Memorial Day, Birthday, Visits

I hope everyone had a wonderful Memorial Day. It was the last day of our family visit. We had a great visit. It was a nice balance of activity (zoo, restaurants, outdoor play) and just hanging out at the house (lots of erector set building, good conversation, and general horseplay with the children). Ava joined in the conversations with everyone else. It was really the first time we've had houseguests since Ava's started talking so much. She did a pretty good job of communicating. Most of the time, our guests were able to figure out what she was trying to say. I took comfort from that.

We spent some time outside in the sprinkler. Traditionally, my children are extremely suspicious of sprinklers and treat them with great caution. Today, we seemed to break through and the kids started to run through the sprinkler and laugh and giggle with glee. I loved watching them play. As I looked back at the pictures I realized how similar in size the kids look right now. I understand why people occasionally ask us if they are twins. There were many things that were difficult about having children 15 months apart, but it is starting to pay off now. I love watching them play together and talk together more and more as peers.

(Yes, Michael does indeed have his swim pants on backwards. He did that after a trip to the bathroom. When we pointed it out to him he said, "I like them that way." We just let it go. It gives the pictures that special, unique touch.)

Yesterday was also my birthday. We didn't do anything spectacular to celebrate, but my husband made sure my day was special in little ways that all added up. First, he let me sleep in. Several times during the day he took care of things (lunch, putting the kids down for nap) letting me have a few quiet moments to myself. Those things sound little, but around here they are much appreciated. It was a nice, quiet birthday.

Seriously?

First I wrote about how I really did need to find Ava a regular playmate.

Then I wrote about the miraculous discovery only a few days later that a little girl Ava's age lives only a few houses away in our neighborhood.

We had one very nice playdate and then a few weeks later we had another very nice playdate. We seem to have some difficulty coordinating regular playdates, but I can live with irregular.

Then one day last week as I was driving by their house on the way to ours...

Counterproductive?

We're trying to rebuild our deck and therefore we have a ton of random pieces of cut-off wood lying around. I had a brilliant idea to drill some holes in a piece of wood and let the children play with the block of wood, some wood screws and a couple of screwdrivers.

1. They loved it.
2. Michael gets to play with a screwdriver and screws in a sanctioned way.
3. Hmm... do I really want to give him additional, sanctioned, practice with a screwdriver? (See this and this for reasons that this activity is possibly counterproductive.)

Reality Check

When we started all of this Ava had too little speech to give her any kind of formal articulation assessment. You can't ask an essentially nonverbal child to label pictures in a book so that you can score how well they did making sounds. Now that Ava has so many words her early intervention therapist and I decided to give her an articulation test to see where she is.

The Goldman-Fristoe Test of Articulation 2 is very simple in concept. It is a book of pictures. Your child labels the pictures and the Speech-Language Pathologist transcribes how your child pronounces each word exactly as your child says it. The test is designed so that after all of the pictures have been pronounced your child has attempted to pronounce every consonant sound (and some blends) in every position (beginning, middle, end) of words in which they appear in the English language.

We gave the test to Ava. It took us two sessions. There are a lot of words on the test and it is hard to get a two year old to focus. She did better than I expected. She got sounds on the test that she doesn't usually get in regular conversation. I was feeling pretty good about the whole thing.

Then I scored the test. She got a standard score of 72. That's equivalent to the 7th percentile. That means that 93% of children her age perform better than her on this test. Wow! Seeing that number was a huge reality check for me.

I've been so focused on all the improvements. She's made amazing progress since we started getting her help. She had no words. Now she had more than I can count. She went from one-word utterances to two and three-word phrases. Now we are frequently hearing four and five-word sentences. She was a pretty silent toddler who wasn't even trying to talk any more - a toddler who had to resort to gestures and pulling me around to ask for what she wanted. Now she talks all the time. She communicates with her parents, grandparents, brother, teachers, and friends. She even talks to herself. She tries to sing and hum. I was proud. I was excited.

Now, with this new number (7th percentile!) I am sad and discouraged again. I know that this new information takes nothing away from all of her accomplishments. I do know that. I know that this new information is a valuable reality check. It gives me information I can use to go forward and plan our next steps. As a speech-pathologist the test results are interesting, valuable, and even a little exciting. As Ava's Mama, those test results make me sad. They are a reminder of her struggle and the long road that is still ahead of us. Reality really stinks sometimes.

Six!!!

