When I was told that I would have to drive nearly an hour south of my house to have Bubbles' speech assessment (for Apraxia testing) done, my response was that it was just fine; I didn't mind driving to San Francisco (1.5 hours north),
as long as the person was qualified.
Our regional center (which is a fabulous superlative among other regional centers) (in other words, I implicitly trust them) assured me that they had contracted with a speech pathologist who had over 25 years of experience. No worries, right?
I was a little surprised, after I wound myself up a redwood lined road, to be introduced (by speech pathologist A, the person with whom the appointment was made) to another woman with a small bag of toys and a large stack of paper, and we were led down a short trail to a yurt complex. This is where the assessment was to be conducted.
Okay, I guess this is totally fine - I don't need conventional! I just need someone experienced! Plus, I am all about the mountain life, so I just decided that we were lucky to have testing done in such a beautiful setting.
Then, speech pathologist A told speech pathologist B (woman with bag) that she would leave us to do her thing.
(uhhhh.....huh?)
Her 'thing' turned out to be 'The Assessment'.
(what???)
Well, I didn't expect this but then again, perhaps it would be all just fine. And she seemed very nice, anyway, so what was I worried about? Just chill out and stop talking fast, I told myself as I tried to give her the quick rundown on Bubbles' particular articulation deficits.
She put her toys on the floor, giving him immediate access to what I thought were to be used as tools in the testing. I had a brief 'what is she thinking?' moment, but took a deep breath and smiled. We would be fine. Bubbles quickly examined the meager assortment of toys and then started to put them back in her bag. He was done.
"Nnn wan paeee!" (don't want to play) He exclaimed, shaking his head vigorously and pulling me towards the door. "Wan go go
now!" (these toys are stupid and I am leaving)
"HAHAHA!" I shouted, way too cheerfully, "WE ARE GOING TO PLAY!! PLAY AND HAVE FUN!! FUN FUN!!"
He looked at me dubiously (I swear he did) and said, "I. WAN. GO."
She said, "Hey Bubs! We're gonna have FUN! Come over here and play with me!"
He wasn't convinced but he gamely sat down, patting the floor next to him for me to join him, which I did.
She hauled out a very thick packet of paper which turned out to be The Test.
She said, "Okay, Bubbles! I am going to say a word and then I want you to repeat it after me.
(???)
(seriously)
(if you needed some explanation? Extremely and unnecessarily long instruction for a two year old being assessed for language deficits.)
I said, "I'm not sure he will be able to understand your instructions."
(BIG SMILE!)
She said, "Bubbles, I will say a word and then you say it after me."
(oh!)(simplified!)
Bubbles began to put her toys back in the bag
again, as a not-so-subtle message to her that she could leave. Right away, please.
She vascilated between practiced happy tolerance and visible frustration as she continued to present a word to my son and ask him to 'repeat it after she said it'.
Bubbles attempted a few models and then again went for the door.
"I go go go."
"I think you need to simplify the instruction. Can you say the word and then tell him,'
Your turn'?"
She tried saying the instruction this way and he started to comply without too much thought given to protest. Because he has been coached for months through ABA to respond to simple instructions.
After a few more repetitions, he again went to the door.
"I wan go go!"
She said, "We may not be able to get through this today if he can't follow instructions."
(WTF???)
I looked at the giant packet in front of her - the packet we were expected to complete with her - and said, "He's used to ABA -based speech therapy. He works well for motivators."
She replied, "Oh, I didn't bring anything with me."
I looked at the small pile of discarded toys in front of her.
"Let me run up to my car and see if I can find something to use - I have milk and that will help!"
I told Bubbles I would be right back, and he understandably began to protest being left there.
"Bubbles. I will go to the car and get milk. And a lollipop. Then I will come right back here and play with you."
He sat back down on the floor with this stranger and was compliant.
I wandered up to the car and spotted speech therapist A (the one with whom the appointment had been made) chatting on her deck with someone. I was still mighty confused about the whole scenario, and retrieved the milk and lollipop and a fruit leather from the car.
When I walked back down to the yurt, Bubbles was working well with speech therapist B so I hovered outside the screened door and waited for him to have another attention break.
