is usually recommended that you remove gluten and casein for three months in order to determine if these foods are in fact, problematic for your child. So, taking this reality into consideration is important when weighing the pros and cons. Testing Options for Gluten Sensitivity There are a few ways to test for gluten sensitivity, so discuss your options with your pediatrician, integrative or MAPS doctor, or other trusted health professional. The following are common gluten sensitivity tests: IgG antibody testing for gluten Gliadin IgA & IgG ( Doctor's Data -- Celiac & Gluten Sensitivity Test Genetic testing for HLA variants My son began his holistic apraxia attack plan in September of 2012 right when he turned four years old. At that time, he did an ALCAT test , which showed a "severe intolerance" to wheat and a "moderate reaction" to gliadin, which is one of the components of gluten. He also showed a "moderate reaction" to casein. A couple of years later, I also did a nutritional genetic variant report with Tree of Life , which has continued to be a golden source of information. I actually found out about this company from a grandmother I met at my older son's travel baseball game in Myrtle Beach. Both me and my son have recently submitted our saliva samples for an updated and more expansive test with them. Over the years, I have stuck with the following tests to keep an eye on the status of his gluten sensitivity since he now eats gluten freely without cognitive issues: Total IgG Antibody Total IgA Antibody IgE for Gluten, Wheat, Milk & Casein IgG for Gluten How to Start a Gluten-Free Diet Without Getting Overwhelmed Every child is different, but exploring a gluten-free diet under the guidance of a knowledgeable practitioner can be a low-risk, holistic option worth considering. An example of a gluten-free, casein-free breakfast that my family likes. Here are a few tips for making the transition to a gluten-free diet a little easier: Start with breakfast swaps Focus on naturally gluten-free foods (fruits, veggies, rice, potatoes, etc.) Buy things online that are delivered to your house like produce co-ops and stores like Vitacost. Seek support from a holistic health practitioner, integrative MD, nutritionist, or dietician. In Closing You're already doing so much—and your love, advocacy, and intuition matter more than you realize. There’s no one-size-fits-all path for Childhood Apraxia of Speech, but with knowledge and support, you can find what works best for your child. Whether gluten-free is the right next step or just part of a broader journey, you don’t have to figure it out alone. ******************************* Curious about whether a gluten-free diet could help your child? Although it is outside of my scope of practice to provide you with a particular diet recommendation or meal plans, I can provide you with additional resources, testing options, and specialist recommendations if you feel like you need more support than I am able to provide. I offer educational material and personalized, no-pressure consultations to help moms like you explore holistic options for apraxia of speech—without the overwhelm. Let’s put together a gentle plan that fits your family’s needs and values. For more information, click here to get started . Sources: (1) “Apraxia a Common Occurrence in Autism, Study Finds,” by AHSA. September, 2015. https://leader.pubs.asha.org/doi/10.1044/leader.RIB1.20092015.18 (2) " Reversal of Autism Symptoms among Dizygotic Twins through a Personalized Lifestyle and Environmental Modification Approach: A Case Report and Review of the Literature,: by Christopher R D'Adamo, Josephine Nelson, Sara Miller, Maria Rickert Hong, Elizabeth Lambert, Healther Tallman Ruhm. Journal of Personalized Medicine, June 15, 2024. https://www.mdpi.com/2075-4426/14/6/641 (3) "Healing the New Childhood Epidemices," pg. 154, by Dr. Kenneth Bock. (4) “Gluten Sensitivity and the Impact on the Brain.” by David Perlmutter, MD. November 21, 2010. https://www.huffpost.com/entry/gluten-impacts-the-brain_b_785901 (5) “Outsmarting Autism,” by Patricia S. Lemur. (6) “Healing the New Childhood Epidemics,” pg. 206, by Dr. Kenneth Bock. (7) “Beating Apraxia,” by Tori Starling. Jake’s Journey with Apraxia, January 3, 2013. https://jakes-journey-apraxia.com/2013/01/03/beating-apraxia/ (8) “Syndrome of Allergy, Apraxia, & Malabsorption: Characterization of a Neurodevelopmental Phenotype That Responds to Omega 3 and Vitamin E Supplementation,” by Claudia Morris, MD and Marilyn Agin, MD. Alternative Therapies, July/August, 2009. (9) “GOED Exchange 2011: Plenary Session 5 — Innovative Uses of EPA and DHA,” by Dr. Claudia Morris. https://www.youtube.com/watch?v=W3Nc76D7nPg (10) “Childhood Apraxia of Speech: Exploring Gluten Sensitivity and Changes in Glutamate and GABA Plasma Levels,” Pediatric Neurology, February, 2024. Simply Holistic Solutions, LLC provides general health information intended for educational & informational purposes only. The information on this website is not a substitute for medical or dietary advice, diagnosis, or consultation with a medical professional. Always check with your child's physician, speech-language pathologist, dietician, nutritionist, or trusted healthcare professional(s) before trying or implementing any information obtained here.

