So, Ava arrived about 15 and a half months after her brother. My pregnancy with her was also completely normal and full term. Her birth was also natural and uncomplicated. My mother, who was in the delivery room, said that she felt that Ava spent a little more time than normal before getting her shoulders out. I pay attention to this only because my mom was a practicing ob/gyn nurse 30 years or so ago. However, when I mentioned that to my ob later, he said that he thought everything was fine. She was a healthy 8 lb, 12 oz. baby. She also had severe newborn jaundice which was treated well and cleared up in under a week. She wasn’t an easy baby, but she was easier than her brother. She had reflux for which she was medicated for the first year of her life or so, but that’s the only medical history of note. She was more interactive. She made some vocalizations. I don’t remember what exactly, but I remember that it was “more than Michael did at her age, and look how he turned out – she’s fine.” She didn’t have any of the unusual staring at lights or fascination with screws type behaviors. Her eye contact and turn taking were more appropriate as well. I was just so relieved to not have a repeat of Michael’s first 15 months that I didn’t really take her red flags seriously enough. Because in retrospect, they were there. If you remove the lens of “this is better than Michael, so it’s all going to be ok”, there was plenty to be concerned about on her own merit.
Yes, she had more vocalizations than Michael, but they weren’t enough, at the right age, or of the right types. She had a few vowels, but almost no consonants. No sense of vocal play. No reduplicated syllables. She didn’t imitate at all. Even though I’m a speech-pathologist, I’ve never raised a baby with typical speech development. Therefore, I didn’t really appreciate how behind her babbling was. She had a few “words” at her 18 month pediatrician visit. We thought she had an approximation for Michael and one for kitty. I don’t remember the rest. They pretty much all disappeared. By the time I called First Steps at 21 months of age the only words she used regularly were “yeah”, “da” (that), and “mo” (more). We’d also occasionally hear “uh oh” and “ha” (hot).
At the 18 month pediatrician visit, she seemed to be trying, and I was still entrenched in the she’s almost where Michael was at this age and he turned out fine mentality. Three months later she had lost what little she had and the lack of progress at a time when she should have been starting to talk more and more triggered enough concern that I couldn’t keep my head in the sand any more. And I started to make phone calls.
If it hadn’t been for our experience with Michael, I’m pretty sure I would have had Ava evaluated months earlier. So be it. We all do the best we can.
A Speech Pathologist Mother and Her Daughter Diagnosed with Childhood Apraxia of Speech
Friday, January 21, 2011
Thursday, January 20, 2011
Genes
Well, my husband is my perfect partner. That sounds terribly sappy, but it’s true all the same. I would not trade him for anything. I think we combine in a way that makes amazing, sweet, smart, kind children. However, those children do not have typical language development.
Ava has been the main topic here because we’re dealing with her diagnosis of apraxia, but that story actually begins with Michael. My pregnancy with Michael was completely normal and full term. Natural, uncomplicated birth. Healthy 8 lb, 6 oz. baby boy. He did have rather severe newborn jaundice which wasn’t well treated, but that’s a story for another time. He screamed for months. I kid you not. Somewhere 6 months in or so I remember asking my husband if he would ever be happy and awake at the same time. I was worried even then. He didn’t make eye contact. He was more interested in the lights or ceiling fan than in faces. We didn’t get the smiles or coos. There was very little interaction. Almost no babbling. He didn’t even make vowel sounds until 8 months of age. When he’d play with toys he was more interested in the screws on the bottom of the toy than in actually playing with it. He wasn’t interested in turn taking games like pat-a-cake. Red flags were everywhere and a speech-pathologist I saw them. But I was a new mom and insecure, and no one else seemed to be listening.
He had no words at his one year pediatrician visit. Our pediatrician told me if he didn’t have three words at his 15 month visit we’d begin testing. He had three- barely - at that visit and they all had come in that week. (Ava was born, incidentally only 2 weeks after that 15 month pediatrician visit). When he did begin talking, his first sounds were very atypical. He had /k/ and /g/ and enjoyed making clicking sounds with his mouth. I was very concerned. And about more than just his speech.
And then it just clicked. The words came more and more quickly. Ten words, then 50, then more than we could count. Two to three word combinations came between 20-22 months of age and he was using 3-5 word sentences at two. At three he’s pretty much completely intelligible to strangers and using long sentences with complex structures and vocabulary.
It was our own little miracle. A breathtaking relief. And the experience completely colored the way we looked at Ava’s development.
Ava has been the main topic here because we’re dealing with her diagnosis of apraxia, but that story actually begins with Michael. My pregnancy with Michael was completely normal and full term. Natural, uncomplicated birth. Healthy 8 lb, 6 oz. baby boy. He did have rather severe newborn jaundice which wasn’t well treated, but that’s a story for another time. He screamed for months. I kid you not. Somewhere 6 months in or so I remember asking my husband if he would ever be happy and awake at the same time. I was worried even then. He didn’t make eye contact. He was more interested in the lights or ceiling fan than in faces. We didn’t get the smiles or coos. There was very little interaction. Almost no babbling. He didn’t even make vowel sounds until 8 months of age. When he’d play with toys he was more interested in the screws on the bottom of the toy than in actually playing with it. He wasn’t interested in turn taking games like pat-a-cake. Red flags were everywhere and a speech-pathologist I saw them. But I was a new mom and insecure, and no one else seemed to be listening.
