Say it Out Loud: Struggling with Childhood Speech Apraxia
The first few moments of my life were nearly my last. While my mother was in labor, my heart rate dropped rapidly and the doctor had to perform an emergency c-section to save my life. He found the umbilical cord wrapped tightly around my neck, cutting off the flow of oxygen to my brain. To the sound of a silent hospital room, my mother anxiously asked, “Why isn’t the baby crying?” After what must have felt like an eternity, my lungs finally filled with air, much to my parents’ relief.
Those few moments caused years of developmental delay. My primary challenge was verbal communication. In preschool, I was diagnosed with childhood apraxia of speech, a motor disorder in which the brain has difficulty coordinating the mouth’s muscles to make the correct sounds. Apraxia is a neurological disorder, not a speech impediment. It was torture to be constantly misunderstood and overlooked; no one but my parents took the time to understand what I was trying to say. Even my grandparents had difficulty at times, and they saw me nearly every week.
I struggled to develop fine motor skills. Things most children perfect over time never progressed for me, like coloring inside the lines or holding a pencil the right way. My mom, a former fifth-grade teacher, was acutely aware that this spanned beyond simple muscular development and started researching my symptoms and eventually sought help from a physical therapist. At my first evaluation, she was told to look closely at how I drew people. I drew all of my stick figures without arms; I subconsciously didn’t think that they were important since I had so little control over my own. In physical therapy, fun things like coloring and connecting the dots became chores that I failed to execute properly.
Activities requiring hand-eye coordination were exercises in constant embarrassment. I struggled with things like arts and crafts, and I grew used to being picked last in gym class. I never picked up long-term hobbies like other kids my age. It was too difficult to do things like play piano or throw a ball, and that was on top of struggling to simply have a conversation with other kids my age. I felt isolated from my peers and developed passive behaviors due to my lack of self-esteem. I will never truly know if my sweetness, empathy, and meekness are natural personality traits or were developed as a result of my struggles in those formative years. My dad tried to get me to be more assertive, noticing that I always gravitated towards the back whenever there was a line or crowd of other kids. I felt like an observer in my own life instead of someone in control.
The cycle of misunderstanding ostracization started again with each first day of school. My teachers couldn’t understand me and treated me like I was the stupid kid in class. Then, a few weeks into September, they would get back my standardized test results and tell my parents how pleasantly surprised they were with my exemplary scores. Their behavior towards me changed overnight, even when they couldn’t always understand what I was saying.
I was acutely aware that there was something wrong with me. I was called out of class multiple times each week to see the in-school speech therapist while everyone else enjoyed quiet reading time. Instead, I spent hours sitting in a room practicing making sounds again and again, never able to get it quite right. I blamed myself for being unable to annunciate because I didn’t know why I was the way I was, and I internalized a deep sense of shame about my perceived failure. Whenever a kid in my speech therapy class graduated, we had a party with cupcakes to celebrate their accomplishments. When I graduated, my dad told me that it wasn’t because I had perfect speech, but because they couldn’t do anything more to help me. What was supposed to be a celebration of my progress turned into another way for him to think of me as beyond repair.
To me, my words sounded clear and I couldn’t grasp why people couldn’t understand me. One day in third grade, I had an allergic reaction to some poison ivy and my mom had to come to pick me up. I remember walking from the nurse’s office to go get my backpack and running into my classmates lined up in the hallway. One of the kids asked me what I was doing and I said, “I’m going home.”
They looked at me funny. “You’re going bone?” they repeated back to me, half-mockingly.
“No,” I said, “I’m going home!”
They continued to stare. “What?”
After a few rounds of this I got so frustrated that I just threw up my hands and turned around to go get my things. That cycle of misunderstanding and bullying continued throughout my childhood.
Like most kids with childhood apraxia of speech, I started to grow out of it when I got to middle school. I joined the speech and theater club because some of my friends were doing it. Twelve-year-old me would have jumped off a bridge with them, and for someone with apraxia of speech, joining this club was on par with jumping off said bridge. I discovered that if I practiced and wrote my words in advance, I could speak clearly. When I wrote down my words, I could get them just right by editing them multiple times. I would speak with confidence after rehearsing my speeches and working out the parts where I struggled. I honed my debate skills and won several tournaments. I continued to push myself beyond my comfort zone. I was cast in a minor part in a school play, and later I spoke the clearest I ever had in my life, for my bat mitzvah speech. My family was so proud of me; they couldn’t believe they understood every word.
Still, not everything was perfect. In eighth grade, I helped write the school’s morning announcements for the other kids to read each morning and decided to try my hand at reading live on-camera after receiving encouragement from a teacher. Shortly after, I overheard the cool kids mocking me behind my back for the way I spoke. I wish I could say it didn’t affect me, but every preteen wants so badly to just be normal. Even my accomplishments were embarrassing to me because I didn’t want to be praised for doing what I felt I should have been able to do all along.
I struggled with depression as a teenager, after my mother’s untimely passing. While at my doctor’s office, a specialty wellness clinic focusing on teenage girls, I was given a psychological evaluation and it came back borderline depressed. My dad insisted it was situational depression, and therefore not as serious as “real” depression. Instead of seeing a therapist, he made me see a speech pathologist because he felt I wasn’t succeeding in communicating, and if I could just do that, everything would be better. Again, I felt deeply ashamed over something that I had no idea was not my fault. I was battling depression over the loss of my mother and struggling to make friends in the wake of a horrible trauma. The fact that I couldn’t communicate or really assert myself only pushed me further into despair and self-harm. I am eternally grateful for that speech pathologist who, instead of forcing me to practice speaking, served as a makeshift counselor and role model. She would listen to me each week and provided support that I need during those teenage years. Occasionally, my dad would comment on my lack of progress when it came to things like storytelling and talking on the phone, convinced that my vocal shortcomings were why I was unable to develop and maintain friendships. Most teenagers can’t relate to someone who battling depression after a traumatic event; I had a hard enough time processing my own feelings, so how could I expect someone else to?
Over a decade later, I was reading articles online and came across an article about Ronda Rousey, a professional wrestler, and her struggles with childhood apraxia of speech. It floored me to discover that she was unable to form an intelligible sentence for the first part of her life due to the exact same circumstances of my own birth: an injury from the umbilical cord wrapping around her neck. Could this be what caused me so much pain? I always knew about my close-call birth, but I had no idea that it could have caused all of the challenges I faced as a child. I immediately called my dad and told him what I had read. He brushed it off when I told him about apraxia. He said, “Yeah, well, that’s always what your mother thought it was.”
Years of heartache and shame disappeared in an instant, replaced by rage that I had blamed myself the entire time for something that was out of my control. I pressed him on it further, but he still seemed to put the blame on me for just not trying hard enough. As an adult, it didn’t matter anymore – I had the perspective I needed to come to terms with my struggles. While every parent just wants to do the right thing for their child, the narrative he had built up in his head about his passive and shy daughter was too powerful to see what was right in front of him the whole time: a tough and resilient woman. I developed emotional strength, conquered my apraxia, and triumphed. This was not something I failed at, this is a war I am winning.
I fight battles to this day stemming from childhood verbal apraxia. Skills that I never fully developed in childhood continue to impact my communication. I never picked up a knack for storytelling, but my writing skills developed much fuller than they would have otherwise since the written word was the strongest form of my voice for so long. I am unable to speak improvisationally, but I can publicly speak if I write each and every word of the speech in advance. I still struggle to assert myself, but I have always been able to stand up for others. I have to remind myself of the things I can do, instead of the things I cannot.