Nightmares and Dreams

I rarely remember my dreams, but I had what I consider to be the worst nightmare of my life recently.  The nightmare started out well, as they usually do.  Michael and I were in some kind of store having a great time together.  The shelves in this store were made out of a really lightweight plastic, and when a spot was empty on the shelf you could see through to the next aisle over.  Michael was on one side of the shelf and I was on the other and we were playing peek-a-boo.  We were both having a blast.  Then he started trying to climb through the hole to get to me and the entire shelf and all its contents began to fall towards him.  I tried to catch the shelf to prevent it from falling but I couldn’t hold it up.  That shelf and the next three shelves all toppled over like dominos burying Michael underneath. 

My first response in the dream was embarrassment – not worry.  The shelves were so lightweight I really thought he was ok under there and I was more embarrassed that we had made such a huge mess in the store and attracted so much attention.  Then I started frantically trying to dig him out.  When I found him, he was mostly limp and dazed.  He was confused and murmuring, “Mama” over and over again.  Then, in a flash, in the way of dreams I suddenly knew that this was very bad.  I cradled him in my arms sobbing.  I knew he was going to die.  Then I woke up.  My face was covered in tears and my heart was racing.  I felt sick.  Seriously, it was the worst nightmare of my life. 

As a contrast, I also recently remembered a good dream.  In high school I lived in Pennsylvania in a home with a pretty unique architecture.  For example, this house had two kitchens – one on each end.  It also had two bathrooms side by side.  The elderly couple who owned the house before us apparently liked to keep things separate and converted a screened in porch to an extra kitchen and one large bathroom into two small ones. 

In my dream my family as it is now (my husband and I, and Michael and Ava) were living in the PA house.  I was in the extra kitchen and found a previously undiscovered cabinet full of old toys.  The kids were elated.  As I pulled the toys from the cabinet I found a hidden door and tunnel.  We crawled into the tunnel and found a passageway that ended in a secret playroom and nursery.  The playroom was full of really cool 60s era toys and the nursery was kind of like the one in Peter Pan.   It was a bedroom for two decorated beautifully with two twin beds, small dressers, lamps, mobiles, a rocking horse, etc. 

As I describe it, the dream sounds pretty mundane and unremarkable, but it felt like adventure, discovery, and treasure all rolled into one and left me feeling happy.  Well, I was happy until I found out that I was awoken by my husband calling for assistance because Michael had thrown up.  Isn’t life with young children always like that?

Gestural Prompts for Apraxia – Therapy Techniques

Using hand signals (sometimes referred to as gestural prompts or visual cues) paired with specific speech sounds has been very successful at helping children with apraxia learn and use those sounds. Every professional book I have read about apraxia has a section on this technique. Every speech pathologist I’ve been working with uses gestural cues. It has worked exceptionally well with Ava. I’m going to explain the therapy technique, give you a specific example of how we’re using the technique with Ava right now, and then give you descriptions of several of the prompts we’re using right now.

Using hand signals is very simple actually. You just make sure your child is actually watching you, and then use the signal as you say the word. For example, right now we’re trying to get Ava to use the /t/ sound at the ends of words. She’ll say “ha” instead of “hat.” I will repeat the word emphasizing the /t/ sound at the end and at the same time I make the hand signal for /t/ (tapping the index finger on your upper lip right under the nose). The visual cue in addition to the auditory cue really seems to help her focus on that missing sound. Almost all the time now, she’ll then repeat the word adding the missing sound. She often uses the gestural cue herself when she repeats the word correctly. We’re also using the technique in the middle of words. Ava will say “tu uh” for “turtle”. If I use the hand signal for /t/ while emphasizing the /t/ sound that should be in the middle of the word, she will repeat, “tu tuh.” She still can’t make the /r/ or /l/ sound in that word, but she can add the /t/ in the middle.

These are the gestures we are using as our hand signals. You can use a different signal, it just needs to be consistent.

• T - tap the index finger on the upper lip right under the nose
• D - tap the index finger on the lower lip above the middle of the chin
• P - close your fist and pop it open (into a "5" position)
• B - use the ASL sign for /b/ and tap the hand gently against the side of your chin
• M - gently pretend to pinch both lips closed together with your index finger and thumb
• N - push index finger against one side of your nose as if you're trying to close one nostril
• SH - finger across your lips like you're shushing a child

There are more. You can find a hand signal (or make one up) for any sound you might be working on. Here is a link to a great video of a woman demonstrating a hand signal for almost every sound. Some of her signals are different from what I described above and that’s ok. You can use any signal you’re comfortable with as long as that symbol is consistent. Also, don't feel like you need to learn all of these at once. Pick one or two to start with and if that goes well you can always learn more. Be sure to choose a sound that your child is currently working on and check with your SLP. She or he may already be using a hand signal for that sound.

Other than tapping, this is the technique that has been the most successful with Ava. I highly recommend it.

Two and Three

Michael and Ava are only 15 and a half months apart in age. So, when Ava was born, Michael was a very young one. Parenting a one year old and a baby was… challenging. We got very little sleep. Michael didn’t understand that sometimes Mama and Daddy needed to tend to Ava, and Ava certainly didn’t understand that sometimes Mama and Daddy needed to tend to Michael. Everyone was in cloth diapers. We changed lots of diapers and washed lots of diapers. There was lots of crying. It was just a rough time. The learning curve for jumping from one baby to two was very steep.

Fast forward a year. Now the children are one and two. They’re both mobile, but not particularly steady on their feet. They’re still both in cloth diapers. Only one of them is talking. This was worrisome. They’re old enough to both want the same toy at the same time. Going out was a challenge because they were both at ages where they had to be closely supervised to make sure they didn’t tumble down a small step, or fall into the creek, or try to climb something they couldn’t get back down from. Again, challenging.

Now we’re at two and three. This stage is nice. They’re both out of diapers (except when asleep). They both talk (yea!). They’re both relatively steady on their feet. I no longer feel like they must be wearing long pants when they’re walking on the sidewalk to prevent bloody knees. They can feed themselves at the table. They can climb up and down most play structures successfully. They can both get up and down the stairs safely. Almost all the baby gates are down. Even the one at the top of the stairs is rarely used. They’re playing with each other. They’re having conversations with each other. I am starting to remember why I wanted my kids to be so close together. I wanted them to be playmates and friends. That is starting now and I like it. I’m beginning to feel less like I’m drowning and more like I’m taking control.

I expect things will only get better from here. Well, better until they’re both pre-teens and teenagers at the same time. That will be a whole new challenge that is thankfully still very far away.