He continued to comply with the testing and the wordy instructions; I was so proud of him as I watched. He
is two! He was being so good for this person he didn't know, just for the sake of being good!
Eventually though, even his good nature wore thin and there was still a giant stack of papers to get through.
When I came back in, she said, "Well he definitely qualifies!"
I asked, "For Apraxia?" (really? this quickly into the test? wow!)
She raised her eyebrows, "I don't know that yet. He qualifies for services, though - he definitely has a delay."
::blink blink::
::repeat::
"Well we know that! He has been getting ABA-based speech therapy for nine months!"
At this point I realized she knew nothing about him. She hardly knew why she was there testing him; she thought it was to see if he qualified for any speech therapy at all, and was unsure why she was asked to perform the test for Apraxia on him.
She did, however, hear the 'ABA-based therapy', and after that I could tell she spent the next ten minutes trying to assess whether or not she thought he was on the spectrum.
Suddenly, the questions shifted.
"Is his eye contact usually better than this?"
"Why is he getting ABA instead of traditional methods?"
Once she was satisfied with my traditional 'yes he
has already been assessed and yes we are pretty damn sure he is not autistic, and by the way, ABA doesn't always suggest autism' explanation, the testing resumed.
I broke out the milk, and would offer him one sip of milk for each word he would say, which was...painstaking. He isn't used to having me as his ECI/speech therapist/ABA instructor; and, while I practice regular ABA with him throughout the day, he could see this was a set-up. Speech therapist B (STB)would get visibly frustrated each time he (loudly) protested, but I held true to the principle and made him follow through to receive his motivator. The motivators were at first, the milk and lollipop (one lick at a time, though when he got sick of me taking it away from him and took a big chomp out of it, he was sternly chastised by STB because now that he had something in his mouth, she couldn't ask him to repeat a word. I confess, I suppressed a giggle.), but he soon tired of those, so we moved on to whatever else caught his interest in the
room yurt.
The fan? Okay, after you
have a turn (say two words) you can press the button on the fan.
The pillows? Okay, after you have a turn (say two more words), you may jump on the pillows.
The pile of yoga mats? Okay, after you have a turn (say two more words again!), you may knock over the pile of mats.
This went on and on - the pages kept turning, the questions kept coming, and my son continued to be allowed to bounce his way around the yurt in carefully measured doses and
try to escape endure it.
In between his bursts around the room, STB asked me questions about his history and language development.
One of the questions went something like this, "Does Bubbles understand a two-part instruction?"
And I thought, 'Observation skills, much? OMG were you in the room with me for the past two hours when I was telling him that he would have to do A to get B?'
I did
not say that out loud.
Another question asked if Bubbles could understand concepts and reasoning - I pointed out that he had stopped crying about me leaving him in the yurt (with a stranger) earlier when I told him I was going to the car and would be back with treats.
When I asked her a few questions, they went like this:
Q: "So, do you work with children much?"
A: "I work in a nursing home. I work with stroke-onset Apraxia victims."
Q: "Have you done many of these tests with the outcome of Apraxia?"
A: "I've never done this test on a child before!"
When I came out of my shock-induced coma, I thanked her for her (two hours! of) time and gathered up Bubbles, who by this time had charmed STB by showing her around the garden he had just discovered. He hugged her goodbye and said, "Enk-thu (thank-you)."
And we wound back down their mountain to recover from the ordeal and drive back up our mountain.
And because
Squid is always good at making my brains
think, I asked myself this at the end of the day:
Was it a bad experience because we were expecting someone more qualified and the assessment may have to be re-done and it was a rather painful two hours the first time around?Or,
Was it a good experience because the ABA skills which I have been working so hard to learn and incorporate for Bubbles' ultimate progress proved to be resourceful and successful in getting Bubbles through a test which was not performed in a developmentally appropriate manner?
Top layer: fruit leather strips, pretzel thins, and bacon.
Seaweed rice cake, 1/2 sour pickle, granola bar, pocky, baby star noodle snack, dried snappeas, cottage cheese, salami and crackers.
TJ's cheesey puffs, caramel cookie, pear, PB&J, Judy's breadstick and brie cheese rounds, raspberries.