What Does “Root Cause” Really Mean? When you first hear the diagnosis of Childhood Apraxia of Speech , overwhelm, confusion, and fear often sets in. Most parents are told the same thing: it’s a neurological motor speech disorder, the cause is unknown, and frequent, intense speech therapy is required. But as a mom who has walked this road with my own child, I know there’s more to the story. The truth is, there is a root cause(s) for symptoms and there are reasons the brain isn’t coordinating speech the way it should. I always say symptoms are like the check engine light coming on in your car. When this happens, do you put a piece of duct tape over the light, go a little slower, and hope for the best? Or, do you take your car into the mechanic to see what’s going on under the hood? Finding the root cause means asking why the symptom is happening in the first place. And that question changes everything. Why Root Causes Matter with Apraxia Imagine a vase with a small crack. When you patch it without addressing why it cracked in the first place, you’re just covering up the symptom. The underlying structure is still weak, so pressure builds and new cracks eventually form. This is what happens when we ignore root causes. Root causes matter because: They affect the whole child, not just their speech. Apraxia rarely exists alone. If we only treat speech, we miss the bigger picture. By finding and addressing root causes, we can reduce the total burden on the brain and body, which may improve results in speech therapy. Comorbid Conditions and Apraxia of Speech According to the non-profit group Apraxia Kids, “Childhood Apraxia of Speech only occurs in roughly 1% of the population and more often than not, other issues are also diagnosed at some point including autism spectrum disorders, fine and gross motor difficulties, learning disorders, literacy difficulties, and hearing loss.” (1) Building on that statement, a 2023 study analyzed 375 kids with Childhood Apraxia of Speech with an average age of four years and nine months old. Out of the 375, only one child had no comorbidities! The study states, “Comorbidity appears to be the rule, rather than the exception, for children with CAS.” (2) A few interesting facts from this study are: Average number of comorbid conditions was 8.4. Average number of “communication-related comorbidities” was 5.6. Top 4 common comorbidities: expressive language problems, receptive language delay, articulation deficit, and non-speech oral apraxia. It was especially insightful that this study included seven pages of comorbidities. The numbers you see here are the numerical findings out of 375 children. Conditions that I found of interest from a holistic, whole child perspective were: feeding difficulties (124) vision problems (64) ADHD (63) tonsillectomy (42) sleep disturbance (39) behavior problems (38) autism (32) GI problems (29) anxiety (22) sleep apnea (12) allergies (8) dyslexia (8) iron deficiency (7) asthma (6) Keep in mind, these are current conditions, not ones that may spring up in the future or ones they may have had in the past. Imagine how much more comprehensive a treatment plan could be if all children with apraxia of speech were given a full work up that included their comprehensive symptoms and diagnoses. For an even greater understanding of their condition, testing for things like nutritional deficiencies, food allergies and sensitivities, genetic vulnerabilities, impairments in detoxification, and total load could be exceptionally beneficial in determining root cause and putting together their whole body puzzle. Lessons From History: When the Root Cause Was Missed Looking back, there are examples of how medicine has misunderstood root causes: 1.) Pellagra: Once believed to be an infectious disease, it was later discovered that it was caused by a niacin (vitamin B3) deficiency due to a diet high in corn and not enough nutrients. Symptoms included diarrhea, dementia, skin issues (dermatitis), and in severe cases, depression, confusion, anxiety, and hallucinations. The mental component of this condition often resulted in a diagnosis of insanity and admission into a mental asylum. Between 1906 and 1940, there were three million cases in America, with 100,000 of those resulting in death. By the 1950’s, the case of pellagra was solved, although it is sometimes seen today in malabsorption, alcoholism, and malnutrition. (3) 2.) Scurvy: For years, sailors died from what was thought to be a mysterious illness, when actually, they had a severe vitamin C deficiency. Symptoms included fatigue, bleeding gums, joint pain, slow-healing wounds, and heart problems. It was eventually discovered that giving the sailors lemons cured their symptoms. (4) 3.) Rickets: During the Industrial Revolution, this illness affected European children who spent most of their time indoors. It was later discovered that the symptoms of this illness like soft bones, bowed legs, bone pain, weak muscles, dental issues, and growth problems were caused from a vitamin D deficiency. (5) My Son’s Apraxia of Speech Root Causes When I began this journey with my son’s apraxia, I quickly realized speech therapy was necessary, but it was not enough. His progress was slow, and he had other symptoms that didn’t make sense. Once I started supporting his root causes, things shifted. Yes, his speech improved, but so did everything else. His physical symptoms and sensory issues slowly faded away, and his ability to learn clicked into place. Addressing root causes gave him a stronger foundation to build on. It’s also been beneficial to understand his vulnerabilities as he’s continued to grow and develop. Our integrative MD gave my son the following root cause diagnoses for his apraxia of speech: Nutritional Deficiencies: Testing showed that he was low in vitamins A, C, E, B2, B6, B7, B9, B12, CoQ10, magnesium, and zinc. All of these are essential for brain and nervous system health. Antioxidant Deficiencies: Since he didn’t have antioxidants to neutralize his out-of-control free radicals, oxidative stress resulted.This caused inflammation, and mitochondrial damage and dysfunction. Poor Methylation: Genetic vulnerabilities, high total load, and a host of other problems led to a body that wasn’t detoxing well. Fat Deficiency and Trouble Metabolizing Fats: Not only was he deficient in healthy fats, but his body was having a hard time breaking down and processing fats. This was a massive problem because essential fatty acids and other healthy fats are vital for brain health. His deficiency of fat-soluble vitamin E fits in here as well. Some of the symptoms of E deficiency that made sense in regards to his apraxia of speech were: muscle weakness, oxidative stress, coordination problems, and nerves not transmitting signals correctly. Fat malabsorption and lack of pancreatic enzymes are possible causes of this deficiency. Poor Gut Health: Allergies, gluten and dairy sensitivities , and leaky gut created all sorts of problems. Because the gut is integral for the health of the body, when it’s not working well, every system—including the brain and speech—can be affected. Gut issues can also lead to problems with nutrient absorption