Ava loves cucumber and dip. She ate all the cucumber on her own plate (about 1/4 of a rather large cucumber). Then she eyed Michael's plate and asked if she could have his cucumber. He had already decided that he wasn't going to eat his, so he gave his cucumber to Ava. That quickly disappeared too. At this point, the girl had consumed half a cucumber.

She looked down rather pitifully at her plate and said, "No more on Ava's blue plate!" Six!! That's a six word sentence from the same little girl who had only three words in her entire vocabulary four and a half months ago. I'm practically speechless myself in awe and gratitude. (Standard disclaimer: No, that sentence was not pronounced "correctly" with every sound present, but all the words were there and I could understand them.)

A Little Bit of Innocence Lost

A while back, I got Ava a box of assorted hair accessories hoping that three kinds of hair bands, two kinds of hair clips, and two kinds of barrettes all in 6 colors each would fascinate her enough to persuade her to let me put a barrette in her hair.

Instead she calls them all her treasures, the box they came in her "treasure box", uses the hair bands as bracelets, and thinks it's hilarious to put the hair clips on all her fingers at once. Well, at least it was entertaining.

A couple of months ago, when I was trying to persuade Ava yet again that these things were HAIR accessories by putting them in my hair, Michael decided that it was great fun and wanted me to put them in his hair. It was adorable. We all had fun. Ava though Michael looked great while still completely resisting participating herself.

Today I got the box back out for yet another try. My mom was over and snuck a hair clip into Michael's hair from behind. After asking her to take it back out he said, "I'm not a girl. I don't want those in my hair." I was actually completely surprised. I've never said anything like that around the house. He must have gotten that from school. It isn't that I want him to wear pink hair clips forever. I'm just sad that a little bit of innocence has been lost. He thought it was fun before and it was fun. Now he won't participate in that fun any more because someone at school told him hair accessories are only for girls. He's growing up so fast.

Social Dynamics

I try hard to find playmates for my children. Michael has a weekly playdate with a boy up the street who is only 6 weeks older than he is. We've been getting together regularly for at least a year and a half. They are a wonderful family and it has been pretty amazing to watch their relationship develop from two babies playing side by side to two boys who run off to play independently. Ava is just starting to get together regularly with a little girl in our neighborhood who is only 4 months older than she is. So far, they mostly just play in the same space, but that is fairly typical for a couple of two year olds playing together.

I have a friend too. We've known each other since before marriage and children. Now she has a little girl,Cara, who turned four just a few weeks after Ava turned two. She is 8 months older than Michael and almost exactly two years older than Ava. We try to get together on a weekly basis too. It's great that the kids get along, but mostly, we just want to get together ourselves.

Usually, Cara and Michael play together. That was especially the case before Ava started talking. Or all three children would play independently. When they came over yesterday though, a whole new dynamic appeared. The two girls went off together. Cara was actively engaging Ava and trying to make her laugh. They were tickling and wrestling and just being silly. They climbed on the playset together. In fact, every time one wandered off, the other would follow. The girls played together for extended periods of time while Michael ended up a bit neglected.

I was torn. It was amazing to watch the girls playing together even with the two year age gap. The communication, enjoyment, and togetherness was like something that had been gift wrapped for Ava and it was beautiful. At the exact same time, I hurt for Michael. He was trying to get in on the fun, he really was. But somehow he just ended up sidelined. The girls weren't deliberately leaving him out. They were just interested in different activities.

I suppose that when Ava tags along on Michael's playdates she is the one sidelined, but somehow that doesn't make me as sad because the pair playing together are age matched. It was just fascinating to watch gender and personality determine the playmates more so than age. Social dynamics start so very young.

Shadow Play

Ava was playing with her shadow in the basement playroom. She was standing on a step stool and the setting sun was coming in through the basement window lighting up the wall. Ava noticed her shadow and was delighted. She waved and played with it for several minutes and her Daddy was able to catch it on film. I stole the pictures from him and put them together so you could see.

What to do with an old baby wrap?

I was trying to think of creative ways to use a few old baby wraps I have lying around and I came up with this. We're redoing the basement's drop ceiling so I have access to the guts of the ceiling. I tied the wrap in a loop to a 2 by 4 in the ceiling. Voila. Instant indoor swing.

