Archive for the ‘speech’ Category

The Graduate

Elliot got the boot. Was told to hit the road. Don’t let the door hit you on the heinie, little guy.

He’s officially an early intervention graduate today.

Eight months ago my nearly-speechless baby would head butt me for attention. He still head butts me, but at the same time he will yell, “I bonk you, Mommy!” So, progress.

He also says things like, “Alden take my rocket ship!” and “I shoo the kitties. Shoo shoo kitties!!” and “I bite you nose? I bite you nose!!!”

Now that he can talk, he likes to narrate.

— I look at that race car, Mommy?

— I take it?

— I vroom it?

— I frow it?

He’s going to do those things no matter what I say, but he enjoys the Q&A.

We get so much joy hearing all the crazy things that have been swimming around in his brain. Now that the impediment has cracked open, it spills out all day every day. He called me at work the other day to tell me there are “zhombies in the dollhouse.”

His sensory issues faded to almost nothing over the time we were focusing on his speech. Sandy feet was a reason for a meltdown a year ago. Now, total non-event.

He still has some oddities that I expect to unfold and change, maybe coming on stronger and maybe fading away. Some of them, like military-precision toy aligning, feel comfortable to me because I know I did the same thing when I was a kid. His speech therapist offered to re-evaluate him in a few months to make sure he isn’t stalling or slipping. I’m going to take her up on that. The University of Tennessee speech therapy lab has been a wonderful resource for us.

Speaking of, Tennessee Early Intervention Services was the source of all this important assistance for our family. It’s free and all Tennessee families are eligible regardless of insurance or income. I had a heck of a time finding them, though, so let’s let Google help them help people.

For speech delay evaluation, speech therapy, developmental delays, motor skill delays, early intervention, cognitive delays, communication delays and adaptive delays, you can contact Tennessee Early Intervention Services (TEIS) at 1-800-852-7157

More information on eligibility can be found here.

 

 

Late Talker

Nearly six months ago, our speech therapist gave Elliot a hard-to-read evaluation. She tells me now that they felt fairly sure he was autistic, but wouldn’t have said that to us then. This whole time she refused to offer us any diagnosis, saying it is too early and he’s too young. Oh how I wanted a diagnosis. I wanted specificity so that I could customize our response, work up a battle plan, research resources. I asked her if she thought it might be apraxia. “Maybe,” was all she would say. In the meantime, we treated the symptoms without knowing the source. She was right, of course. Even at the time I acknowledged it, and I definitely didn’t want to get the “wrong” label and wind up going down an unhelpful road. It wouldn’t have been good for us or for Elliot had we heard, “There’s a good chance he’s autistic” at the outset.

Now after another battery of tests we have our official answer. Late talker.

Elliot’s speech appeared. And then it surged. Now, at just past two, he tells (terrible) knock knock jokes.

He tore through the tests (when he felt like it), and wound up at a much higher age level. I’m not going to invest in this idea that he’s now advanced, any more than I believed that he was in the first percentile half a year ago. He was behind, now he’s ahead. He’s always been fine.

I’m so grateful. Even it it’s the case that he never needed such intensive (or any) intervention. We’ll never know and that’s fine. A small group of talented, compassionate adults stepped right into our lives and got to work for no other reason than a baby needed some help. I feel like every person involved likes and cares about Elliot and our family. We don’t pay a penny for any of it. I know our tax dollars do, but since when does being the recipient of social services guarantee you any kind of respect or compassion?

He says a lot with his eyes.

There’s an interesting little something with Elliot and the way he communicates with and perceives the world. He still has a little sensory strangeness. Just a few weeks ago he refused to walk on a floor of highly-polished marble. He still doesn’t like sand on his feet, but he’s graduated from screaming to complaining. He lines up his toys by type and color. He loves toy stores because there he can line up the exact same toy, snaking them through the aisle until the supply runs out. He’s a quirky boy.

In our intake interview last March the woman asked us how Elliot’s delays were affecting his life. I told her honestly they were not. Her question, though, gave me clarity on exactly what I was looking for. It was help for Elliot before he was affected. I didn’t want him to get to preschool — a year and a half away — and struggle to communicate. He’s so cheerful and sweet, and I will go to some pretty great lengths to protect those qualities in him. Some day I’ll expect him to be resilient enough to maintain in the face of adversity, but maybe we could let him get out of diapers first.