and assimilation. The Energetic Body One piece that often gets overlooked in the conversation about root causes is the energetic body. Just as electricity powers your home, the body’s energetic system powers its biological functions. Energy flows along the internal meridian network and sometimes blockages can occur. Just like a traffic jam on the highway, when the road is closed and traffic is detoured. These blockages and imbalances in energy can cause the body to struggle to function at its best. Let’s look at the 2015 study, “Clinical study of post-stroke apraxia treated with scalp electric acupuncture.” A total of 60 adults with post-stroke apraxia of speech participated and they were divided into two groups of 30. One group received speech rehab only, and the other group received speech rehab plus scalp electric acupuncture. After four weeks of treatment, for those who only had speech rehab, 16 out of 30 improved. For those who had speech rehab and acupuncture, 30 out of 30 improved. The conclusion of the study states, “The scalp electrical acupuncture combined with speech rehab training obviously improves speech apraxia in stroke patients so that the speech disorder can be relieved. The efficacy is better than that in simple rehabilitation training.” (7) When my son was younger, I added acupuncture into his care plan—not as a replacement for nutrition, therapy, or medical support, but as another layer to tackle apraxia from all angles. As a side note, I’ve spent the past ten years looking for an energy medicine modality that checks all my boxes. I wanted to find something that was easy, pain-free, accurate, affordable, and accessible from anywhere in the United States. I decided on Energy4Life’s Bioenergetics Wellness System, which is designed to uncover and address energetic imbalances. I look forward to exploring the possibilities of this type of technology with the apraxia kids. How to Determine What Your Child’s Unique Root Causes Are Root causes reveal themselves through a mix of detective work, observation, intuition, and testing. Some of the ways to uncover them include: 1.) Symptoms: Physical symptoms are clues that help you understand what is going on in the body. This includes things like: eczema, constipation, diarrhea, stomach aches, ear infections, dark circles under the eyes, low muscle tone, food reactions, asthma, sensory issues, fatigue, mood swings, trouble sleeping, coordination issues, and more. 2. ) Total Load Assessment: Picture your child’s body as a bucket and when the bucket is full of stressors, symptoms occur. Things that fill up a child’s bucket include: processed food, sweets, eating foods they are allergic or sensitive to, pesticides, antibiotics, medications, chemical-laden household & personal care products, heavy screen time, emotional stressors, and more. 3.) Medical History: Birth trauma, frequent sickness, antibiotic use, pharmaceuticals or supplements that the mother took during pregnancy and at delivery, are a few examples of puzzle pieces here. 4.) Major Stress Events: Severe illness, surgery, mold exposure, vaccine reactions, or family crisis are examples of things that can trigger symptoms in children already vulnerable. 5.) Lab Testing: Gut microbiome testing, nutritional deficiency testing, Organic Acids Test (OAT), and basic lab work can provide concrete data about what’s going on inside your child’s body. 6.) Genetic Testing: This is useful for insight into MTHFR, food allergies and sensitivities, and other genetic markers associated with some cases of apraxia. In Closing There is no one-size-fits-all path for this unique speech disorder that ranges from mild to severe communication challenges and symptoms. It’s also important to keep in mind that sometimes root cause(s) can be identified, but if the symptom burden is too high and the underlying pathology runs deep, it may be harder— or even impossible—to erase every challenge. In these cases, the goal is progress, not perfection. Root cause work isn’t a magic pill and it’s not an overnight solution. But it is powerful because it addresses the why, not just the what. Consider this analogy: If a fish is swimming in a dirty tank and gets sick, what would do? Would you give the fish medicine or try to nurse it back to health? Or, would you first try to change the water to see if that would make a difference? Root cause is about changing the water. Addressing apraxia’s root causes supports not only today’s speech issues, but also other symptoms and future potential health challenges. It’s about looking at the whole child, and creating the healthiest possible foundation for the brain and body function at its best. When I work with a mom, I get a full list of symptoms that the child has experienced in the past plus ones they currently have. The purpose is to track before and after results, and also to give me clues as to what’s going on inside of the body. In other words, the “symptom” is not the focus; “root cause” is the focus. *************************** If you enjoyed reading or listening to this, subscribe to the blog so you don’t miss next month’s article: “Digging Deeper Into Root Causes: Medical and Stress Triggers for Childhood Apraxia of Speech.” This will be a deeper dive into the medical history and stress events noted in the section, “How to Determine What Your Child’s Unique Root Causes Are.” I'll also go into the reasons why I think my son's root causes were triggered to begin with. If you would like to learn more about the holistic apraxia process, please click here to get started. **************************** Sources: (1)“Co-Occurring Disorders,” by Apraxia Kids. https://www.apraxia-kids.org/virtual-education-series/comorbidity-2/ (2)“Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review,” by Chenausky, Baas, Stoeckel, Brown, Green, Runke, Schimmenti, Clark. Journal of Speech, Language, & Hearing Research. Volume 66, Number 3. February 16, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10205100/ (3) “The unwavering doctor who unraveled a medical mystery,” by Sarah Schmitz and Eve Lowenstein. International Journal of Women’s Dermatology. Volume 5, Issue 2. June 2019. https://www.sciencedirect.com/science/article/pii/S2352647518300406?via=ihub (4) “James Lind: The man who helped to cure scurvy with lemons,” by Marcus White. BBC News, October 4, 2016. https://www.bbc.com/news/uk-england-37320399 (5) Nutritional rickets: Historic overview and plan for worldwide eradication,” by Roger Bouillon and Leen Antonio. The Journal of Steroid Biochemistry and Molecular Biology. Volume 198, April 2020. https://www.sciencedirect.com/science/article/abs/pii/S0960076019304364 (6) Vitamin E Deficiency, by Tyler Kemnic and Meghan Coleman. StatPearls [Internet] July 4, 2023. https://www.ncbi.nlm.nih.gov/books/NBK519051/ (7) [Clinical study of post-stroke speech apraxia treated with scalp electric acupuncture under anatomic orientation and rehabilitation training] by Yujuan Jiang, Yuxia Yang, Rong Xiang, E Chang, Yanchun Zhang, Bingfang Zuo, Qianwei Zhang. July 2015. https://pubmed.ncbi.nlm.nih.gov/26521575/