Michael likes to lay in it on his tummy and twist himself around until the swing won't turn any more. Then he picks up his feet and twists until he's so dizzy he can't stand. Ava likes to sit in it and be twisted and left to untwist, or to be pushed in traditional swing style. At the moment these activities are closely supervised because Ava sometimes gets tangled in the swing when she tries to get out on her own. I pick it up out of their reach when I'm not in the room.

It's a ton of fun though and certainly a better use of an old baby wrap than leaving it lying folded in a drawer.

Here's a picture of Ava in the new swing. Sorry it is so blurry. The swing was moving pretty fast. At least it gives you the idea. And just for fun, here's a picture of Ava in a different baby wrap when she was only three weeks old.

If anyone has any other great ideas for what to do with an old baby wrap, speak up. I'd love to hear them.

No problem.

Last night at dinner Ava was wandering the kitchen with one of her Daddy's wrenches. She walked up to him and said, "Look Dada! Look." He replied, "Yes baby. Could you put that on the table for me?" Ava walked over to the kitchen table and plopped the wrench right down on the edge of the table. She said, "No problem Dada!"

It completely cracked us up. I'm not sure she knew why we thought it was so funny. Did she get that from me?

Ms. J and Magic

I haven't spoken much about Ms. J recently. She's the local apraxia expert we're fortunate enough to be seeing twice a month. We saw her again yesterday morning. She is so good. She has amazing one-on-one sessions with Ava. I shamelessly eavesdrop through the door. She takes my 26 month old little girl and gets her to work on her speech for 50 minutes straight and enjoy it the whole time.

She's also magical. I will go and she will tell me work on something (the one I remember most is "work on two-word phrases"). I will tell her, "Sure!" while thinking to myself, "Yeah, right! There's no way Ava will be doing that in the next two weeks, she isn't even close." Every single time, Ms. J has been right. Every single time. She was right about the two word phrases. She was right when Ava first started being able to imitate final consonants. She was right about using the hand signals.

Well, this time she told me to work on the /k/ sound. I've been trying off and on to stimulate a /k/ production from Ava. I'll say, "Say /k/." Ava will respond, "/t/". Every time. She just can't make a /k/ or /g/ in the back of her mouth. Think about it for a second. Try to explain how to make the /k/ sound. It would go something like this:

1. Bring the back of the tongue up to the roof of your mouth so that you completely block all air flow from your mouth. Leave the front of your tongue down.
2. Build up air pressure behind your tongue.
3. Now, let the air out in a little explosion by dropping the back of your tongue down. If you do it right, it will make a /k/ sound.

Ok. Now imagine trying to explain that to a two year old. Just not possible. So, when we're trying to stimulate a sound a child isn't making we have to use indirect methods. Sometimes you're lucky and the child can imitate the sound even though they aren't using it on their own. Or sometimes it is a sound that is easy to see, like /m/, because you make the sound with your lips. Then you might be able to help the child make the sound by showing them how. But /k/ is made in the back of the mouth. You can't just have the child watch you.

Ms. J took an indirect approach to getting Ava to make a sound in the back of her mouth. Essentially she had Ava open her mouth wide. Then she used a tongue depressor to hold down the tongue tip which will often force the back of the tongue up. Ava hated the tongue depressor and was happy to open her mouth wide if only the tongue depressor stayed put away. Then Ms. J had Ava imitate a kind of growling, "scary" sound. With the mouth wide open and the head tilted slightly back, making that noise is a giant step towards making a /k/ sound because you're making a sound way in the back of the mouth by moving the back of the tongue up. That's the first step we needed. Hopefully over the next two weeks I will be able to use that technique to shape a true /k/ sound from Ava.

If you had asked me two days ago if I thought there was even a possibility of getting a /k/ out of Ava in the next couple of weeks I would have said, "No way, absolutely not." One visit with Ms. J later and I think there's a distinct possibility. Magic I tell you. Magic.

Tall People Can Reach High Locks

Ava and I were in a public restroom. Now, this is how the experience usually goes. Ava uses the potty first. Then I try to get my business done while begging her not to open the door just yet. The sounds of muffled laughter from other stalls are always helpful.

Well, this time, the door lock was too high for her to reach. It was wonderful. In fact, I'll admit it, I kind of enjoyed watching her fruitlessly try to reach the door lock secure in my knowledge that she couldn't reach it.

Ava stepped back, frustrated and said to me, "door high." I replied, "Yes, sweetheart. The lock is really high." She looked up at the lock again, and then back at me. Then she said, "Mama tall." I was astounded. I didn't even know she knew what tall meant, much less that she would make the connection to how the concept applied in this particular situation. And then she used it in a sentence well enough that I completely understood what she was saying.