I’ll keep watching, but soon I expect this period will fade from the front of our minds. We’ve agreed that Elliot’s therapy will stop at the end of this semester, in three weeks. We’ll let his in-home teacher go at the same time. I love them, but it isn’t right for us to insist on holding onto scarce services when someone else could be using them.

I’m so glad we did it. I’m so glad we’re finished.

Speech Therapy, Twice Weekly

I’ve asked myself, considering, if we really need to be going to speech therapy two times a week. It takes a hunk out of my work week, forcing me to work more at night to catch up. We schedule appointments pretty early to minimize the impact on my schedule, but that means we have to haul Elliot (and sometimes Alden) up and out. It’s kind of a long drive, in the opposite direction of my office. Our in-home teacher comes once a week, sometimes upsetting the nap apple cart and leaving us with a cranky baby for the rest of the evening. Elliot’s on track developmentally, which is what I’ve said I want all along. So why will we keep going?

This is why.

Good now doesn’t mean good always. I don’t feel ready to let go of the help. I hope I’ll know when, but I’m sure it’s not now.

Elliot In Speech Therapy

 

 

Chatterbox

Imagine that I am whispering. If it wouldn’t be annoying I would type this in a teeny font.

Elliot is talking.

Actually, let me say this… ELLIOT IS TALKING! That’s right, I went all caps lock.

Still, I am afraid of saying too much too soon. If you can think of anyone for whom hubris worked out be sure to let me know.

For so long it was a whole lot of not much. Then suddenly it was “school bus” and “walrus” and “palm tree.” It was as if he got his teeth into a simple sentence or two and was thrilled by the effects of his communication. Now he can identify all the letters in the alphabet and the sounds they make. Now he can say the names of all the Pixar Cars.

His speech therapist told me how worried they were when they met him. She felt he was likely autistic. He scored below the first percentile on expressive language. I didn’t even know that was possible. I spent weeks researching. A guy on a plane told me about a special school in Atlanta, just for boys with language problems. I took notes.

Now, I don’t know what to think. His speech is still hard to understand. His therapist wants to keep him. It’s obviously helping and he loves going. That’s an easy decision.

She says the average 2-year-old has about 200 words. Elliot has more than that now. Can you believe it? Because I cannot. I swear they all came in a rush… 5, 10, 15 new words a day.

All I’ve wanted is for him to catch up to where he should be. I know that some people (who love us and are awesome) will celebrate that he appears to be “normal” now. I think it’s too soon to draw conclusions. And Elliot has always been as normal as he needs to be. I’m not any happier with him now. But happy for him? My heart sings.

A New Developmental Phase

A few weeks ago I reported that Elliot broke new and important ground.

“Mama” rode in on a wave of words. We’ve left behind parsing every syllable: “Was that ‘mmm’ for moo? I think he’s trying to say moo! We just drove past some cows. Seriously, I think he’s trying to say ‘Moo’!.” Now it’s more like: “Did I tell you he’s saying hippo? Well, hubbo anyway. He started a few days ago. Show him a Sandra Boynton book and he’ll do it. Super cute.”

Less, exciting, but still a relief.

I suppose I expected that when I told his therapist about this change she would proclaim him “normal.” I even fretted a little bit that he wouldn’t continue to qualify for services.

You parents who have been there may be thinking, “Oh dude, you are so kidding yourself.” Or maybe just, “I remember that.”

It’s a new phase, not for Elliot but for me. Denial and unrealistic expectations. I was hoping, perhaps all along, to be rewarded for my ready acceptance and can-do attitude by a complete reprieve within just months of our first diagnostic appointment.

I burbled out all my news about Elliot’s progress. After just a moment of happy response his therapist moved right into how quickly we could get him up to two appointments a week. Have you ever blurted out, “I think we should get married!” right as your beloved said, “We need to spend some time apart.” I have not (Thank you Baby Jesus.) but that’s about how far apart we were. I was disoriented, and it took a few minutes for my brain to catch up with my mouth.