In 1992, the CDC recommended that pregnant women take folic acid (synthetic, man made B9) to prevent neural tube defects (spina bifida). Also, in 1998 folic acid was added to all enriched grain products. It’s also in our baby formula. What if it was unknown that a large portion of the population couldn’t process this synthetic form of B9 due to genetic mutations like MTHFR + others? What if all these moms and babies were pounded by synthetic folic acid and the body started viewing this as a threat. An unwanted invader forcing the brain to methylate, myelinate, and to just shut up and do what’s it's told. What if some of these kids were more sensitive than others, and for a small fraction of them, this assault created an autoimmune condition in the brain’s folate receptors? Moms felt like they had a folic acid safety net conveniently provided by their doctors and government. So, they started eating less of natural folate sources like leafy greens and citrus. Around this same time, processed food came in hard and strong. What if these babies’ brains started to become starved of folate, which prevented critical brain development functions from happening – methylation, myelination, and neurotransmitter production. What if without enough folate, they couldn’t methylate properly, and therefore couldn’t detox effectively? DNA and inflammation spun out of control. What was each child’s weakest genetic link? In came more crap food, more pesticides, more vaccines, more illness, more antibiotics, more pharmaceuticals, more screen time, more time indoors. So. Much. Crap. And impaired methylation also meant depleted levels of glutathione – the master antioxidant that excretes toxins out the body. The toxins wanted to leave, but they had no where to go. So, the pathology went deeper and other parts of the body became inflamed. The brain, the gut, the lungs, the ears ... so many places ... all screaming for help. The baby got more vaccines. More combinations. As young as possible. Every three months, every six months. Make it efficient. As many as possible in a visit. Send mom home with a sample of Tylenol after the shots, tell her to make sure she has her own bottle on hand ... tank that glutathione even further. But with some of these kids, was there even any glutathione left in their tanks? But, no. Don’t think, don’t ask questions. Trust.  Baby gets a fever, or eczema, or asthma, or diarrhea. The immune system tries to do the right thing. Tries to regulate. Keeps trying to push out the toxins.  Nope, give that Tylenol. Do that steroid breathing treatment. Slather that eczema cream over their wounds. Silence the body because it’s not smart. We are. Just trust us.  But, no. Something went wrong. Right, left, pharmaceutical companies, doctors, moms, insurance, not enough money, too much money, an insurmountable toxin burden coming from every freaking direction.  Trust the science. Don’t trust the science. Do this. Don’t do that. Fox, CNN, Yahoo, MSN, Instagram, TikTok, influencers, Facebook groups. So many opinions. Who to trust? The perfect storm. What if ... ? What if we silenced the noise? What if we know better, so we start to do better? Do you even know how powerful a mother’s intuition is? How powerful our love is? What if we took back our power as moms and changed the course of our children’s future? What if? *************************** I am a writer and sometimes I get in a flow state and words pour out of me. Straight from my heart and soul, and into words and sentences; time seems to stand still. It's been a while since that happened. But that's what happened with this post. And every time I read this, I'm crying when I get to the end. In this age of information overload, PubMed studies, protocols, root causes, one-size-fits all diagnoses and treatment, and integrative functional medicine versus conventional, I didn't publish this to proclaim, 'This is it! Synthetic folic acid and folate deficiency is the cause of autism and the child chronic health epidemic!' But rather, for us to truly ask ourselves, "What if ...?" There's a popular phrase that describes epigenetics as, "Genetics loads the gun, but environment pulls the trigger." Yes, I 100 percent agree with this, but is it possible that there's a piece of the puzzle in between? Could it be that genetics load the gun, but synthetic folic acid and/or faulty detox mechanisms removes the safety? Then, the brain is weakened and toxins have no way to escape? The hypothesis of folate deficiency being a potential cause of autism is not new. It has been talked about for years. And the same is true of apraxia. A quick google search said, " Folate is crucial for brain development and function. A deficiency, especially in the brain, can disrupt motor control and planning, contributing to apraxia and other coordination issues." I believe folate deficiency was one component of my son's Childhood Apraxia of Speech issues. He was deficient in folate on a NutrEval test and he supplemented with a B complex from a compounding pharmacy that included methylated B12 and folate. I also 1,000 percent know that his detoxification system was significantly impaired back then, and it will always be something he has to be mindful of. I'm reading the book, " The Folate Fix," by Dr. Richard E. Frye this week and thought these folate facts from his book were interesting: " From the earliest stages of embryonic development, folate is vital for forming the nervous system, including the brain and spinal cord. Another primary role of folate is the synthesis of genetic material, which begins shortly after conception and remains crucial throughout a person's life. Folate plays additional roles in brain development, such as supporting neurotransmitter production and promoting myelination, the protective insulation around neurons that enhances signal transmission. Folate is also essential for two critical processes: methylation, which regulates gene activity, and redox metabolism, which protects cells from stress and toxins." So, no question about it ... folate is huge for brain and body health. For some, it may be as easy as bringing deficient levels up to normal with supplementation. But what about the other damage that's been created along the way? What dosage is best to start with? Can too much overwhelm the body and lead to additional symptoms? Is it a matter of carefully putting that safety back on while also removing the things that are contributing to a child's total load? What about the other root causes? Autism, apraxia, ADHD, eczema, asthma, and all of the other childhood chronic disorders and illnesses, will always need to be analyzed holistically -- taking into account all symptoms, total load, and root causes. And doing this through a careful and respectful lens, understanding that the body is miraculous and brilliant, and is always doing what is right in order to regulate, balance, and keep us alive. In closing, this an introduction to folate, folic acid, methylated folate, 5-MTHF, folinic acid, Leucovorin, Cerebral Folate Deficiency, FRAT, and MTHFR. My job is to read all the research, report on what is and is not working for these children, and report back to you with the best-of-the-best information. Strategic planning during the early intervention years is vital.

