We were at the park enjoying the spring weather. I was letting Michael and Ava climb on some bleachers when I noticed a ten month old baby crawling around in the grass nearby. The baby was adorable. She caught sight of my legs first and I saw her gaze travel upwards towards my face. She looked at me. I smiled at her and she smiled back. It was so natural and easy. It was fun and intrinsically rewarding to connect with a baby through eye contact and smiles.
It reminded me again that my own little ones did not do that when they were infants. Now, I’m not saying that they never looked at my face, or returned a smile. That would be an exaggeration. It just wasn’t as natural and as easy as it was with this stranger’s baby at the park. It’s hard to express, but it is so obvious to me that the connection that most babies make easily and naturally with the people around them did not come naturally for my children.
Even now, I’m having to explicitly teach Michael to look people in the eyes to connect with them. I’m teaching him to look in a person’s eyes when saying thank you or making a request. I think he’s slowly starting to realize how powerful that is.
Part of me reacts to seeing a beautiful baby by wanting another one of my own. But there’s the fear that I would be testing fate one too many times. Michael did not develop language, speech, or social skills typically, but has turned out mostly all right. He’s definitely within the typical range at this point and even ahead in some areas. Ava did not develop speech and language typically, and has what I can safely say at this point is a (thankfully mild) motor speech disorder. She’s making great progress and I am hoping that we can -maybe- catch her up by the time she starts kindergarten.
That’s two for two on atypical development though. Three is just not a gamble I’m willing to take with our lives even though I like smiling at the baby in the park. Besides, I’m not sure my husband and I could handle being outnumbered.
A Speech Pathologist Mother and Her Daughter Diagnosed with Childhood Apraxia of Speech
Wednesday, March 23, 2011
Tuesday, March 22, 2011
Structured vs. Unstructured Therapy
Ava is changing at the speed of light. Her willfulness seems directly linked to her language ability. As her language abilities increase, so does her desire to have her way. She can express herself better and she wants her commands to be followed. I suppose it could also be those “terrible twos” I’ve heard so much about. Michael never really did the terrible twos – at least not like this. (Is there such a phrase as the “whining threes”? If so, he’s definitely doing that!)
It’s actually more annoying than cute. I’m finding it difficult to get Ava to sit down for structured therapy sessions. She goes into complete refusal mode and bribery with food no longer works. I’m needing to be more indirect and incorporate small moments of therapy into all of our daily activities.
For example, Ava will run over to her communication board and point to the yogurt calling out "yo-yo, "yo-yo, peas". She loves yogurt and wants it for breakfast and for her after nap snack. She can’t produce a /g/ sound. If I ask her to repeat the word with a /g/ in the middle she’ll just say “yo-yo” again. If I ask her to say, “yo-dirt” (because she can make a /d/ and some consonant in the middle is better than none at all) she’ll say “yo-dur”. The entire exchange takes no more than 30 seconds and yet it is a tiny bit of therapy. Then, as she eats the yogurt I find a way to fit that word in several more times. I’ll ask her, “More yogurt?” and make sure she says, “yo-dur” instead of “yo-yo” in response.
I never push her or try to correct words that she’s doing her best on. I’m trying to improve her pronunciation of words that I know she can do a little better. They don’t have to be perfect. They just need to improve in one way. “Yo-dur” has a /d/ instead of a /g/ in the middle and is missing the final /t/, but it is still closer than “yo-yo” so it’s an improvement.
I liked direct therapy. It’s just so much more intense than the unstructured therapy moments that occur during the day. I get maybe 5-10 practices of “yogurt” during the 15 minute snack. I could get 10-20 during 3-4 minutes of a structured session. I’m not giving up on the structured therapy. I’m going to get a little more creative. I’m going to try to sit down with a game and see if I can get her to work with me if we’re “playing.” I’ll let you know how that goes.
It’s actually more annoying than cute. I’m finding it difficult to get Ava to sit down for structured therapy sessions. She goes into complete refusal mode and bribery with food no longer works. I’m needing to be more indirect and incorporate small moments of therapy into all of our daily activities.
For example, Ava will run over to her communication board and point to the yogurt calling out "yo-yo, "yo-yo, peas". She loves yogurt and wants it for breakfast and for her after nap snack. She can’t produce a /g/ sound. If I ask her to repeat the word with a /g/ in the middle she’ll just say “yo-yo” again. If I ask her to say, “yo-dirt” (because she can make a /d/ and some consonant in the middle is better than none at all) she’ll say “yo-dur”. The entire exchange takes no more than 30 seconds and yet it is a tiny bit of therapy. Then, as she eats the yogurt I find a way to fit that word in several more times. I’ll ask her, “More yogurt?” and make sure she says, “yo-dur” instead of “yo-yo” in response.
