Archive for the ‘speech’ Category

Shhhhhh

Two days ago Elliot looked at me and put his little finger against his pursed lips and said, “Shhhhhhhhh.”

If your kid doesn’t have a speech delay, I can see how this would not seem like news. But for a word/sign/whatever to bust out of nowhere is kind of thrilling. It was clear as a bell! And, bizarrely, not anything I can recall any of us saying regularly much less trying to teach him.

He spent the next few hours shusshing all and sundry. And then… never did it again. Won’t do it.

He’s gaslighting me. (Yes, I am Ingrid Bergman in this scenario.)

A few months ago he spent a few hours calling me “Mamamama” (close enough). And never did it again.

He’s Charles Boyer, y’all.

Elliot does have a consistent and excellent roar. It’s multi-syllabic, contains lots of vowel combinations and changes in intonation. He uses it to indicate: dinosaurs, bears, dragons, all big cats, chameleons, lizards, spiders and the waitress we had last weekend with the huge, curly hair.

His speech therapist said today that his eye contact and response to his name is much better. He’s getting more comfortable with her. He’s also clearly getting more comfortable with the very kind therapy assistant because he was just full of “No” (verbal) and “Won’t” (implied) today. She was the picture of patience and did not put him upside down in a bucket, which was my inclination.

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At the Start

We were back at the language lab on Thursday. We had a chance to review the evaluation with his speech therapist. She stood firm on the “below first percentile” bit. Before I even got a chance to ask, she answered the only question that really matters to me right now. “I still consider us to be in the diagnostic phase.”

I didn’t know it until I heard it, but that was exactly what I wanted.

Of course I want to know WHY. WHAT IS THE PROBLEM?! More, though, I want to be sure Elliot is given a lot of careful consideration, rather than just run through a battery of tests and pasted with a label. There are general truths, and there is my individual kid. (Who can certainly communicate he hates the shower his father is giving him at the moment.)

I think this is the right time to get down where we are, before my memory of the details gets hazy and my horrendous sense of time starts me down the road of, “Wait, did he start talking before or after prom?”

I looked at his chart at the lab. It says he has the receptive language of a 9-month-old and expressive of a 6-month-old. This isn’t right. I can’t totally deny denial. And I appreciate being called out on it. But he is not that delayed. His therapist did agree that he was much more communicative that day, and that some of his results come from non-compliance with the test. Which were administered by strangers in a strange place. Non-compliance comes up quite a bit in little Elli’s reports. If there are any parents of highly compliant 18-month-old babies out there, please speak up. I would like to meet you and shake your hand. I also might let the air out of your tires. But in a really admiring way.

So, eye contact was much better. I was glad to hear that, as I’d spent a good part of Wednesday staring him down like a snake charmer. Trying to gauge, you know.

I know he knows his name. Whether he will always answer to it or not is different. I guess we will have to measure that with the “Is Your Baby Being a Jerk?” test.

A few outlying details I want to capture:
— Elliot has some minor sensory issues. They all relate to his feet. He’ll eat anything. He’ll stick his hands in anything. He did not, however, like walking on a soft-surface playground that undulated a little bit. Moreso he did not like walking on a highly polished marble floor in a hotel we visited. The biggest reaction, though, was to sand. He could not tolerate on toe touching one grain of sand on the beach.
— He’s lost a few words. Overall his vocabulary is slowly growing, but he stopped saying “woof woof” when he saw a dog. That has reemerged recently. He said “boon” for balloon for at least a week around his birthday, and then stopped saying it. The therapist got him to say “boon” once on Thursday, which caused me to furiously whack Damon on the leg in excitement.
— As far as he can be tested (He’s non-compliant, you know) his hearing is fine. The pediatric ENT wants to measure a few more tones when he’s around two. But what we can know at this point is all coming up fine.
— He uses “look!” compulsively. It was his first word, learned after a week of “Look! Fireworks! Look! Mickey Mouse!” at Disney World. We were so charmed. Little did we know how often we’d get to hear it. He says it 100 times a day. You can hear it in the last video I posted of him. It’s super cute and strange.

Elliot is super cute and strange. Like every other parent of a kid with an “issue,” I don’t want that issue to define him. What I’m writing about makes up such a fractional part of his existence. I’m part of the problem.

And yet, soon I want to write about the most common causes of speech delays and my thoughts on whether any of those things are what we’re facing. Maybe we can start a pool!