I started out like most of us — doing everything I was told, trusting, and never questioning the system. Although I ate pretty healthy, I didn’t hold my children to the same standards. They had all the usual kid junk food we are conditioned to believe is acceptable. At the time, my belief pattern was: They are children — young, strong, and healthy. What could possibly go wrong? When my oldest son, Luke, was two, he developed severe asthma, and had to take breathing treatments along with oral steroids. I was working full time and life was a series of holding my breath until the next episode came. The next trip to the ER. The next sleepless night, strapping my body around his while he screamed, forcing him to suck in the Albuterol mist. He was one of the first kids to take Singulair before it had a black-box warning. Although this medication stopped the wheezing, it also turned him into an overly rambunctious four-year-old. A year later, I took him off all meds and although he had gut issues for a while, he never had asthma again. When Luke started kindergarten, I got pregnant again. By this point, I had quit work and was a stay-at-home mom. I didn’t eat quite as healthy when I was pregnant this time, and although I gained 60+ pounds, I had a smooth pregnancy and delivery. Again, I was trusting of the system and had “the works” at the hospital: the doctor manually broke my water, I took Pitocin to induce labor, an epidural, and gladly accepted narcotics to take the edge off. Twenty-four hours later, I was wheeled out with a fresh, new, squeaky-clean baby we named Jake. Around three months old, Jake's skin became inflamed and itchy. I remember thinking maybe he was allergic to the sun because he would break out in hives every time he went outside. After taking him to the doctor, he was diagnosed with atopic dermatitis (eczema). He was prescribed a steroid cream, which he would continue for the next couple of years. Although it would clear up for a bit, it would always come back, progressively getting worse. His feet were always the worst and the severity broke my heart. When Jake was nine months old, I gave him a bite of eggs and he broke out in hives. Then came the ear infections and mild asthma. During this time, antibiotics, breathing treatments, and Benzocaine ear drops were our norm. At age two, he was diagnosed with allergies to eggs and peanuts. Life was really hard. Recommended eczema treatment had progressed to bleach baths followed by steroid cream on his legs, feet, and ankles that were wrapped in saran plastic wrap at bedtime. For added benefit, I was told to put hot, wet pajamas on him for maximum medication absorption. “How will he be able to sleep?” I asked. “That sounds miserable.” The doctor reassured me that it was no big deal. I did it one night, but felt too bad to do it again. At this time, a few things pushed me over the edge and stirred me into researching alternate healing paths: The standard, suggested route of medical care was making him worse, not better.
 Since he had been on steroid cream since he was three months old, it had stopped working. He was prescribed a stronger cream with a black-box cancer warning. 
 A dermatologist told me, “This kid is allergic to the world. He will be on medication for the rest of his life.”
 My pediatrician was insistent that Jake get the flu shot, but didn’t want to do it in his office because of his allergies. He said, “If the flu shot causes him to go into anaphylactic shock because of his egg allergy, he needs to be at the allergist’s office.” I thought it made more sense to risk getting the flu vs. risk going into anaphylactic shock. 
 A couple of months after Jake's second birthday, I made an appointment with a naturopathic doctor. He went on a food elimination diet for three months, and ate fruits, veggies, and protein. He also took a probiotic and quercetin. The food elimination diet was like pressing a reset button on his system. The eczema and asthma didn’t go away completely, but improved dramatically. His ear infections tapered off. He continued eating clean, only eliminating his allergies to peanuts and eggs. I thought things were getting better, but then he started having more allergic reactions. By the time Jake was three, he was diagnosed with eight food allergies: eggs, peanuts, some tree nuts, gluten, dairy, fin fish, some shellfish, and pineapple. Life got harder and more stressful. Having a child with this many allergies felt like I was walking through a mine field every day. Also at age three, he was diagnosed with childhood apraxia of speech (CAS) . He was already in speech therapy, but at this point, his apraxia treatment increased to therapy two times a week plus targeted work at home every day. Once I got this diagnosis, I started researching like crazy and stumbled upon the research study on apraxia, led by Dr. Claudia Morris and Dr. Marilyn Agin. The results of the study suggested that the root cause of apraxia of speech in children could be gluten sensitivity + nutritional deficiencies + omega 3 and/or vitamin E deficiency. The stats impressed me – 97% of 187 children showed some level of improvement with supplementation.
