So Ava continues to do well with her feeding hierarchy. She's pretty much just accepted that she has to take a bite of the food she doesn't like in order to receive more of the food she wants.
Her technique so far has been to pop that food in her mouth and let it sit front and center on her tongue as if I had put something horrendously nasty in there. She grabs her milk and swallows it down as if it were a pill-tasting it as little as possible. In the name of substantial progress, I was letting the fact that she was treating perfectly yummy food like dirt go.
Well, yesterday morning, in the middle of our weekly OT session I had set her plate up with small pieces of sausage. They were the size of large blueberries. A bowl of cheerios to use as a reward had been set to the side. She asked for cheerios. I told her she'd need to eat a small bite of sausage first and I stepped away from the table to grab a knife. Usually I cut a tiny sliver off the larger piece of sausage for her to try.
Well, when my back was turned she popped the entire piece of sausage in her mouth and tried to swallow it whole by gulping several large gulps of milk. I turned around to see her choking back up all the milk and finally (thankfully) the piece of sausage too right back into her lap.
I calmed her down, cleaned her up, and told her I was proud of her for trying such a big piece. I then tried to explain that we can't swallow such big pieces without chewing them first. I'm pretty sure she didn't really get it.
So now we're working on teaching her to put food in the side of her mouth and to chew it up in an exaggerated way. We're teaching the technique with foods she likes first. Once she's really good at it, I'll have to insist she actually chew the things she doesn't like before swallowing them and getting a reward.
I'm pretty sure that this next step forward is going to be a big struggle.
A Speech Pathologist Mother and Her Daughter Diagnosed with Childhood Apraxia of Speech
Tuesday, September 13, 2011
Monday, September 12, 2011
Is it that I don't remember?
I had the privilege of holding a three week old little girl last night. As she snuggled in my arms I watched all of the fleeting facial expressions and listened to the grunts and snuffles and sighs. It was so sweet.
I don't remember my babies being so expressive so young. To be honest I don't remember them being so expressive even much older. Is it that I just don't remember? Is it that I was too sleep-deprived and stressed to notice? Or does the apraxia start to show so early if you know what to watch for? Do the problems with motor-planning show up even as tiny infants? Apraxia is neurological in origin. Presumably it is there from birth. How does it impact their infancy and our introduction to motherhood?
I don't remember my babies being so expressive so young. To be honest I don't remember them being so expressive even much older. Is it that I just don't remember? Is it that I was too sleep-deprived and stressed to notice? Or does the apraxia start to show so early if you know what to watch for? Do the problems with motor-planning show up even as tiny infants? Apraxia is neurological in origin. Presumably it is there from birth. How does it impact their infancy and our introduction to motherhood?
Sunday, September 11, 2011
Nine Months Ago
After listening to Ava sing the Itsy Bitsy Butterfly, I found myself trying hard to remember what she was like before.
At 21 months of age, you want most typically developing children to have a spoken vocabulary of at least 10-24 words. By 24 months of age you want to see 50 spoken words and some two-word combinations. You also expect those words to contain almost all vowel sounds and a wide variety of consonants. You would expect a typical history of cooing, laughing, smiling, and babbling as an infant.
Ava did not have a typical history of cooing, laughing, smiling, and babbling as an infant. At 21 months she used no more than 4 different vowel sounds and 3-4 consonant sounds. Her spoken vocabulary at that time is well represented in this video I took one day (11-30-2010 to be exact) while we were reading a story before bed. She had about three words: "de" (that or there), "uh" (used in a variety of ways for emphasis), and "oh no".
I remember taking this video. It was after I had finally accepted that there was a problem and I needed to pursue getting Ava evaluated. I took the video thinking it might be helpful to show it to someone because I knew she often wouldn't "talk" at all in front of strangers. As it turned out, I never used the video for that purpose, but I wanted to share it now. It is a good representation of what Ava's expressive language looked like before we started intervention.
Ava - 21 months old - Childhood Apraxia of Speech before therapy
At 21 months of age, you want most typically developing children to have a spoken vocabulary of at least 10-24 words. By 24 months of age you want to see 50 spoken words and some two-word combinations. You also expect those words to contain almost all vowel sounds and a wide variety of consonants. You would expect a typical history of cooing, laughing, smiling, and babbling as an infant.
Ava did not have a typical history of cooing, laughing, smiling, and babbling as an infant. At 21 months she used no more than 4 different vowel sounds and 3-4 consonant sounds. Her spoken vocabulary at that time is well represented in this video I took one day (11-30-2010 to be exact) while we were reading a story before bed. She had about three words: "de" (that or there), "uh" (used in a variety of ways for emphasis), and "oh no".
I remember taking this video. It was after I had finally accepted that there was a problem and I needed to pursue getting Ava evaluated. I took the video thinking it might be helpful to show it to someone because I knew she often wouldn't "talk" at all in front of strangers. As it turned out, I never used the video for that purpose, but I wanted to share it now. It is a good representation of what Ava's expressive language looked like before we started intervention.
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