I also want to synthesize all the fantastic advice and support that has come in via the link from my friend Katie. She is, as always, using her powers for good. Our good in this case. Her kindness and yours are so appreciated.

Speech Therapy Evaluation

We took a family walk after dinner. Alden lit our way through the twilight with his flashlight. Occassionally I would feel a stab of anxiety and think, “What is that?”

“He exhibited minimal eye contact and did not consistently respond to his name.”

Our neighbor has a new puppy. She was kind enough to suggest we’d be doing the puppy a favor if we let her meet the boys. Delight all around.

“Elliot frequently did not respond.”

Back at home we watched Little Einsteins and raced toy cars. The boys laughed and laughed. So did I, except for when my stomach would suddenly drop a little bit.

“Results of the REEL indicated receptive language at the 2nd percentile with a descriptive rating of poor and expressive language below the 1st percentile with a descriptive rating of very poor.”

Damon and Elliot were just getting started on building a train track when I took Alden down for bed.

“In the initial session, he frequently said ‘look’ but without meaningful intent. He also said ‘ba’ for ball… No other vocalizations or verbalizations were noted during the session.”

Looking back on our walk I realize that Elliot did not make a single sound the whole time.

I dreamed last night that I was watching my boys from the top of a high hill. They ran into the street and I was yelling for someone to get them. No one did, but they still crossed safely to the other side.

Therapy

Elliot’s first speech therapy session was enlightening. Remember when I said I don’t know what he’s supposed to be doing now? Yeah. Lots more than he is. It was the first time I had that moment (that I absolutely knew was coming) of distress and pity for my sweet baby. The two therapists (one a student) showed a real gift for working with little kids. I watched him cheerfully, happily totally fail to understand what they were asking of him. That was hard.

No one can tell me why Elliot’s speech isn’t developing as it should. I don’t even speculate.

Right now he is cocooned in our family. He doesn’t pay any price for his delays. I’m counting on Team Elliot to get his chatter in order before he has any idea there was ever a problem.  There are now four professionals working on this one 30-pound baby. While I don’t care to speculate on the grown-ups’ weight, I have to think that’s a winning ratio.

65%? 70%?

We met Elliot’s lovely home teacher — J — last week. Elli did that thing, you know the one, where your kid makes you look silly and over-reactive. Not just me, right? In fact, he ran around the room saying “Look!” and “Ball!” of course, but also “Hat! Woof woof! Uh oh! Ock! (sock) Uck! (stuck)” So, yeah, he suddenly says many more words than he did during his evaluation. That makes me happy. It also makes me look a little like a developmental Munchausen case. He will also point to eight different body parts (eight more than he did a month ago) and accurately identify various family members when asked. Also new. Best of all, when I say, “Where are your curls, Elliot?” he will run his fingers through his hair.

Rationally, I know he’s doing this all late. And there’s probably something else he should be doing now that he’s not. I just don’t know what that is. I guess I could, I don’t know, do some research. On the internet and all. I seem to have time to update Foursquare, so surely I could do that. His first speech therapy is today. I plan to have him recite the Gettysburg Address and then do the full 7-minute version of Rappers’ Delight.

Seriously though, internet research on your child’s developmental delays: That way madness lies. Who hasn’t started looking for help with a rattly cough and ended bidding tearful goodbyes to friends and family? I’ll dig through the hysterical fear-mongering if I have to, but I’m not there yet.

I don’t know what to think about our little Elli. Other than I like him so much. I’m sure he will reveal himself to us in time.

One on hand, he likes to wear baskets on his head. (Hat! Hat!)

On the other hand, he understands how the milkshake maker works.

I’m pretty sure the basket thing is hereditary, anyway.

60%

A very kind developmental specialist came to our house last Thursday. She brought tennis balls! And blocks! And she was very popular with Elliot. He flirted and giggled, really putting his best baby foot forward. She was a little bit of  a tease, what with all the putting the ball under the cup, but Elli was able to get past it.

I told her about the things most concerning to me. He has a few words he used to say, and now doesn’t. He will no longer tell me what the damn dog says, even though he used to do it unprompted regularly. Occasionally he sounds like he has something in his mouth. He doesn’t have many words. He doesn’t do many consonants. He’s not much of a babbler. I felt like every sentence I said started with “He doesn’t…”

All that said, when she called to say he’d scored 40% behind on communication skills it rocked me back a little bit. We’re a family of communicators. We will communicate the stuffing out of you. If she’d told me he is 40% behind on parallel parking or swimming in a straight line skills I could make a very strong nature AND nurture argument for shrugging my shoulders and saying, “What can you expect?”