 A month before Jake's fourth birthday in August of 2012, he had an appointment with Dr. Taz, a reputable, integrative MD in Atlanta. After a thorough check up and seven vials of blood, I found out he was severely deficient in all vitamins and minerals. His omega 3,6, and 9 levels were a little off, but nothing extreme. His amino acid levels were all over the place. He tested negative for celiac disease. At this time, Jake began eating a gluten and dairy free diet, and supplementing with probiotics, glutamine (an amino acid that aids digestion), quercetin, CoQ10, and B vitamins. He also responded amazingly well to acupuncture. He continued on with his speech therapy regime of two times a week. Each day his health and speech improved. Three months after beginning his treatment plan, he was speaking in basic sentences, able to correct his errors, engage in spontaneous conversation, and look at a picture and tell you what it was. This was huge! Nine months later, his errors were consistent and age appropriate. At this time, he also went to Foundations Developmental House in Arizona for four days of intensive speech therapy. A few months later at 5 years, 2 months old, he dropped his apraxia diagnosis. Jake continued on with a clean, gluten and dairy free diet for the next couple of years, and had no additional speech or learning problems. When he was 12, he began treatment with a nutrition response testing practitioner who assisted me with his food allergies. I gradually added back his allergens, with the help of homeopathic remedies, digestive enzymes, Betaine HCl, and Reiki to calm his stress/fear response. He is now free from all of his allergies with the exception of fish. This allergy will require a more robust desensitization process. My plan is to do either specialized chiropractic care or BioSet. My goal is to have this allergy eliminated by the time he graduates high school ... especially since fishing is one of his favorite hobbies! Not only did I get real-life education and experience during these thirteen years, but I also got to witness the miraculous healing power of the body. At first I thought I'd just go on about my life ... maybe get back into IT or put my journalism degree to use and write full time. But then I realized I had changed and could never go back to the person I was before. I started taking classes on the things that interested me the most in Jake's healing journey. Four years later, Simply Holistic Solutions was created. I'm excited to step into this next chapter in my life and look forward to connecting with moms who are going through similar struggles with their children. I'd love to hear more about your child's story. Where are you at in your own journey with apraxia? Does your child have additional symptoms or diagnoses other than apraxia of speech?

When your toddler isn't talking, the instinct that something deeper is going on can hit hard. As a mom to a child with apraxia of speech, I know firsthand how frustrating it is when you suspect apraxia as early as 18 to 24 months, yet are told to wait until age three for a diagnosis. My Early Intervention Experience with Apraxia of Speech My journey through that in-between period began at age 27 months. Up until that point, I had been buried with my son’s other health issues: horrific eczema, asthma, six ear infections, multiple rounds of antibiotics, steroid creams, breathing treatments, gut issues, and food allergies. After I cleaned up his diet and added a few basic supplements, his health started improving. But then I noticed that he wasn’t talking like the other kids his age. My time as a mother during the wait-and-see phase was filled with worry, frustration, confusion, and overwhelm. My son started speech therapy at 27 months old with our state-funded early intervention program. Her job was to teach me how to help him to speak. She introduced me to the basics of speech therapy. She taught us a little sign language, gave me literature to read, and encouraged simple communication like “more” and “eat.” Two months later, a second SLP entered the scene. She was the first person to tell me that she suspected Childhood Apraxia of Speech. During speech therapy, she read him books, sang songs, and did cutting and pasting exercises. One of the first nursery rhymes she started with was, “Five little speckled frogs, Sat on a great big log. Eating the most delicious bugs.” My son just stared silently at her, big smile planted on his face, while she belted out this tune each week. Once she started drilling words, she didn’t work on the same letter or words each week, and some of the first words she introduced to him were two-syllable and not simple. I pressed her to make an “official” apraxia diagnosis prior to age three, but she would not. Her response was, “It doesn’t matter if he has x, y, or z. I’m still going to treat him the same way.” When she said this, I remember thinking, If we don’t know what it is, how in the world are we going to fix it? Fear and frustration quickly set in as the weeks dragged on. A few days before my son’s third birthday, she officially diagnosed him with Childhood Apraxia of Speech. At that point, I had some education under my belt and knew I must find a better solution as soon as possible. At this time, I had the following frustrations: The early intervention time before his official diagnosis felt wasted and I had seen no progress with his speech. Why did he do basic speech therapy if apraxia was suspected? What would it have hurt to go ahead and start apraxia-specific therapy like Kaufman cards, Prompt, DTTC, and/or hand cues? Why can’t apraxia be diagnosed before age three? I hear these same concerns from other parents and and asked two SLPs to provide insight on how to make the best use of the time prior to an official speech diagnosis. Speech-Language Pathologists Provide Answers to Apraxia of Speech Early Intervention Concerns Katie Grecco, our fifth SLP, who did an amazing job in helping my son to overcome apraxia, answered this question: What can a parent do while waiting for an apraxia diagnosis so they don't feel like they are wasting valuable early intervention time? “From the perspective of a speech-language pathologist who has worked with children in early intervention as well as in Pre-K who present with characteristics of Childhood Apraxia of Speech, I recommend focusing on the following three areas: Imitation: Make motor and vocal imitation fun and within the context of play.  Include large motor movements, mouth movements, animal sounds, non-speech sounds (example: gasps of excitement), isolated vowel and consonant sounds, simple syllable shapes (consonant + vowel, duplicated syllables), simple two-word combinations. Praise and celebrate all communicative efforts and imitation attempts. Even when your child tries and isn't successful, let them know what a great job they are doing by trying their best.  Continue to simplify your target so they are able to be successful even if you need to reduce your expectation. Supplemental communication aids: Use of simple core vocabulary boards can be a wonderful tool for learning and using language while also reducing frustration.  Here's one of my favorites:  Core Board - WordPower - Tell Me Board , along with a video about how to use these tools at home: " How to Use a Communication Board to Get Your Child Talking. ".  Always verbalize along with using the pictures/symbols to teach and encourage language use.” Shandy Laskey -- Speaking of Health & Wellness, LLC -- speakingofhealthandwellness.com Shandy Laskey , SLP and Functional Nutritional Therapy Practitioner, elaborated further and answered each of these pre-apraxia diagnosis questions: Why do basic speech therapy before the age of three if apraxia is suspected? I can't speak specifically to Jake's experience because I wasn't his SLP, but I will say that most SLPs are not diagnosing Childhood Apraxia of Speech (CAS) before age three because it's difficult at that age to differentiate between CAS and other speech-language disorders, especially other motor speech disorders. It is especially difficult to differentiate and identify if it's CAS when a child younger than three years old has less than 50 words.  