All in all, a very nice trip to the restroom.

Subtle Problems are Harder to Explain

I was talking with our early intervention therapist about Ava's speech trying to figure out what it is that still worries me. Ava is doing so much better. She looks more age appropriate. That is good, of course, but I know both as an SLP and as her mother that there is something there I need to pay attention to.

Yes, Ava is still missing individual sounds (k, g, f, v, r, l, etc.), but all of those sounds develop late anyway and aren't always present in a young two year old anyway. And, some of them are starting to emerge a little. I'm seeing hints of an /f/ and hints of a /k/ for example. So, I'm not crazy worried about the missing sounds. Sure, the fact that they're missing makes her harder to understand, but in a relatively age appropriate way.

Yes, she still exhibits quite a few phonological processes. The big ones are final consonant deletion (leaving off those final consonants) and syllable reduction (taking a three syllable word and saying it as a two syllable word). Again, phonological processes are a normal part of speech development, and it isn't too age inappropriate for her to still be exhibiting some. It's particularly reasonable given that she's only been talking at all for a grand total of three and a half to four months. So, to summarize, I'm not too worried about the phonological processes either.

What I do see are signs of a motor planning problem - apraxia. I have a little girl who has a lot to say. She understands what she hears. She has a great vocabulary. She wants to put together 4-5 word sentences which is pretty darned good for a just turned two year old. However, whenever the syllable structure gets complicated she struggles. Whenever she tries to put together over three syllables she struggles. Whenever she's trying a new word or sentence structure that is complicated she struggles.

Yes, her motor planning problem is mild, but it is definitely there. And, more importantly, it is holding her back from her potential. I think without the apraxia she'd be startlingly articulate. As it is, she struggles to express everything she'd like to. I'm told that she's extremely quiet at school and hardly talks at all. At home she's trying to talk all the time, but she doesn't at school. Is it a confidence issue? It is because the processing demands are higher in a higher stress environment? Is it just her personality to be shy at school? I don't know, but I want her to get to a point where she is able to say everything she wants to and she isn't being held back by the apraxia.

And so we will continue to work on it. It is so easy to get distracted by the sounds she can't say or the phonological processes she exhibits, but the bigger issue is definitely the motor planning. The best strategies I've found to help with the motor planning problems are the tapping and the visual prompts. We'll stick with using those in context to help her say the things that she wants to say. And we'll see how her speech continues to develop over the next several months.

Ava's Speech - What next?

Ava's speech continues to improve in subtle ways. She's talking all the time. Her sentences are often multi-word sentences. She's a full conversational partner in the household. She listens to the conversations around her and tries to participate. She initiates new conversations. She is trying to sing songs. Slowly she's starting to use consonants in the middle of words and put some on the ends of words. Her vowels are usually correct now. The consonants that are missing are still missing, but they are consonants you wouldn't necessarily expect a young two year old to be using like /f, v, k, g, r, l, ch, J, s/. She still has difficulty with more complex syllable structures like C1V1C2V2, but those would be difficult for many typically developing early two year old children too.

She looks so different from the child who less than four months ago had only three "words", very few sounds, couldn't imitate, and scored at the 4 month old level on the early intervention speech and language assessment. She had so many of the items on the checklist for early red flags for Childhood Apraxia of Speech.

Now her therapists are starting to hint that she's looking more and more age appropriate. They're starting to say that the remaining issues she has look more like articulation or phonological issues than apraxic issues. This is exactly why Speech-Language Pathologists are reluctant to diagnose Childhood Apraxia of Speech this early.

If Ava had/has Childhood Apraxia of Speech it is mild. Anyone with moderate or severe CAS would have improved much more slowly. She's in an odd place. She's outgrown many of those "early red flag" signs (although her history of those red flags will never change). She's not quite old enough for the classic signs of Childhood Apraxia of Speech to show up yet.

We're in an odd limbo place. She's made great strides that have brought her to a place that is almost age appropriate. You could argue that we could stop therapy or go to therapy fewer times a week. After all, I am a speech therapist and I'm working with her at home too. I'm also able to monitor her for signs of backsliding. However, it took therapy multiple times a week over several months (and possibly multiple kinds of supplements) to achieve those improvements. I don't want to stop too early. She wasn't making any improvements before the therapy (and supplements).