I understand now (or rather I admit the possibility to myself) that Elliot isn’t going to progess in a linear way until he rings a bell and gets his pass to Normal Talker Town. Or maybe he will. I guess I can continue to admit that possibility too. I might also suffer some reversals, mis-perceive the process, throw out my gratitude for all our excellent help and instead stamp my feet about how we never wanted it in the first place

Causes of Speech Delay

Good session with the speech therapist today. We spent a little time on the “Why” of it all. The bad news is that she can’t tell me instantly and comprehensively what the problem is, and then fix it five minutes later. Your tax dollars NOT at work, people.

The good news is that she didn’t tell me after the first few session that she was pretty sure he was autistic. She told me that today, and that as she’s gotten to know him her feeling has changed. Autism isn’t the end of the world, and of course we would deal. But that’s a loaded word, and I’m grateful she didn’t make me deal with it at the same time I was digesting the fact that my baby needs intervention on the scale of 3x a week.

He’s getting great help. I love his speech therapist, in particular. Whatever the problem is, he’s making progress. But eventually we’re going to have to decide what the cause of the delay is, as his ongoing treatment will need to be more customized as he gets older.

While Elliot’s therapist is only available to me a few hours a week, Dr. Google is on call 24/7. I’ve been doing a lot of research. I’ve also gotten lots of great comments and notes from wise mothers and therapists (thank you so, so much!) with valuable information.

The most common causes of speech delays (combined info from multiple sources) and my take on whether that’s what we’re living with.

    Mental Retardation/Intellectual Disability

Marked by delays in language, auditory comprehension and gestures. He definitely has language delays. He tested poorly on comprehension, but I think there was a lot of “won’t” in that “can’t.” It’s my feeling that he understands us most of the time, inclusive of times when I’m talking about something conceptual or referring to something not visible. He’s a gesturing fool. If this is the reason, it’s a mild case. I think it’s unlikely.

    Hearing Loss

He passed his hearing tests as well as a baby his age can. They won’t be able to test him in more detail for about a year. We’ve already got our apointment set with the pediatric ENT for that time. If he has hearing loss, it’s mild. He can clearly hear. Theoretically possible there’s a distortion issue, but I doubt it.

    Maturation Delay

This is when the central neurologic process required to produce speech matures late. Most common in boys, and often runs in families. We’ve got no family history of this, but last time I checked he IS a boy. Certainly possible. This is my favorite option.

    Expressive Language Disorder/Apraxia

I think these are two different things, but I haven’t been able to tease them apart. ELD seems so widely defined that I feel like apraxia can fit in there. Someone smarter than I am will have to explain it to me. The hallmark here is that children have normal intelligence and hearing, but a brain disfunction makes it difficult to translate ideas into speech. When I asked about it today, his therapist said apraxia is definitely a possibility. He does not, however, show a physical groping for words with his mouth that is apparently common with apraxia. That’s one strike against, but not enough to put this in the unlikely camp. These kids are more likely to deal with things like dyslexia when they’re older. Entirely possible.

    Receptive Aphasia/Auditory Processing Disorder

This a receptive (no kidding) language issue. The desriptions I’ve read of aphasia sound too severe to fit. In general, he understands us. I don’t think this is it.

    Autism

The many variants and severities of autism would require me to write a book. I know autism can have a late onset, and it’s possible that we’ll see more as he grows that takes us back to this path. But if he’s autistic, it’s not profound. (I have heard about severe, profound late-onset autism, but I’m going to call that a unicorn for now and leave it alone.) He doesn’t display unusually repetitive behaviors or express extreme focus on things or actions. He’s very attached, demonstrates eye contact, responds to his name, etc. He is slow to warm up with strangers, which is why he set off alarm bells by refusing to demonstrate those things in his initial evaluations. So, he’s still in the common diagnosis window (up to 36 months) but I don’t think this is it.

I’ve left off my list other common causes of speech delays that I know are not possible. Those include cerebral palsy, selective mutism, psychosocial deprivation, bilingualism, structural problems and prematurity.

I also read about something called Einstein Syndrome. Aside from the fact that it seems to have been made up by some dude with a book to sell, I think this is an excellent option for us to consider. Or at least for me to contemplate along with my fantasies about finding out that I am Oprah Winfrey’s lost half sister.

Milestone

Who gets to go to Dollywood?

Elliot In the Piggy Parade

Elliot In the Piggy Parade

Babies who say “Mama” get to go to Dollywood!