Tuesday, February 8, 2011

First therapy session – Ms. J

We had our first session with Ms. J this weekend. To remind you, this is the speech-pathologist who is our local expert in apraxia who I almost missed the opportunity to work with. The session went very well. It is amazing how cooperative (comparatively) Ava can be in order to get to play with new toys. Well, except these:

I believe these are a relatively popular toy. Ava did not like them at all. Let me interpret her urgent gestures and grunting for you…. “Please put those away….no really. Now. Please. Now. I mean it. Get those away from me. Far away. Out of sight. Right this minute!” So, after the failure to use sing-a-ma-jigs as a fun new toy we moved on to better new toys to play with.

It was an introductory meeting. Everyone was getting to know each other. It wasn’t an instant miracle therapy session where I heard things I had never heard before. I wasn’t expecting that. What did impress me was how quickly Ms. J was able to figure out exactly:

  • what Ava is currently capable of
  • what Ava is not capable of
  • what we should start to work on first.

Then she was able to give me some great ideas on how to start working on those things.

I came home with a lot of information and was able to sit down and reflect on what I learned. I sat down and listed about nine things off the top of my head to focus on over the next two weeks that I wouldn’t have been working on if I hadn’t met with her. I’m very happy. I think she was the missing piece in our equation. I have the skills to work with Ava myself, but not the expertise and experience to know what is most important to work on first. With the guidance of an expert, I expect to be 10 times more effective and that is very exciting.

On a completely different note, one thing she didn’t do is confirm a diagnosis. I want one, of course. Which sounds bad, when I think about it. Why on earth would I actually -want- my baby to have a diagnosis? It just makes things concrete. It gives me something specific to fight. Anyway, she didn’t give a firm diagnosis for the same reasons no one else will. It’s too early to tell for sure. She noted some specific characteristics of Ava’s speech that are consistent with apraxia (speech and language history, limited vowel repertoire, etc), and some that are not consistent (Ava actually has decent prosody). We’re going to approach therapy from a motor planning perspective, so what we call the problem is not important.

To confirm the “it’s a small world” phenomenon, Ms. J actually knows the First Steps therapist we’ve been assigned to and thinks well of her. Our First Steps therapist, Ms. A, is actually a former student of Ms. J and they work together as colleagues now. Nice to know Ava will soon be surrounded with excellent therapists.


  1. I would love to know the ideas you gathered from your meeting. We are always on the search for new things to try.

  2. Well, the ideas are pretty specific to Ava and the way she's "talking" right now, but I'm happy to give you an idea of the types of things I'm talking about.

    Some of these things are longer term and some are short term. Longer term goals are to stimulate two-word phrases, final consonants, and back sounds (/k/ and /g/). She's using none of those at the moment.

    Short term goals are to work on lip rounding (necessary to make a good /oo/ as in "boo" sound) vs. lip spreading (necessary to make a good /eee/ as in "he" sound). We'll also continue to get in lots of practice with the sounds she's already using frequently and the sounds she's only using occasionally (/s/ and /sh/).

    She wants me to include visual hand cues in my work with Ava. She pointed out that Ava's vowels may become more pure and less distorted on their own as she gets more practice with them and as we improve lip rounding and spreading.

    I don't know how helpful any of that is, but those are the types of things I was excited to leave with. :-)


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