Tuesday, October 28, 2008

My Boy Talk Pretty Some Day

On Friday, just one week after I was tearfully explaining that my child did not belong in a special ed classroom, I took my son to the school district recommended SLP (speech & language pathologist, or 'person', because my vocabulary does not prefer the word 'pathologist') for a school district recommended assessment. Yes, another assessment. Apparently, when the transition from early intervention to school district occurs, the school district has to hire their own person to assess the child, even if the last assessment was just one month ago.
This person (the new SLP) had met Bubbles for less than thirty minutes when she declared that she suspected he was 'quite bright'.
(I grinned; we have 'suspected' the same thing, but that pesky little language bias creates doubt!)
She did a receptive language test on him and he did not stop answering (pointing, but he would add the word if he knew how to say it) until they reached close to a four year old level. I was beaming; it was the first test performed with him (since the school district got involved) that was actually age appropriate and not expressive language biased.
The SLP seemed rather excited herself; she explained that his apraxia was so evident through his oral motor deficits, and that currently it was physically impossible for him to coordinate his language, but that for him it was completely fixable! Because his cognitive ability does not appear to be compromised, it really is an issue of exercising, learning, and therapy. She believes that he might even talk pretty one day! She actually believes that he will; I am reservedly skeptical.
We have never heard any prognosis for children like our little guy, other than 'With the right therapy and hard work, you do the best and hope for the best! Some kids become verbal communicators'.

OMG really? That was the best we could hope for? Vagueness?
What is the right therapy?
Hard work? If he can't work hard then we give up?
Hope is the only thing you can tell me?
The best? That seems rather relative.

Actually, I have to say I have been rather calm-ish with the actual diagnosis, if not with the anxiety of transitioning to the school district and our first IEP. The diagnosis has been a bit mysterious, but we are sure that it is not fatal, and therefore in Gwendomama's world of relativity: Not that bad.
See? The bar was low for this boy.
Just survive, and we'll give you the world!
Luckily he does not ask for the world. Just a steady supply of nitrite-free bacon.

So, to recap: She thinks he can get better and learn himself to talk real good.

Shorter recap: My new guru.

She explained that he could not form certain sounds because of his oral motor deficits. She said she guessed he only ate a few select foods. "OMG!" I said, "HOW DID YOU KNOW?"
We had worried that his refusal of foods was a sensory issue, but that theory never panned out with other sensory issues. Apparently, Bubbles has been eating the foods which are safe enough for him to chew and swallow. His swallow is fine, but his tongue coordination is underdeveloped or non-existent (lateral motion). She watched him eat a lollipop, and holycow did I feel stupid when she pointed out something I always thought was a little strange, but apparently I get used to strange things easily: He stuck out his tongue and moved the lollipop over and across his tongue to lick it. There was not one effort on the part of his tongue as a tool. He can't do it.

To paraphrase the guru: Basically, Bubbles' oral-motor deficits, combined with his apraxia-based muscle incoordination severely hinder his ability to execute the oral-motor movements necessary for speech production. Children with apraxia learn to speak in much the same way as a person would learn a second language (which absolutely supports our argument to keep him in his typical preschool).

She was impressed with his cognitive ability, and he was incredibly charming as well. She seemed impressed with his ability to focus and work (play-incentive-based)I pointed out how nicely he cleaned up a mess he made and complied with most instruction. Because of ABA, my child will be able to work with this person in the most productive fashion; his attention span and focus are rare to be found in your average three year old.

She agreed with the moderate to severe (more on the severe end) of apraxia diagnosis, and claims that this is an area of her expertise and interest. She did wonder, however, why one area of his speech and babbling was so incongruous with a typical apraxic child: He is able to use complicated rhythm and syntax in his play language, while most children with apraxia apparently sound more robotic. I said that sometimes he would be playing and babbling animatedly and then he would stop and turn to me to say something like, "I. Wan. Joos. Pees." in a somewhat robotic voice.
"No," she said, "He really has highly developed inflection and emotion in his babbling. It had to be compensated for in some way....Hmmmm....does he really like music?"
(the ZOMG fairy had covered the room in ZOMG fairy dust)
"Does he?" I sputtered, "ZOMG he is very musical! He loves music! He has been to probably 100 music classes with me too, because I am a music teacher!"
"Ahhhh," she said, "That explains it."