I'm just not sure what to do. Continue therapy for now? Reduce therapy and see if she's still improving or at least maintaining her skills? Stop therapy for a while and wait to see if she falls behind again?

What do you guys think?

The Campaign Against the Mama Phase

About a week ago I complained about the over-the-top Mama phase Ava is going through. A very nice commenter, JR Morber, made some well thought out suggestions. She said that they used a combination of strategies to fight a Mama stage with her son. I'm going to summarize her suggestions in list form.

1. Mama should be a little less effective at meeting the child's needs. Slow down. Make them wait.
2. Refuse to respond to small requests unless Daddy can do it.
3. "Pro-daddy praise campaign."
4. Special Daddy-only activities.
5. Re-arrange routines so that Daddy is taking the major role in care whenever possible.
6. Resist stepping in during Daddy-child interactions.

It sounds like a thorough, well thought out plan. And it sounded like a lot of work. At the time I thought that things weren't bad enough to put that much work into trying to fix the problem. I was just hoping that eventually the phase would pass.

Well, things continued to get worse over the next several days. Then one morning Ava pitched a fit just because her Daddy said "hi" to her during a moment that she thinks of as a Mama time (getting her from her room when she wakes up in the morning.) That was it. We immediately adopted JR Morber's plan.

We're about two and a half days into the plan. Essentially, if my husband is home, he takes point with Ava. When she protests we make some excuse about Mama being busy and then I just leave the room so I'm not an audience for any complaints. Daddy has been making extra efforts to (although he's always good) be funny, nice, and entertaining. Daddy has dressed her, put her down for nap and bed, put her into the carseat and taken her back out, played with her during play times, helped her at the dinner table, etc. It's working beautifully. We're already seeing a big change and it is wonderful.

Thank you, thank you, thank you to JR Morber if you're reading this.

We'll keep this up for several more days and then hope that the good will towards Daddy lasts when we go back to taking turns with the children.

Independent Entertainment

My children seem to be entirely dependent on me for their entertainment. "Mama, will you play with me? I'm lonely." Michael will say. Or Ava will demand, "Mama! Pay! (play)" We have a beautiful playset outside with three levels and a slide and some swings. We have a sand table and a box full of balls, chalk, bubbles, jump ropes, bats, and squirt bottles. However, when we're outside all they seem to want is for me to push them on the swings. They haven't learned to climb up into the swing and pump on their own yet. I need to encourage some independence in their play.

Last night after dinner we added two new things to the backyard. They are so simple and yet the children loved them and played with them independently for at least 20 minutes until it was getting dark and time to go in for bath. First we added a disc swing. When I bought it I daydreamed that we'd hang it low and the children would be able to get on it by themselves and swing without me. Well, as it turns out they cannot get on the swing by themselves. Ava cannot hold on even if we put her on and Michael can only hold on for about 30 seconds before falling off although he loves the 30 seconds. It looked like it was going to be a failure until Ava decided that she loved to grab the swing, pull it back and make it go "high!" She'll do it over and over again. Michael wanted to hit it with a bat and watch it swing around and absolutely loved it, but the swing was a little too low to make hitting it with the bat easy.

This gave us the idea to suspend a wiffle ball just at Michael's hitting height. He had a blast "whacking" the ball over and over again. He loved the sound of the bat hitting the ball. He loved watching it fly away from him and giggled every time the string brought it back bumping into him. It was hard to drag him away and he can't wait to try it again.

The two new additions were a complete success. Hopefully the newness won't wear off too quickly.

Better Late than Never

Ava had her second playdate with Sara yesterday morning. Illnesses, a variety of other commitments, and some travel conspired to disrupt every attempt we made at setting up a second playdate. It took us two months, but we finally managed to get together again.

The weather was perfect. It was about 70 degrees and sunny. We spent about an hour playing in the backyard. Sara was shy at first, but then realized that we had fun things like chalk and bubbles and squirt bottles. They played in the sand table, climbed in the playhouse, and went down the slide. The girls are still at an age where they mostly just play in the same space rather than really playing together. They were usually doing the same things though, and it was nice to see the two small bodies side by side playing together.

If we can manage to get together regularly it will look so different a year from now. Michael and his friend are now talking to each other and I can hear sounds of preschool conversation drifting towards me from a bedroom or playroom when they get together. I hope that I will hear that from Ava and Sara in time.