Still, as the world is a funny place, 40% behind is better than 20% behind. 40% qualifies him for early intervention services. 20% qualifies him for “Sorry about your luck!” I did share with the evaluator that my greatest fear was not having a problem I suspected confirmed but that he’d be one of those kids who loses out on help because his problems aren’t quite bad enough. We were prepared to go it alone through private speech therapy or whatever else he needs, but in a situation like this there is no way we can recreate the comprehensive nature of being embraced by “the system.”

By the way, I think I need to probe with them if Elliot’s issues can be fully explained as a communication deficit. I don’t think he’s not saying “woof woof” anymore because he physically can’t. I don’t know why. Maybe he’s messing with me.

Our case worker (or whatever you might call that person who will  coordinate our efforts) will come back on Valentine’s Day to create a plan. I think it’s a baby version of the IEP (individual education plan) that older kids get. I’m looking forward to seeing her, both because I’m eager to continue to unravel the mystery and because I enjoy any reason to talk about my kid unreservedly without worrying about social niceties that require I let it go already (Oh hey, blog readers!).

Here’s why I’m still not losing sleep over this: With the exception of some teething rage, Elliot is a perfectly cheerful little guy. I know that learning deficits have the potential to some day make him miserable. But for now they’re not. So we’re going to regard our development glass as half full. It’s more than half full. It’s 60% full.

On an unrelated note, I’m leaving in 45 minutes to get sinus surgery. It all happened so fast. Last week I went in for an allergist appointment. Cat scans happened. A doctor said, “You have the biggest turbinates I’ve ever seen.” (Go me!) and then they were booking the surgical suite. I’ve never had general anesthesia before. I like to micromanage my doctors in process, remind them that I’m there and a person and all that. So I’m probably a little more nervous than I’m letting on. I’ve heard everything from, “You’ll be up and about in a day or so.” to “You’re going to need to go on short-term disability.” We’ll know the truth shortly.

 

 

Elliot Days

Sometimes my husband teases me that I favor Alden. Not because it’s true, but because it makes me swat him and he thinks that’s funny. It’s natural, I suppose, for me to talk more about Alden since he… talks. He’s funny. Elliot’s funny too, but much more in a “you had to be there” sort of way since he’s not yet really verbal.

Speaking of. Elliot is 16  months old now, and still not saying much. I know. Everyone knows at least one kid who didn’t speak until he was four and went on to be an Oxford scholar or a Disney Mouseketeer or insert-whatever-impressive-outcome-here. I swear I’m not actively worrying. But. At his one-year checkup the doctor said, “His language development (receptive primarily) isn’t quite there. Let’s keep an eye on it.” Then at the 15-month checkup he said that and then he said, “Do you have a history of learning disabilities or speech impairments in your family?” He still feels comfortable taking a wait-and-see approach. But knowing the value of early interventions, I’m done waiting and am more into seeing.

A very nice woman from the early intervention services for our state came and did a preliminary evaluation at our house. I’m amazed at how easy that was to make happen. After a little flailing around trying to figure out who to call, the whole thing just rolled. I didn’t need a doctor referral. All I needed was my own opinion. Nice, that trusting the mom bit.

She concurred that Elliot isn’t where he should be both in speech and receptive language, so now someone else is coming out to do a more in-depth analysis. It may well turn out his problem is too mild to qualify for services, but I’ve been reassured that if that’s the case I will be directed to other resources that can help close the gap.

The problem itself is odd. The best way I can describe it is that he doesn’t do nouns. Weird, I know. But if I tell him to “Kiss Daddy” he will kiss… whoever is closest. His few words are all verbs and exclamations. “Look! Up!” There are a few other oddities. He used to say “Boon” for balloon, but doesn’t anymore. He sometimes sounds a little like there’s something in his mouth, but when I go fishing I find it’s empty. He’s never said “Mama.” Jerk.

He is making progress. “Ball” is a new entrant to the vocab and I think he sees enough of those that it will stick. Balloons can be a little thin on the ground, after all. Also, in the course of one day he suddenly picked up the ability to point to four different body parts after looking mystified about the location of his nose during many months of daily prodding. He’s also, and always has been, very attached and affectionate. And he’s generally happy. I feel like I can stay pretty sanguine as long as he’s happy.

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