I never push her or try to correct words that she’s doing her best on. I’m trying to improve her pronunciation of words that I know she can do a little better. They don’t have to be perfect. They just need to improve in one way. “Yo-dur” has a /d/ instead of a /g/ in the middle and is missing the final /t/, but it is still closer than “yo-yo” so it’s an improvement.
I liked direct therapy. It’s just so much more intense than the unstructured therapy moments that occur during the day. I get maybe 5-10 practices of “yogurt” during the 15 minute snack. I could get 10-20 during 3-4 minutes of a structured session. I’m not giving up on the structured therapy. I’m going to get a little more creative. I’m going to try to sit down with a game and see if I can get her to work with me if we’re “playing.” I’ll let you know how that goes.
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Monday, March 21, 2011
Therapy Progress - Practice and Generalization
It’s been about a month since my last update on Ava’s speech therapy progress. This month her therapy sessions have been rather sporadic. Doctor’s visits, surgery, and a variety of illnesses have interfered with her therapy schedule. She’s seen Ms. J twice, Ms. A three times, and Ms. E four times. I’ve probably only worked with her about three times a week on average. So, there’s been less therapy overall, and the therapy has been a bit inconsistent. This winter has been hard on us.
This month she made the jump from talking with only one word sentences to frequently using two word sentences. She’ll occasionally use three or even four word sentences now too. For example she’ll say, “Ava no pink shoes.” She’ll also string together several two word sentences in a row to get an idea across. For example, she’ll say, “dada shoe,” “mama shoe,” “me no shoe.” The idea she’s trying to get across is, “Hey, why am I the only one here with no shoes on?” but she’s using the tools at her disposal to communicate the idea in a simpler way.
The jump to using more than one word at a time was huge and exciting. It opens up a lot of possibilities where communication is concerned. However, since that jump, progress is slowing down a bit. I’m not seeing huge changes week to week any more. That’s to be expected. She’s made some dramatic changes. She needs some time to just practice her new skills. She’s learning what it’s like to live in a world where she can talk to people and sometimes they can understand. She’s getting to have back and forth conversations with people for the first time.
About two weeks ago, Ava put two words together for the first time. Since then, she’s been practicing that skill. She combines things in new ways and puts new words together. She experiments with putting three words together. Her first two word phrases were adding an owner to an object (Papa house) and an adjective to an object (pink flower). One of her first three word phrases put both an owner and an adjective with an object (Papa pink flower). This week it’s all about negatives. “no, no, no” So she’s experimenting with adding a negative to her sentences. She said, “Ava no purple pockets,” when trying to explain that her purple jacket doesn’t have any pockets.
To summarize, Ava continues to amaze me. She’s made huge progress this month. Last time I wrote an update she was a one word kid. Now she can occasionally string together four. So much going on in that two-year old mind – I am thankful that she can now share some of it with me.
This month she made the jump from talking with only one word sentences to frequently using two word sentences. She’ll occasionally use three or even four word sentences now too. For example she’ll say, “Ava no pink shoes.” She’ll also string together several two word sentences in a row to get an idea across. For example, she’ll say, “dada shoe,” “mama shoe,” “me no shoe.” The idea she’s trying to get across is, “Hey, why am I the only one here with no shoes on?” but she’s using the tools at her disposal to communicate the idea in a simpler way.
The jump to using more than one word at a time was huge and exciting. It opens up a lot of possibilities where communication is concerned. However, since that jump, progress is slowing down a bit. I’m not seeing huge changes week to week any more. That’s to be expected. She’s made some dramatic changes. She needs some time to just practice her new skills. She’s learning what it’s like to live in a world where she can talk to people and sometimes they can understand. She’s getting to have back and forth conversations with people for the first time.
About two weeks ago, Ava put two words together for the first time. Since then, she’s been practicing that skill. She combines things in new ways and puts new words together. She experiments with putting three words together. Her first two word phrases were adding an owner to an object (Papa house) and an adjective to an object (pink flower). One of her first three word phrases put both an owner and an adjective with an object (Papa pink flower). This week it’s all about negatives. “no, no, no” So she’s experimenting with adding a negative to her sentences. She said, “Ava no purple pockets,” when trying to explain that her purple jacket doesn’t have any pockets.
To summarize, Ava continues to amaze me. She’s made huge progress this month. Last time I wrote an update she was a one word kid. Now she can occasionally string together four. So much going on in that two-year old mind – I am thankful that she can now share some of it with me.
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