NutriiVeda and Apraxia: Two Week Update

We've been using NutriiVeda for about two weeks now. I'd say, on average, Ava has been getting about one scoop per day rather than the two scoops that are recommended. I find that she won't finish the yogurt if I mix in more than about 1/2 to 2/3 scoop into the four ounces of yogurt and we have yogurt 1-2 times per day. Since Ava is a pretty picky eater, I haven't found many other opportunities on a daily basis to sneak it in.

So, we've been using a NutriiVeda "dosage" of about one scoop per day with our two year old daughter for about two weeks now. My opinion is that I am seeing a difference in her speech. She is talking a lot more. She talks all the time. She's also trying to sing. She's never really done that before. Before, she would sing a single word if I paused while singing a song, but now she is trying to sing herself. She's trying to follow along with all the words. She has even tried to sing a song entirely by herself once or twice. Another thing Ava is doing that is new is self-correcting. As she was talking to herself, I heard the word "water" which she said as "wa wa." A moment later I heard her pause and correct it to "wa ter." I was amazed. She corrected the word entirely on her own showing that she's listening to her own speech more and can tell when she says a word correctly and when she doesn't.

None of this is proof of course. Perhaps she would have made all this progress without the NutriiVeda. However, until someone conducts a rigorous scientific study, we can't know for sure. All we can do is talk to parents who have tried it and ask them if they feel they saw improvement after starting to use NutriiVeda with their children with Childhood Apraxia of Speech. I'm saying that I think I'm seeing improvement. Use that information as you will.

If you found this information useful you might also be interested in the following articles:

NutriiVeda for Childhood Apraxia of Speech: Information and Resources

Omega-3 Fish Oil for Childhood Apraxia of Speech: Information and Resources

How much contrary is normal?

Ok. I need some reassurance here. How much contrariness is normal for 25 months of age? My firstborn never really went through a huge "No!" and temper tantrum stage, so this is pretty new to me.

Ava seems to refuse to cooperate as her default response lately. Time to get dressed? Nope. It's a struggle. Time to eat something that isn't bread or fruit? Nope, absolute refusal. Time to go outside. Nope, she wants to stay in. Time to play? Nope, she'd rather watch television. These things I can mostly deal with. Mostly.

It's the next level of contrariness that really gets to me. If she accidentally bumps her brother and I ask her to say sorry she absolutely refuses. She runs away from us pouting and whining and would rather spend an incredibly long amount of time in time-out than just say "Sorry." If she's having trouble with something and you attempt to help, she'll throw down the offending item and refuse to play with it any more rather than accept assistance. If she wanted to go first and has to go second she will refuse to continue to participate in the activity. If asked to share something, or give back something she has taken she simply refuses.

And then there's her absolute refusal to let her Daddy do anything for her. If she wants milk I have to get it. If she wants down from her booster seat she'd rather stay in than let her father help her. If she has to go to the bathroom she'd rather wait an hour than let Daddy help. We were walking together tonight and she wouldn't even hold his hand. I do believe it's starting to hurt his feelings. And it isn't that she doesn't like him. She loves seeing him come home. She loves to tickle and wrestle with him. I think it is just another way for her to insist on getting her way rather than ours.

Someone please tell me that this is within normal limits for the age. And if it is normal, how long does this last? And could you possibly share some strategies for dealing with it?

Toe?

Today we were getting ready to go outside. It was an amazing spring day. The temperature was about 65 degrees with a light breeze. The sun was shining brightly. When playing in the sun short sleeves felt wonderful. We had just finished putting on shoes and socks and were heading out the door to play when Ava said, “toe” and looked at me expectantly.

I had no idea what she meant. She repeated herself politely once or twice in response to the apparently blank look on my face. When I responded with, “I have no idea what you want sweetheart, can you show me?” she started to get frantic chanting over and over, “Toe! Toe! Toe! Toe! Toe!” It was obvious that she wasn’t going outside until I figured out what she wanted. I felt terrible and as she got more and more frustrated and anxious so did I. Finally, when she started heading for the coat closet I realized that she was asking for her coat.

I wasn’t expecting the request because it was so nice outside so I didn’t have any context to guess until she gave me a clue. In retrospect, “toe” for “coat” makes perfect sense. She leaves off the /t/ at the ends of words and she can’t make a /k/ sound so she used a /t/ at the beginning instead. That turns coat into toe. The whole exchange couldn’t have taken more than 60 seconds, but it was a pretty intense 60 seconds and we were both relieved when we finally figured it out.