He had no words at his one year pediatrician visit. Our pediatrician told me if he didn’t have three words at his 15 month visit we’d begin testing. He had three- barely - at that visit and they all had come in that week. (Ava was born, incidentally only 2 weeks after that 15 month pediatrician visit). When he did begin talking, his first sounds were very atypical. He had /k/ and /g/ and enjoyed making clicking sounds with his mouth. I was very concerned. And about more than just his speech.
And then it just clicked. The words came more and more quickly. Ten words, then 50, then more than we could count. Two to three word combinations came between 20-22 months of age and he was using 3-5 word sentences at two. At three he’s pretty much completely intelligible to strangers and using long sentences with complex structures and vocabulary.
It was our own little miracle. A breathtaking relief. And the experience completely colored the way we looked at Ava’s development.
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Wednesday, January 19, 2011
Expanding Horizons
My son is a little over three years old. I am watching him explore his world and his place in it. It’s extraordinary to watch his world expand little by little and see him gain confidence. We waited a long time to switch him from his crib to a toddler bed simply because he was so happy in his crib. He would play happily for an hour before falling asleep and another hour after he woke up before he would call for someone to get him. He slept well. We didn’t see any need to change that prematurely. However, as he approached his third birthday we decided to make the switch and he was excited about it. It made me a little sad though that I would go up to get him an hour or so after he woke up and find him still in the bed. It didn’t even occur to him that he could crawl out on his own.
Then one day it just happened. He left the crib. And chaos ensued. He’d still happily play in his room…but for two or three hours. And never fall asleep. Overnight he went from taking two and a half hour naps to no naps at all. I loved that he was enjoying a new level of independence. I was still essentially getting a break in the afternoon since he happily spent all of that time in his room, but he still needed the sleep. I finally found a solution. I let him play for anywhere from 30 minutes to an hour and then I go sit in a chair in his room. That effectively pins him to his bed and he falls asleep within 10 minutes. And sleeps for at least 2 hours.
Concurrently with all of this we’ve been potty training. He’s been day trained for quite some time, but he began showing interest in taking himself to the bathroom rather than going in his nap/bedtime diaper if he was awake. So we told him that if he needs to go to the bathroom he can leave his room and do that quietly and return to bed. A whole new level of chaos has ensued. Minutes after leaving the room doors begin to slam and running feet can be heard. Last night we put him to bed at 8pm and he was still awake when I was going to bed at 10:30. And that time is now spent entering and leaving his room. Another favorite is peering down at us from the upstairs balcony in a manner he thinks is quiet. I have no idea what he thinks he is doing, but he also goes into and out of his closet slamming the sliding doors open and shut each time. Feet thunder back and forth over our heads.
I love the independence and exploration. I love that his world had grown from the confines of his crib, to toddler bed, to his room, to the areas outside his room. However, I miss the beautiful sleep. And I’m pretty sure he does too. I’ll give him a week or so to see if the exploration grows old on its own, but if not I guess I’ll have to do the sitting with him trick at night time too.
Then one day it just happened. He left the crib. And chaos ensued. He’d still happily play in his room…but for two or three hours. And never fall asleep. Overnight he went from taking two and a half hour naps to no naps at all. I loved that he was enjoying a new level of independence. I was still essentially getting a break in the afternoon since he happily spent all of that time in his room, but he still needed the sleep. I finally found a solution. I let him play for anywhere from 30 minutes to an hour and then I go sit in a chair in his room. That effectively pins him to his bed and he falls asleep within 10 minutes. And sleeps for at least 2 hours.
Concurrently with all of this we’ve been potty training. He’s been day trained for quite some time, but he began showing interest in taking himself to the bathroom rather than going in his nap/bedtime diaper if he was awake. So we told him that if he needs to go to the bathroom he can leave his room and do that quietly and return to bed. A whole new level of chaos has ensued. Minutes after leaving the room doors begin to slam and running feet can be heard. Last night we put him to bed at 8pm and he was still awake when I was going to bed at 10:30. And that time is now spent entering and leaving his room. Another favorite is peering down at us from the upstairs balcony in a manner he thinks is quiet. I have no idea what he thinks he is doing, but he also goes into and out of his closet slamming the sliding doors open and shut each time. Feet thunder back and forth over our heads.
I love the independence and exploration. I love that his world had grown from the confines of his crib, to toddler bed, to his room, to the areas outside his room. However, I miss the beautiful sleep. And I’m pretty sure he does too. I’ll give him a week or so to see if the exploration grows old on its own, but if not I guess I’ll have to do the sitting with him trick at night time too.
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