Last week, Bubbles gave us a glimpse of what he knows. At some point over the last month, it all started to fall into place for him - he started to ask questions, narrate, parrot, try new sounds. He will even attempt a three syllable word, as long as the first two syllables are 'firetruck'. Over the weekend, the clouds parted, and language poured forth, streaming into my child and our lives.
Just a sampling:

Where did Daddy go? Daddy, where did you go?

(To Supergirl's friend) Hey! Where your mama go? Why your mama home?

I wan watch a mooo-veeeee? Meeeeease?

Mama! I sit on table! (he used 'on'!)
Me: Bubs, are you allowed to sit on the table?

Fire Truck, Fire Truck, Fire Truck; repeat x 37

(As we turned down our cross street) NO GO HOME! I wan go heh-cop-purs again again again NOW! (I want to go back to the amusement park in Vallejo and ride helicopters again like we did after the wedding last weekend!)

(Today at preschool to some kids messing with the 'special sharing toys' table) NO NO STOP IT! Teacher say NO. You STOP IT.

This is just the beginning. I am so glad that he will be able graduate from his talented and tireless ECI whom, over the past year he has challenged to become the best ECI ever, glowing with the skills she has taught him. I can't think of a better gift with which to part.
(Okay, actually I did think of a pretty nice gift to add to that, but shhhhh......not til her last day!)


Squid said...

(imagine me as Lesley Ann Warren in Victor/Victoria right after she figures out that "Victoria" is "a boy")

Yay! Yaaaaaaay!

Headless Mom said...

This sounds like a major victory!

Yay for Bubbles and for you!

Tricia said...

YAHOO!!! YIPEE!! WHO0HOO!!! He's talking, He's talking, He's talking,


Mama Deb said...

That is some really great news. I'm so happy that you got some! (good news, that is)

mamadaisy said...

Hooray! Yay Bubbles!

and hey, can we have some pics of this fabulous talker and his big sis? pretty please? i miss your kids, and i can't just stop by the house yunno...

InTheFastLane said...

This sounds like a VERY promising beginning!

Cindy said...

That is friggin awesome news. Go Bubbles! Give that kid a mike!

SongMom said...

To quote Squid, whose image is perfect (and I wish I'd thought of it first! or even at all): YAAAAAYYYYY!

Rachel Inbar said...

I'm so jealous... all the professionals I've run into seem to have more problems than the kids they evaluate :-(

The Turtle and the Monkey said...

I am very excited after reading this post. I am very happy for Bubbles! That is wonderful.

You are giving me insight and hope in this world of speech therapy. My son shows some of those same characteristics...the food, the chewing problems, etc...I wonder how much of his speech problem is oral-motor. This is the light bulb moment for me...I wish we had such wonderful resouces here. Our EI only sees Monkey twice a month. I am going to press for someone to evaluate this further.

Thank you for sharing!!

drowninginkids said...

I know i told you that my son who is 9 now was diagnosed with apraxia at 18 months. Your story is so familiar to me. Apraxia is incredibly frustrating to deal with because there is so little information about it and a lot of so called professionals have no idea. Toby did speech therapy privately for seven years and is now 80% legible to strangers. He has really blossomed and most of the fears i had for him have never played out. His apraxia is now making reading and writing hard for him, but we are facing this challenge head on.

The Kitchen said...

Hey - I found your blog through Living Laura.
I want you to know that my now 14 year old was diagnosed with severe apraxia around the age of 2-3ish. We did intensive speech, motor, sensory - you name it - therapies 6days a week for 7 years. (I can hear you gasp...)
He is now out of that world - has been for a long time. It was like the doors were opened and the words began to flow and flow (and now they never STOP) around 3 1/2-4ish. He needed lots of articulation work, but now is clear and perfectly fine.
I promise you this will continuely improve, and you will hear words more and more with time!!! I promise.