In many cases, a skilled SLP can identify whether the child is experiencing a motor speech issue in the 18-24 month range as long as the child is using enough verbal speech to assess their motor movements and speech patterns. It's important to see CAS as one of the diagnoses under an umbrella of motor speech disorders, understanding there are more motor speech disorders than just CAS. For example, dysarthria can look similar to CAS under age three, especially when a child is using very few words. The specific diagnosis becomes more important as the child grows older because the therapeutic approach should shift as they mature and have more capacity for more intensive speech-language therapies and approaches. It's also important to note that some children with CAS also have Whole-body Apraxia or a Developmental Coordination Disorder, informally known as dyspraxia. When this is the case and you can clearly see that the child has difficulty with motor planning throughout their body, for gross and fine motor movements overall, not just for speech. In these cases when the child is younger than three, we need to zoom out and focus on supporting coordination of the whole-body and gross motor movements before focusing intensely on motor planning for speech. What would it hurt to go ahead and start with apraxia therapy like DTTC, Kaufman, or Prompt? It's very nuanced! These approaches are excellent for children with diagnosed CAS, especially school-aged children, in conjunction with other diet, nutrition, lifestyle supports. While these therapies are often recommended for children with CAS, they are applicable and supportive for children who have motor speech disorders, which CAS falls under the umbrella of. In my clinical opinion and experience, whenever a child is struggling with what appears to be a motor speech disorder, multi-modal / multi-sensory cueing techniques and hierarchies (auditory, visual, tactile) should be utilized for support, regardless of age, and if there's a diagnosis of CAS. That being said, some of these approaches in their pure forms can sometimes be too intensive for some children. Especially for very young children, which is why they aren't the default for most Early Intervention SLPs. When I was an Early Intervention SLP working with children younger than three, I incorporated techniques from these motor speech-based approaches and blended multi-modal cueing hierarchies into my child-led, play-based therapy sessions. Before age three, therapy really should be child-led and family-centered vs. drill based therapies or other intensive types of motor speech-based therapies. You don't want to lose a kid in the therapy session. It’s all about maintaining rapport and you have to "meet them where they are.” But that doesn't mean that a skilled SLP can't or shouldn't be utilizing all of the tools in their toolkit when they see that the kiddo is struggling with motor planning for speech. What can a parent do while waiting for an apraxia diagnosis so they don't feel like they are wasting valuable early intervention time? I love this question because there's so much that parents can do to support their children at home. Rather than focusing so much on the diagnosis during those early years, focus on the tailoring the approach to meet your child's needs. During this time, kids need the foundational supports in place before starting more intensive speech-language therapies for CAS. If I personally had a child who was suspected to have CAS and was in the 18-24 month range waiting for formal CAS diagnosis, here are a few things I would consider: 1. Speech therapy: While SLPs are a wonderful resource, it's important note that not all SLPs are created equal and on the same page. Find someone who you can see building a great rapport with you and your child, and ask if / how they're using motor speech-based strategies and/or multi-modal cueing hierarchies in their sessions (even when they're play-based, child-led, and family-centered). 2. Anything that can be done to support the child's central nervous system, especially younger than age three, can be really transformative in addition to speech therapy. Examples include: Movement-based therapies like reflex integration and neurodevelopment movement Craniosacral therapy or craniosacral fascial therapy Pediatric neurological focused chiropractic care (ex: PxDocs) 3. Consider occupational therapy (OT) or physical therapy (PT) if the child is struggling with coordinating motor planning of their whole body. Keep in mind that the movements of speech production are our finest fine motor movements that we use, and development builds upon development. We develop gross motor skills before we develop and master fine motor skills. 4. Lower “total load” with diet changes, targeted nutrition, and lifestyle changes. 5. Diet and bio-individualized nutrition supports the child's overall health, wellness, development, and central nervous system regulation. While there isn't a large body of research looking at diet, nutrition, and CAS, there is some research that exists, in addition to growing body of anecdotal evidence from families, like Tori and Jake's story. There are more and more case reports coming out all the time about individuals (both children and adults) whose motor planning disorders improved when they changed their diet, especially the removal of gluten containing foods, and improving the gut-brain connection. 6. “Clean up" the diet by removing artificial colors/dyes, artificial ingredients, GMOs, gluten, dairy, corn, and soy and focus on the gut-brain connection. 7. Assess if there are any nutritional deficiencies that could be playing a role (Vitamin E and Omega-3, for example) and address deficiencies with targeted supplementation as needed. 8. Spend plenty of time outside daily, getting lots of movement and "heavy work" for regulation (bonus if they're barefoot). 9. Drop down to the child's level whenever possible, so that they feel seen and heard while struggling to get their words out. This also helps them to see mouth movements clearly. 10. Try your best not to talk for your child or complete their sentences while they're attempting them with you. Stay patient and model the correct form back to them once they've said it. 11. Incorporate daily, at-home speech-language development practice for at least 10-20 minutes. For example: Get down on the floor with your child and let them lead the play. Follow their lead, meet them where they are, and use minimal language. Also, repeat the words or phrases they've said back to them with clear and exaggerated speech modeling. Place toys near your face to get them to look at your mouth while you speak. Don't withhold anything from your child making them "work" for it with their speech. This is a quick road to shut down and self-esteem issues. I hope this has been supportive and gives you, the reader and presumably the parent, a sense of direction. I'm wishing your child and family all the best! I'm so grateful to Katie and Shandy for sharing their knowledge and expertise on this topic. They are the best-of-the-best! I hope you were able to find a few pieces of gold to help you in your own early journey with apraxia or other speech-language disorder. Although this was an abundance of information, it was created on hypotheticals for general educational purposes. There are still more interventions that can be done, but I hope this gets you trending in the right direction. It is key to understand that each child is unique and what works for one child, may or may not work for another. A skilled SLP or other holistic, integrative, etc. professional, will always be able to provide outside-the-box solutions to best meet your child's goals and needs. Question: What has your own experience been like with early intervention prior to age three? Has it been positive or negative? Would love to hear your story in the comments . All the best, Tori Guest writer: Shandy Laskey, M.A., CCC-SLP, FNTP Speaking of Health & Wellness, LLC  speakingofhealthandwellness.com   Shandy also serves as the Director of Community Development for  Documenting Hope .

