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My youngest daughter was diagnosed with Childhood Apraxia of Speech a little after she turned 2.
This is a neurological disorder, it is kind of the same thing that happens to dementia patients. It is the inability to make your jaw, tongue, lips all do the correct things for the correct sounds-at the same time.
It is not that she does not understand.
She would say the same thing 6 different ways, So it was very difficult to even distinguish a pattern.
We use the Kaufman approach, she has a OT (Occupational therapist) and a speech pathologist. She is currently in her 2nd year at a AMAZING public special needs preschool in our school district. She has improved leaps and bounds and even though we still struggle daily I am extremely grateful for the progress.