Oral apraxia involves the muscles of the mouth. A person with oral apraxia can produce normal movements reflexively or during everyday activities, but cannot imitate or perform these same movements when asked. The difficulty may range from mild awkwardness and hesitation to complete absence of voluntary movement. For example, the person may be able to smile in response to something funny but unable to smile for the camera when asked or able to open the mouth during a yawn, and unable to do so for the doctor.
Alanna continues to make gains in speech production, but it is oh so very, very slow. She may learn a sound, or a combination of sounds, but then can't switch between the sounds or put them together in a new way. Sometimes words are generally reproducible but other words she can't always say when asked.
Welcome to apraxia, autism's happy cousin that makes speech very difficult and in some cases impossible.
The most frustrating thing is that once a child with autism is motivated enough to speak, they still can't because the words don't come easily. When the words don't come, it frustrates the child even more, making them less motivated to speak.
I am resigning myself to the fact that at least for the forseeable future, Alanna will have to rely mostly on augmentative communication to be able to "talk". She is fluent in PECS but it is time to move on to a voice output system, and that is likely to be the iPad with Proloque2Go.
I am sad because I feel like I am giving up, but also happy in that I know she will make some great gains in expressive communication with a system designed for it (trying to have a conversation with PECS is, at best, tedious).