This past week I’ve been reminded of the miraculous power of the Triple Warmer meridian and what an integral role it plays in the healing of this generation. Every single time when things go awry in my world, calming triple warmer is always my first line of defense. Why? Because it works. What is Triple Warmer? Triple Warmer is a meridian in Traditional Chinese Medicine (TCM) that is governed by the hypothalamus gland. It “networks information to all the meridians and the organs they serve.” (1) It’s purpose is to protect the body from harm. For example, if the body has a fever due to infection, Triple Warmer is on full alert, fighting to keep you alive. But sometimes, the body gets confused and attacks things that aren’t “really” the enemy. Triple Warmer is said to be in overdrive for conditions such as ADHD, autoimmune disorders, anxiety, allergies, and more. I love how Donna Eden explains Triple Warmer: “ It is the energy system that governs the immune response, the fight-or-flight response, and the establishment of survival habits. As civilization, and technology in particular, have advanced, the ability of triple warmer to sort out what is friend and what is foe has been overwhelmed, so that for many people, triple warmer is on continual alert .” (1) When to Use Triple Warmer Calming Exercises Here are the times over the past week that I have calmed Triple Warmer and witnessed the body miraculously shift out of an overactive response and into a state of calm: 1.) Myself: If I wake up in the middle of the night and can’t fall right back asleep, triple warmer neurovascular holds always come to my rescue. 2.) Ironically enough, shortly after I published my book "Voice of Truth" where I declared to the universe that my son was no longer allergic to the ocean, he had a reaction while fishing. The past two times, he got a rash under his arms, but this trip his eyes also swelled and became itchy. I gave him a minimal dose of Benadryl and did about 45 minutes of Triple Warmer and other energy medicine exercises. 3.) I consoled a teething baby by placing my hand on the meridians along his torso (root, sacral, solar plexus, heart) and repeating to Triple Warmer, “You are safe.” It was so interesting how I could feel his body slowly sink into relaxation mode. 4.) I am working with a teenage girl right now using Reiki, Eden Energy neurovascular holds, and NES infoceuticals. This week, I did additional research and found this article to be exceptionally useful and incorporated some of these techniques into our session as well. (2) Closing Triple Warmer calming exercises are exceptional in helping the body to get out of fight or flight and relax. There are many ways to achieve this and there's always something for everyone. In my next blog post, I will be sharing a few of my basic, go-to techniques for calming Triple Warmer. Have you ever incorporated energy medicine and/or Triple Warmer exercises into your child's wellness regime? If so, what were your results? Sources (1) Eden, Donna. "Triple Warmer: It's Hotter Than You Think." Touch for Health Archives. https://www.touchforhealtharchive.com/Journals/2007/2007Eden.pdf (2) Yordy, Jan. "Energy Techniques to Assist Highly Anxious Children." Energy Connection Therapies. https://www.cmcgc.com/media/handouts/310602/a8_jan_yordy.pdf

According to the current statistics, about one in 36 children have autism spectrum disorder and it is four times more common in boys than girls. There are no official stats on childhood apraxia of speech, although it is believed to be one to ten per 1,000. At one point in my life, these numbers were just a stat I read about … something that happened to other people, but certainly not to me. I had no idea what these moms and children were going through until I was dropped into this world myself. My son was diagnosed with childhood apraxia of speech the day before his third birthday. This is a disorder where the brain knows what to say, but the mouth, tongue, and jaw do not cooperate. After speech therapy, a clean diet, supplements for things he was deficient in, and acupuncture, he entered kindergarten apraxia free. He is now 15 and went on to have no other learning problems. Around Thanksgiving of last year, I was cleaning out my computer and I stumbled upon a document I created a decade ago with all my favorite blog posts I had written about my son’s journey with apraxia. I was fresh back from the Documenting Hope Conference and feeling extra inspired, so I made a split-second decision to touch up those blog posts, and I called my publishing partner to make the book magic happen. I titled the book “Voice of Truth: A Mother’s Journey to Help Her Son Heal from Apraxia of Speech.” It is named after the Casting Crowns song, “Voice of Truth,” which was one of my favorite anthems during that trial in my life. I still get teary when I hear it on the radio! Voice of Truth released in May of 2024 during Apraxia Awareness Month. It is available on Amazon in paperback and Kindle. This book is for parents of children diagnosed with apraxia or SLPs who want to learn more about holistic add-ons to therapy, or to simply dive deeper into a mom’s perspective. Reviews are always welcome as they help the Amazon algorithm know that my book is alive!